Rheumatic Fever — Genes & Biomarkers Bad score thresholds and action plans Biomarker / Gene Bad Score Free Actions Non-free Actions GENES HLA-DRB1*07 Carrier allele Hygiene, avoid crowding HLA typing, counseling TNFA -308A Variant present Anti-inflammatory diet Pharmacogenomic panel MBL2 Low expression Infection prevention Immunologist referral TLR2 (Arg753Gln) Risk variant Hygiene, prompt treatment Immunologic workup BIOMARKERS ASO titer >200 IU/mL Rest, hydration Penicillin prophylaxis Anti-DNase B >240 IU/mL Monitor symptoms Serology panel CRP >10 mg/L Anti-inflammatory diet NSAIDs, cardiology consult ESR >30 mm/h Rest, hydration Full inflammatory panel