The ASOT test or the anti-streptolysin O titer is a blood test that is actually being over requested for patients in many parts of the world by some doctors. If the result of the test is high, and in the absence of any other signs of a specific medical problem, many patients are prescribed injections of long-acting penicillin. This is not a correct medical decision by any means.
If this happened to you before or if this is what you are experiencing now, this articl is for you. In this articl we will give you the most important pieces of info that you need about this blood test, the ASOT test.
The ASOT test, or the anti-streptolysin O titer, is over requested in laboratories on a daily basis in many parts of the world. What we need to know about this test here is:
If the result of the test is high, what does that mean?
When should this test be ordered by the doctor anyway?
Why is this test requested more than it should be? What is the non-scientific scenario for ordering that test?
And who is requesting this blood test out of place? I mean who is over requesting this test all the time?
If the result of the test is high, what does that mean?
If the result of this test is high, it reflects that you have antibodies against a microbe called the streptococcus microbe. This in itself is not a discovery. It is not always a problem even at all. Alone, without other signs associated with this blood test result, there is no diagnosis that needs to be made here. Each one of us, over the year, his immune system will be fighting a streptococcus infection at one or more points in time and the ASOT blood test, if high will only reflect that you are fighting or were just fighting this microbe, a routine task that your immune system does from time to time without you feeling any symptoms of any disease. If repeated in a couple of weeks, the test result will likely go down on its own.
However, if the test result associated with certain signs or symptoms like an intensely swollen single joint, I repeat single joints that abates in a couple of days to be followed by another joint that will be inflamed too, or if it associates with an inflammation of the valves of the heart or a certain type of skin rash, only then we might consider, based on the clinical evaluation, if the patient has the disease we call rheumatic fever. Otherwise, the ASOT test has no value really.
When should this test be ordered by the doctor?
Only if the clinical picture of the patient suggests the disease called rheumatic fever or an intense infection with the streptococcus microbe. These are also the situations where we might need to prescribe long-acting penicillin injections.
Why is this test requested more than it should be? What is the non-scientific scenario for ordering that test?
In some clinics, this test is requested for evaluation of aches in the joints in general or arthritis of many joints in the body. If is important to note here that the different causes for aches in the body or arthritis of several joints together do not include any reason for which we need to request this ASOT test.
And who is requesting this blood test out of place? I mean who is over requesting this test all the time?
Non specialists who insist on evaluating patients with aches or patients with arthritis without enough background and enough knowledge in their diagnosis and management.
Conclusion:
If you were prescribed a long-acting penicillin injection by a non-specialist only because of a high result of an ASOT test, you need to consult a cardiologist first and who will confirm if you do have rheumatic fever affecting the heart. This is the most important priority and also, if those injections were prescribed for any aches all over or for arthritis of multiple joints in your body, you better see a specialist, a rheumatologist, to get the right diagnosis for your symptoms as your diagnosis will never be rheumatic fever or any indication for penicillin injections
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This post was prepared and published by Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for online medical consultations that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.
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