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HelpTest ID: ADNAS Anti-DNase B Titer, Serum
Reporting Name
Anti-DNase B Titer, SUseful For
Demonstration of acute or recent streptococcal infection using anti-DNase B titer
Clinical Information
A number of bacterial antigens have been identified in cultures of group A streptococci. These extracellular products are primarily enzymatic proteins and include streptolysin O, streptokinase, hyaluronidase, deoxyribonucleases (DNases A, B, C, and D), and nicotinamide adenine nucleotidase.
Infections by the group A streptococci are unique because they can be followed by serious nonpurulent complications of rheumatic fever and glomerulonephritis. Recent information suggests that rheumatic fever is associated with infection by certain rheumatogenic serotypes (M1, M3, M5, M6, M18, and M19), while glomerulonephritis follows infection by nephritogenic serotypes (M2, M12, M49, M57, M59, and M60).
Glomerulonephritis and rheumatic fever occur following the infection, after a period of latency following the infection, during which the patient is asymptomatic. The latency period for glomerulonephritis is approximately 10 days, and the latency period for rheumatic fever is 20 days.
Interpretation
Elevated values are consistent with an antecedent infection by group A streptococci. Although the antistreptolysin O (ASO) test is quite reliable, performing the anti-DNase is justified for 2 primary reasons. First, the ASO response is not universal. Elevated ASO titers are found in the sera of about 85% of individuals with rheumatic fever; ASO titers remain normal in about 15% of individuals with the disease. The same holds true for other streptococcal antibody tests: a significant portion of individuals with normal antibody titers for 1 test will have elevated antibody titers for another test. Thus, the percentage of false-negative results can be reduced by performing 2 or more antibody tests. Second, skin infections, in contrast to throat infections, are associated with a poor ASO response. Patients with acute glomerulonephritis following skin infection (post-impetigo) have an attenuated immune response to streptolysin O. For such patients, performance of an alternative streptococcal antibody test, such as this assay, is recommended.
Report Available
1 to 3 daysDay(s) Performed
Monday through Friday
Clinical Reference
1. Ayoub EM, Harden E: Immune response to streptococcal antigens: diagnostic methods. In: Rose NR, de Marco EC, Folds JD, et al, eds. Manual of Clinical and Laboratory Immunology. 5th ed. ASM Press; 1997
2. Anti-DNase B. Testing .com. Updated June 28, 2021. Accessed February 11, 2022. Available at www.testing.com/tests/anti-dnase-b/
Method Name
Nephelometry
Specimen Type
SerumSpecimen Required
Patient Preparation: Fasting preferred but not required
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 7 days |
Reference Values
<5 years: ≤250 U/mL
5-17 years ≤375 U/mL
≥18 years: ≤300 U/mL
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86215
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ADNAS | Anti-DNase B Titer, S | 5133-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| ADNAS | Anti-DNase B Titer, S | 5133-4 |
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