Table 2.

Narcolepsy in Comparison with Established Post-Streptococcal Diseases

Disorder	Interval to Symptoms	Increased ASO titers*‡	Increased ADB titers*‡	References
Rheumatic fever		P 68% (n = 786)
arthritis/ carditis	3–8 weeks	P 68% (n = 100)	P 69% (n = 100)	25
Isolated Sydenham		P 33% (n = 60)		26
chorea	1–8 months	P 75% (n = 71)	P 10% (n = 71)	27
Post-streptococcal		P 48% (n = 79)	P 68% (n = 73)
glomerulonephritis	1–2 weeks	C 11% (n = 57)	C 13% (n = 53)	28
		P 78% (n = 37)	P 65% (n = 37)	29
		C 11% (2321)	C 8% (2321)
Narcolepsy	Weeks to	P 51% (n = 67)	P 45% (n = 65)	This study
	months?	C 19% (n = 67)	C 17% (n = 65)

Interval from infection to symptom onset and anti-streptococcal antibody status at diagnosis is reported. % ASO and ADB positive in patients (P), versus healthy controls (C).

*Of note, in rheumatic fever and post-streptococcal glomerulonephritis, evidence of preceding streptococcal infection is part of established diagnostic criteria, causing an obvious inclusion biased toward higher titers.

^‡ ASO and ADB positivity cut-offs were upper limit normal 20% (ULN-20, where 20% controls had higher titers), or, more questionably, as determined by the authors if no controls were included.