Anti DNAse B, Serum

Bacterial/ Viral

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No Fasting Required

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Antibody against streptococcal DNase B enzyme.

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Anti DNAse B Serum Test Information Guide

Why is it done?
- Detects antibodies produced in response to streptococcal DNAse B enzyme, a substance released by Group A Streptococcus bacteria
- Confirms recent or previous Group A Streptococcal (GAS) infection, particularly when other streptococcal serology markers are unclear
- Aids in diagnosis of acute rheumatic fever (ARF) and post-streptococcal sequelae
- Used to differentiate acute streptococcal infection from past infection or non-streptococcal conditions
- Ordered when patients present with symptoms suggestive of post-streptococcal glomerulonephritis (PSGN) or acute rheumatic fever
- Typically performed during acute phase of illness or shortly after suspected streptococcal infection
- May be repeated 2-3 weeks later to demonstrate rising antibody titers, which is more diagnostic than single results
Normal Range
- Normal/Negative Result: < 60 IU/mL or ≤ 1:60 titer (may vary by laboratory)
- Borderline/Weak Positive: 60-80 IU/mL or 1:60-1:80 titer
- Positive/Elevated: > 80 IU/mL or ≥ 1:80 titer
- Very High Positive: > 240 IU/mL or ≥ 1:240 titer (typically indicates recent acute infection)
- Unit of Measurement: IU/mL (International Units per milliliter) or titers expressed as ratios (e.g., 1:80)
- Interpretation Key: Negative results suggest no recent streptococcal infection; positive results indicate recent or current infection; rising titers (from first to second sample) are more clinically significant than single elevated values
Interpretation
- Negative Result: Indicates no recent Group A Streptococcal infection; does not rule out past infection or remote streptococcal disease; may indicate infection occurred >3 months prior or was not due to GAS
- Single Elevated Result: Suggests prior or recent streptococcal infection; single positive value less specific than paired sera; requires clinical correlation with patient symptoms and other test results
- Rising Titers (≥2-fold increase between acute and convalescent sera): Most specific indicator of recent acute Group A Streptococcal infection; samples taken 2-3 weeks apart strengthen diagnostic confirmation; highly suggestive of post-streptococcal sequelae
- High Persistent Titers: May indicate recent acute infection, particularly if concurrent with fever and other streptococcal serology markers; can persist for months following infection
- Borderline Values: Require careful interpretation; repeat testing in 2-3 weeks recommended to establish trend; may represent older infection or laboratory variation
- Factors Affecting Results:
- Timing of sample collection (optimal 2-3 weeks after symptom onset); immunosuppression may reduce antibody response; previous streptococcal infections or rheumatic fever can cause persistently elevated titers; antibiotic treatment may reduce antibody rise if initiated early; laboratory-specific reference ranges and methodology differences
- Clinical Significance: Anti-DNAse B is more specific for GAS than ASO titer; approximately 80% of patients with acute rheumatic fever have elevated Anti-DNAse B; used alongside other streptococcal antibody tests (ASO, Hyaluronidase) and acute phase reactants (ESR, CRP) for comprehensive diagnosis
Associated Organs
- Primary Organ Systems: Immune system (antibody production); cardiovascular system (heart involvement); renal system (kidney involvement); connective tissues
- Acute Rheumatic Fever (ARF): Inflammatory complication affecting heart (rheumatic heart disease), joints (arthritis/arthralgia), central nervous system (chorea), and skin; can develop 2-3 weeks after acute GAS infection
- Post-Streptococcal Glomerulonephritis (PSGN): Immune complex deposition in kidneys; presents 1-3 weeks after streptococcal pharyngitis or skin infection; elevated Anti-DNAse B supports diagnosis; can progress to acute kidney injury if untreated
- Acute Glomerulonephritis: Kidney inflammation characterized by hematuria, proteinuria, hypertension, and reduced GFR; Anti-DNAse B elevation confirms streptococcal etiology
- Acute Streptococcal Pharyngitis: Primary infection affecting throat; antibody response indicates immune activation; elevated Anti-DNAse B confirms GAS etiology
- Streptococcal Impetigo/Skin Infection: Skin-derived streptococcal infections can lead to PSGN and elevated Anti-DNAse B; particularly associated with pyoderma in tropical climates
- Potential Complications Associated with Abnormal Results:
- Permanent cardiac valve damage (mitral stenosis, aortic regurgitation); chronic kidney disease progressing to end-stage renal disease; recurrent streptococcal infections; development of chronic rheumatic heart disease requiring surgical intervention; cardiopulmonary complications
Follow-up Tests
- Repeat Anti-DNAse B (Paired Sera): Collect convalescent sample 2-3 weeks after initial acute phase sample; ≥2-fold rise in titer provides strongest diagnostic confirmation; recommended if initial result is positive or borderline
- Anti-Streptococcal O (ASO) Titer: Complimentary antibody test; used alongside Anti-DNAse B for comprehensive streptococcal serology evaluation; approximately 90% of GAS infections elevate ASO
- Anti-Hyaluronidase Titer: Additional streptococcal antibody marker; useful when ASO and Anti-DNAse B results are inconclusive; may be elevated in skin infections
- Erythrocyte Sedimentation Rate (ESR): Acute phase reactant; elevated in acute rheumatic fever and post-streptococcal sequelae; used to assess inflammation level and monitor treatment response
- C-Reactive Protein (CRP): Sensitive acute phase reactant; elevated in active streptococcal infection and post-streptococcal inflammatory conditions; useful for monitoring treatment efficacy
- Throat Culture/Rapid Streptococcal Antigen Test: Direct identification of GAS if performed during acute infection; negative culture does not exclude streptococcal disease when serology is positive
- Urinalysis: Assess for hematuria and proteinuria suggesting post-streptococcal glomerulonephritis; repeat testing recommended to monitor kidney involvement
- Renal Function Tests (BUN, Creatinine): Evaluate kidney function if PSGN suspected; monitor for progression to acute kidney injury
- Echocardiography: Indicated when acute rheumatic fever suspected; assesses for valvular abnormalities, chamber enlargement, and ventricular function
- Electrocardiogram (ECG): Evaluates for cardiac involvement in acute rheumatic fever; assesses for arrhythmias or conduction abnormalities
- Complete Blood Count (CBC): Assess for leukocytosis and other hematological abnormalities; useful in acute phase evaluation
- Chest X-ray: Evaluates for cardiac enlargement or pulmonary findings in suspected acute rheumatic fever
- Recommended Monitoring Frequency:
- Acute phase: Repeat serology 2-3 weeks after initial test; follow-up ESR/CRP weekly to monthly during acute inflammation; cardiac monitoring every 3-6 months in ARF cases; long-term follow-up annually for chronic rheumatic heart disease; kidney monitoring as indicated by initial PSGN severity
Fasting Required?
- Fasting Required: NO
- Fasting Instructions: Not applicable; fasting is not required for Anti-DNAse B testing; food and beverage intake do not affect antibody levels or test results
- Specimen Collection Requirements: Serum sample obtained via venipuncture; typically 5-10 mL of blood collected in serum separator tube (SST) or plain red-top tube
- Medications to Avoid: No specific medications require discontinuation prior to testing; antibiotics may reduce antibody rise if initiated very early in infection but should be continued as clinically indicated; immunosuppressive medications may reduce antibody response but should not be stopped before testing
- Patient Preparation Guidelines:
- No special preparation required; can be tested at any time of day; hydration status does not affect results; physical activity prior to testing is acceptable; comfortable clothing recommended to facilitate venipuncture; inform phlebotomist of any bleeding disorders or medication allergies
- Optimal Timing: Initial sample ideally collected during acute phase or 1-2 weeks after symptom onset; convalescent sample collected 2-3 weeks later for paired comparison; results more meaningful when tested in context of clinical presentation and other streptococcal serology
- Sample Storage and Transport: Serum should be separated and refrigerated at 2-8°C if testing is delayed; frozen at -20°C or colder for long-term storage; avoid repeated freeze-thaw cycles; transport to laboratory promptly in appropriate biohazard containers

How our test process works!