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PubMed1992

Secretion of Toxoplasma gondii-specific antibody in vitro by peripheral blood mononuclear cells as a new marker of acute toxoplasmosis.

Antigen-specific antibody secretion in vitro by peripheral blood mononuclear cells (PBMC) reflects an in vivo stimulation of the immune system by the antigen. Primary infection of immunocompetent patients with T. gondii causes an acute infection followed by chronic toxoplasmosis. We examined in vitro anti-Toxoplasma antibody production by PBMC during the acute and chronic phases of toxoplasmosis. PBMC from patients with acute or chronic toxoplasmosis and seronegative subjects were cultured for up to 6 days. Anti-Toxoplasma antibodies were assayed in supernatants by ELISA and immunoblotting. Anti-Toxoplasma antibodies were detected in supernatants of PBMC from 29 pregnant women who seroconverted during gestation. PBMC from 17 patients who had chronic toxoplasmosis and PBMC from 10 seronegative healthy controls did not secrete Toxoplasma-specific antibodies. This in vitro antibody secretion was spontaneous, active and transient since it disappeared between 11 and 24 weeks after seroconversion. Anti-Toxoplasma antibody secretion by PBMC from patients with acute toxoplasmosis is consistent with an in vivo stimulation of the immune system by T. gondii antigens. Our results represent a new approach for studying the immunological response during T. gondii infection and could have important implications for the diagnosis of acute and re-activated toxoplasmosis.

Acute Disease↗

PubMed2006

Fulminant toxoplasmosis causing fatal pneumonitis and myocarditis.

The obligate intracellular protozoa Toxoplasma gondii is a serious cause of morbidity and mortality in patients with AIDS. Toxoplasmosis most frequently manifests as life-threatening encephalitis, although extracerebral sites may be involved with or without toxoplasmic encephalitis. Consequently, toxoplasmosis can present in an unusual manner, and may not be included in the differential diagnosis in the absence of encephalitic symptoms. There are few reports of fulminant toxoplasmic myocarditis resulting in death. Toxoplasmic pneumonitis is responsible for less than 1% of HIV-related pulmonary complications, and can occasionally cause fatal septic shock. Two such clinicopathological presentations of toxoplasmosis are reported here. One patient presented with cardiorespiratory signs and symptoms, whilst the second patient presented with pneumonitis and renal failure. Neither patient was initially known to be HIV-infected, nor did they have clinical symptoms indicating toxoplasmic encephalitis. Toxoplasmosis was only diagnosed on autopsy and had resulted in death by causing a fulminant myocarditis and a pneumonitis. As overwhelming toxoplasmosis infection may prove rapidly fatal, these two case reports serve as a clinical reminder to consider toxoplasmosis in the differential diagnosis of HIV-infected patients who present with severe cardiorespiratory signs and symptoms. Furthermore, the cases emphasize the potential importance of early tissue biopsy in patients presenting with immunosuppression-associated organ failure, and show the importance of requesting a postmortem examination if the cause of death cannot be ascertained in vivo.

AIDS-Related Opportunistic Infections↗

PubMed2004

PCR assay using cerebrospinal fluid for diagnosis of cerebral toxoplasmosis in Brazilian AIDS patients.

Highly active antiretroviral therapy has decreased the incidence of opportunistic infections in the central nervous system in AIDS patients. However, neurological abnormalities still remain important causes of mortality and morbidity in developing countries. In Brazil, cerebral toxoplasmosis is the most common cerebral mass lesion in AIDS patients. For these reasons, early, inexpensive, and sensitive diagnostic tests must be evaluated. The aim of this study was to evaluate PCR, using cerebrospinal fluid (CSF) samples to detect Toxoplasma gondii DNA, and to determine if the association of PCR with immunological assays can contribute to a timely diagnosis. We studied two sample groups. First, we analyzed stored CSF samples from 29 newborns and from 39 adults with AIDS without a definitive diagnosis of toxoplasmosis. The goal of this step was to standardize the methodology with a simple and economical procedure to recover the T. gondii DNA. Next, we prospectively evaluated CSF samples from 12 AIDS patients with a first episode of cerebral toxoplasmosis and 18 AIDS patients with other neurological opportunistic diseases and without previous cerebral toxoplasmosis. In all PCR samples, an indirect immunofluorescent assay and an enzyme-linked immunosorbent assay were performed. Samples from all patients with cerebral toxoplasmosis presented positive PCR results (sensitivity, 100%), and a sample from one of the 18 AIDS patients with other neurological diseases also presented positive PCR results (specificity, 94.4%). These findings suggest the clinical utility of PCR in the diagnosis of cerebral toxoplasmosis in developing countries.

AIDS-Related Opportunistic Infections↗

PubMed1998

Improved diagnosis of reactivated toxoplasmosis.

AIMS: To identify antigens detected by western blotting in primary Toxoplasma gondii infection and determine their role in diagnosis of reactivated toxoplasmosis. METHODS: Twenty three immunocompromised patients were tested by IgG western blotting. Patients were grouped retrospectively. Group 1 comprised 15 human immunodeficiency (HIV)/AIDS patients and included: group 1A (six patients with clinical and/or serological evidence of reactivation), group 1B (five patients with clinical evidence only), and group 1C (four asymptomatic patients). Group 2 comprised eight non-HIV/AIDS immunocompromised patients with clinical and/or serological evidence of reactivation. Immunocompetent patients (n = 23) with primary toxoplasmosis were a control group used to determine the progression of the antigens detected. RESULTS: In primary toxoplasmosis, antibodies against 6, 20, 22, 23, 25, 28, 29, and 36 kDa antigens predominated. Detection of four or more of the 6, 20, 22, 23, 25, and 36 kDa antigens was considered to be western blot positive. In two group 1A patients, western blotting indicated past infection. During reactivation, this reverted to being western blot positive. Three other group 1A patients were western blot positive. In three of five group 1B patients, western blot positive results improved serological diagnosis of reactivated toxoplasmosis (p < 0.05). In two of five group 1B patients and all four group 1C patients, western blot indicated past infection. In group 2, two of eight patients reverted from a pattern of past infection to western blot positive. Five other patients from group 2 were western blot positive. CONCLUSIONS: Detection of some low molecular weight antigens is diagnostic of reactivated toxoplasmosis. These antigens can be detected even with normal dye test titres and their detection improves the diagnosis of reactivated toxoplasmosis. They might be the result of the release of bradyzoites from ruptured tissue cysts.

Animals↗

PubMed1998

Cerebral toxoplasmosis and lymphoma in AIDS: perfusion MR imaging experience in 13 patients.

PURPOSE: To evaluate the perfusion magnetic resonance (MR) imaging characteristics of cerebral toxoplasmosis and lymphoma in patients with acquired immunodeficiency syndrome (AIDS). MATERIALS AND METHODS: Perfusion MR imaging was performed prospectively in 13 patients with AIDS who had contrast material-enhancing focal brain lesions (six with active lymphoma, five with toxoplasmosis, one with treated lymphoma in remission, and one with toxoplasmosis plus lymphomatoid granulomatosis). Regional cerebral blood volume (rCBV) was determined by using dynamic echo-planar MR imaging during bolus injection of a gadolinium chelate. RESULTS: The rCBV was decreased (44% +/- 24 [standard deviation] of rCBV in the contralateral regions) throughout the toxoplasmosis lesions and in the surrounding edema of both lesion types, whereas all active lymphomas displayed areas of increased rCBV (258% +/- 99). These differences were significant (P < .005). CONCLUSION: Reduced rCBV i toxoplasmosis lesions is probably due to a lack of vasculature within the abscess; increased rCBV in lymphomas is probably due to hypervascularity in foci of active tumor growth; and decreased rCBV in the edema is probably due to vasoconstriction associated with increased interstitial pressure. Perfusion MR imaging is a rapid, noninvasive tool that may allow differentiation between cerebral lymphoma and toxoplasmosis in patients with AIDS.

AIDS-Related Opportunistic Infections↗

PubMed2001

Survey of obstetrician-gynecologists in the United States about toxoplasmosis.

BACKGROUND: Although the incidence of toxoplasmosis is low in the United States, up to 6000 congenital cases occur annually. In September 1998, the Centers for Disease Control and Prevention held a conference about toxoplasmosis; participants recommended a survey of the toxoplasmosis-related knowledge and practices of obstetrician-gynecologists and the development of professional educational materials for them. METHODS: In the fall of 1999, surveys were mailed to a 2% random sample of American College of Obstetricians and Gynecologists (ACOG) members and to a demographically representative group of ACOG members known as the Collaborative Ambulatory Research Network (CARN). Responses were not significantly different for the random and CARN groups for most questions (p value shown when different). RESULTS: Among 768 US practicing ACOG members surveyed, 364 (47%) responded. Seven per cent (CARN 10%, random 5%) had diagnosed one or more case(s) of acute toxoplasmosis in the past year. Respondents were well-informed about how to prevent toxoplasmosis. However, only 12% (CARN 11%, random 12%) indicated that a positive Toxoplasma IgM test might be a false-positive result, and only 11% (CARN 14%, random 9%) were aware that the Food and Drug Administration sent an advisory to all ACOG members in 1997 stating that some Toxoplasma IgM test kits have high false-positive rates. Most of those surveyed (CARN 70%, random 59%; chi2 p < 0.05) were opposed to universal screening of pregnant women. CONCLUSIONS: Many US obstetrician-gynecologists will encounter acute toxoplasmosis during their careers, but they are frequently uncertain about interpretation of the laboratory tests for the disease. Most would not recommend universal screening of pregnant women.

Acute Disease↗

PubMed2002

Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study.

BACKGROUND: The parasite Toxoplasma gondii infects 30-60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not know, however, whether the changes observed in laboratory influence the performance of subjects in real-life situations. METHODS: The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N=146) and in the general population living in the same area (N=446) was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accident and a level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trend. RESULTS: A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH=21.45, p<0.0001). The value of the odds ratio (OR) suggests that subjects with latent toxoplasmosis had a 2.65 (C.I.95= 1.764.01) times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p<0.0001), being low (OR=1.86, C.I.95=1.14-3.03) for the 99 subjects with low antibody titres (8 and 16), higher (OR=4.78, C.I.95=2.39-9.59) for the 37 subjects with moderate titres (32 and 64), and very high (OR=16.03, C.I.95=1.89-135.66) for the 6 subjects with titres higher than 64. CONCLUSION: The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health as well as economic problem.

Accidents, Traffic↗

PubMed1998

Diagnostic accuracy of HIV-associated central nervous system toxoplasmosis.

Our objective was to examine the accuracy of diagnosis of HIV-associated central nervous system (CNS) toxoplasmosis. Individuals diagnosed with HIV-associated CNS toxoplasmosis and controls were ascertained from a population-based database. Diagnosis was confirmed by response to therapy or by histology. Symptoms, results of anti-Toxoplasma serology and use of Pneumocystis carinii pneumonia (PCP) prophylaxis were recorded. Central nervous system toxoplasmosis was confirmed in 54 (76%) of 75 patients. Reactive anti-Toxoplasma serology was associated with CNS toxoplasmosis (OR=20.4, 95% CI 3.1-175.8). Adjusting for CD4 and use of dapsone or aerosolized pentamidine, trimethoprim-sulphamethoxazole (TMP-SMX) for PCP prophylaxis was associated with lower likelihood of CNS toxoplasmosis (OR 0.3, 95% CI 0.1-0.7). Diagnosis of CNS toxoplasmosis is often incorrect. Another diagnosis is most likely in patients who are anti-Toxoplasma seronegative or who are receiving prophylactic TMP-SMX.

AIDS-Related Opportunistic Infections↗

PubMed2005

Influence of latent 'asymptomatic' toxoplasmosis on body weight of pregnant women.

The latent toxoplasmosis is usually considered to be asymptomatic, however, this paradigm has never been rigorously tested. Here we searched for symptoms of deterioration of physical health (decrease of weight) in infected people by analysis of clinical records of 758 women tested for toxoplasmosis in the 16th week of gravidity. Toxoplasma-positive women have a lower body weight in the 16th week of gravidity (p = 0.02) than Toxoplasma-negative women. Moreover, a negative correlation between weight and the duration of toxoplasmosis was found in a subset of 174 Toxoplasma-positive women (p = 0.04), suggesting that slow and cumulative effects of latent toxoplasmosis, rather than a transient effect of acute toxoplasmosis, are responsible for the decreased weight of infected subjects. Longer duration of gravidity estimated from the date of last menstruation in the set of Toxoplasma-positive women in the 16th week of gravidity estimated with ultrasonography (p = 0.04) suggests a possibility of retarded foetal growth in Toxoplasma-positive women. The prevalence of latent toxoplasmosis is extremely high. Therefore, even its mild symptoms such as the decreased body weight in Toxoplasma-positive pregnant women might in fact indicate an unrecognized serious public health problem.

Adult↗

PubMedDate not supplied

IgM and IgA antibody responses in 12 cases of human acquired toxoplasmosis.

The persistence, in some subjects, of specific IgM antibodies to Toxoplasma gondii for several months after the acute phase of infection has complicated the interpretation of serological test results for toxoplasmosis. Several reports have emphasized the value of the detection of Toxoplasma-specific IgA antibodies for the diagnosis of acute toxoplasmosis. In this article, we report the follow-up profiles of Toxoplasma-specific IgM and IgA antibodies in serum samples obtained from 12 patients at various intervals after the onset of the clinical manifestations of infection. IgM antibodies were detected by the indirect immunofluorescence (IIF) test, antibody capture enzyme-linked immunosorbent assay (cELISA) and enzyme-mediated chemilluminescent technique (CmL). IgA antibodies were quantified by the direct ELISA (dELISA) and cELISA procedures. As defined by the manufacturer of the cELISA test for IgA used, most patients with acute toxoplasmosis have antibody levels > 40 arbritary units per ml (AU/ml). At values > 40 AU/ml, the cELISA for IgA detected significant antibody levels for a shorter time than the other techniques used for IgM and IgA detection. However, IgA levels < or = 40 AU/ml do not exclude the possibility of acute toxoplasmosis since such levels can be reached very soon after infection with T. gondii. The results obtained in the present study show that the serological diagnosis of acute toxoplasmosis may not be such an easy task. Our data suggest that use of the IgA-cELISA concomitantly with IgM antibody screening could permit, in some circumstances, a more efficient diagnosis of acute acquired toxoplasmosis.

Acute Disease↗

PubMed2000

Characterization of tachyzoite and bradyzoite antigens of Toxoplasma gondii recognized by immunoglobulins G, M and A in an experimental model of reactivated toxoplasmosis.

Toxoplasma gondii tachyzoite and bradyzoite antigens that are recognized during reactivated toxoplasmosis were studied in comparison with those recognized during acute and chronic infections, in murine models of toxoplasmosis. Both tachyzoite and bradyzoite antigens of the RH and KSU T. gondii strains, respectively, were resolved by sodium- dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) then probed by immunoblot (IB) (Western blot) with mice antisera elicited by different states of toxoplasmosis to allow parallel analysis of antigen recognition by immunoglobulin G, M, and A antibodies. T. gondii tachyzoite and bradyzoite antigens were well studied by IB recording some specific and commonly shared antigens. A complex array of T. gondii tachyzoite and bradyzoite antigens was revealed in the three states of toxoplasmosis. During reactivated toxoplasmosis the commonly shared tachyzoite and bradyzoite antigens were the dominantly recorded antigens. Also, antigens of tachyzoite at 48 KDa and bradyzoite at 40 KDa were recognized in reactivated toxoplasmosis by IgM and IgG, respectively, and not in other states by the same immunoglobulin. The virulent RH and avirulent KSU strains of T. gondii showed some similarities.

Animals↗

PubMed2000

Ocular involvement in systemic toxoplasmosis: a case report.

We report a case of adult acquired toxoplasmosis with ocular involvement in a 29 year old immunocompetent female. The patient had an illness for approximately 3 weeks characterized by lymphadenopathy, malaise and rash that was diagnosed serologically as toxoplasmosis. At the time of diagnosis, she developed signs and symptoms of retino choroiditis. She had serologic evidence of cytomegalovirus (CMV) infection as well as the recent toxoplasma infection. The patient was treated with pyrimethanime, sulfadiazone and folic acid for 6 weeks, plus prednisone for 4 weeks, during which the illness resolved. Toxoplasmosis is a protozoan infection that occurs worldwide, and is the most common cause of infectious retinochoroiditis in otherwise healthy individuals. Most cases of Toxoplasma infection in the immunocompetent adult are asymptomatic. The most common clinical presentation is localized lymphadenopathy. Ocular signs, which are common in congenitally acquired toxoplasmosis, may rarely be the only manifestation of acquired systemic toxoplasmosis. It has been suggested that concomitant infection with a DNA virus, such as CMV or herpes simplex virus, may facilitate the penetration of protozoa into cells, or that antigenic stimulation from toxoplasma antigens may activate endogenous latent CMV in the recipient. The occurrence of ocular involvement during toxoplasmosis and its association with a DNA virus is reviewed.

Adult↗

PubMed2001

[New trends in ocular toxoplasmosis--the review].

For past ten years some new trends can be observed in the field of ocular toxoplasmosis. In this article on the basis of reviewing scientific articles the author tried to point out important, or new information which may have an impact on clinical researches and clinical practice in the close future. 1. There is evidence that some tissue cysts can be present in untouched retinal tissue, and can produce an inflammatory reaction even many years after primary infection. This concerns both congenital and acquired toxoplasmosis. 2. The coexistence of intraocular inflammatory reaction without focal necrotizing retinochoroiditis in patients with acquired systemic toxoplasmosis was described--but there is no evidence that those inflammations were directly cause by T. gondii parasite themselves. It is too early to include this changes into the classical clinical picture of toxoplasmic retinochoroiditis. 3. For the past ten years there have been published articles showing higher prevalence of acquired ocular toxoplasmosis but this is well documented only in south America. In Europe and USA the frequency of ocular toxoplasmosis cases are low. Despite the different percentage of infected people in these populations, this controversial result can be caused by different distribution of pathogenic and non-pathogenic strains of the parasite as like by differences in human genotypes. 4. There is model of "dynamic equilibrium" existing between host defence and parasite cyst ruptures helpful for understanding reactivation. Level of tissue cyst-specific antigens does not rise in the population of HIV patients or during reactivation of ocular retinochoroiditis--this places the responsibility for reactivation on the side of host immunoresponse. 5. The most specific and reliable laboratory assessment for ocular toxoplasmosis, which is specifically helpful in clinically atypical cases, is combination of IgG, IgA and IgM serology tests made of serum and intraocular fluids. It can proof intraocular production of antibodies. PCR tests have got some value, but they are not as efficient as have been thought previously. 6. There is no efficient treatment diminishing recurrence rate and the time of singular inflammation yet. The combination of pyrimethamine, sulfadiazine and clindamycin, given for 3 to 4 weeks with supplementation of folinic acid for diminishing side effects, can diminish the measure of future scar. Long lasting treatment as it is used in children with congenital disease or in HIV patients can be probably more efficient. Atovaquone is as effective as traditional drugs and gives fewer side effects.

Animals↗

PubMed2002

[Toxoplasmosis in Poznan region, Poland 1990-2000].

The paper summarizes the results of the interdisciplinary studies on toxoplasmosis carried out in Poznan region, Poland. In the years 1990-2000 the specific Toxoplasma gondii seropositivity rates in pregnant women decreased from 58.9% to 43.7%. Significant was an increase in seropositivity in the age group 15-20 years. Cats were seropositive in 70.6%; relatively high seropositivity rate was observed in cats kept at home only (65.7%). Slaughtered pigs were positive in 13.2% with higher rates in older pigs and those originating from small private farms. Screening newborns with noncommercial tests by using Guthrie cards revealed that the congenital toxoplasmosis occurs in 0.55/1.000 pregnancies at screening for specific IgM and 1.08/1.000 pregnancies at screening for combined IgM and IgA. The prenatal screening for toxoplasmosis has not been introduced in Poland. However, the frequency of individual serological testing for Toxoplasma increased from 2.7% to 4.6% of pregnancies. Active health education was introduced in Poznan region and the awareness of toxoplasmosis risk increased from 24.3% to 45.2%. Still 54.7% of pregnant women were inadequately informed and 44.8% of pregnant women, being aware of the risk or not, did not respect specific hygienic measures. The rational control of congenital toxoplasmosis in Poznan region should be based on a routine newborn screening for congenital toxoplasmosis, continuous education of medical personnel and intensive, modern health education especially in adolescents and pregnant women from rural areas.

Adolescent↗

PubMedDate not supplied

[Seroprevalence of toxoplasmosis in pregnant women].

OBJECTIVE: To measure the prevalence of seropositivity for toxoplasmosis in pregnant women and evaluate its association with maternity age, skin color, place of residence and education. METHODS: A cross-sectional study in 1,261 pregnant women cared for at the maternity ward of Hospital Nossa Senhora da Conceição was performed from June to October and in December 2000. Serological tests for toxoplasmosis were performed during their pregnancy or delivery. The variables considered were place of residence, skin color, education and serum tests for toxoplasmosis (IgG and IgM). Microparticle Enzyme Immunoassay method (MEIA) was used. RESULTS: The prevalence of seropositivity for toxoplasmosis in the pregnant women studied was of 59.8% (95% CI: 57.0% - 62.5%). An increase in seropositivity in relation to the mother's age was observed (p = 0.012). On the other hand, a higher educational level was found to be a protective factor against toxoplasmosis (p < 0.001). The hypothesis that the proportion of pregnant seropositive women would increase the farther they lived from capital cities was not confirmed (p = 0.750). Differences regarding race were not observed (p = 0.228). In the multivariate analysis, maternity age presented a linear association with the increase of seropositivity, even after adjustment for education, place of residence and skin color. CONCLUSION: The prevalence of seropositivity in the pregnant women studied is high and justifies the adoption of some primary and secondary preventive measures, until subsequent studies provide greater evidence concerning the rationalization of the diagnostic and therapeutic techniques regarding toxoplasmosis in pregnant women.

Adolescent↗

PubMed1990

[Clinical criteria and evaluation of the pathology and progress of lympho-nodular toxoplasmosis].

We aimed at analysis of the clinical pattern and the course of lympho-nodular toxoplasmosis taking into account the intensity and duration of the illness. Ninety seven patients (69 adults and 28 children) with lympho-nodular toxoplasmosis were examined. Toxoplasmosis was diagnosed by indirect immunofluorescence; the titres of antibodies of IgG and IgM classes were also estimated. Depending on the duration of the illness three periods: early, regression of symptoms and protraction of symptoms were defined; depending on the intensity of signs and symptoms of toxoplasmosis three courses of the disease: acute, subacute and chronic were defined. The analysis showed that clinical picture of lympho-nodular toxoplasmosis was characterized by swelling of various peripheral lymph nodes as well as by general clinical symptoms (88.7% of cases) the intensity and duration of which, to a large extent, determined course of the illness. No correlation between clinical course and duration (early and regression period) of lympho-nodular toxoplasmosis and titres IFA-IgG (before therapy) was found. Pathomorphology of lymph nodes in patients with toxoplasmic lymphadenopathy is a valuable complementary examination which renders it possible to determine the period of the disease.

Adolescent↗

PubMedDate not supplied

New prospects in immunology of toxoplasmosis: skin-tests for control of immunity and immuno-assays and agglutination tests for the detection of specific IgM antibodies.

An excretory-secretory (ES) antigen was extracted from supernatants of cell cultures infected with Toxoplasma gondii, purified and controlled according to current standards. In 638 volunteers, the correlation with fluorescent antibody was 94.2% and no false positive skin tests were noted. The skin test did not transform an originally negative serological test into a positive one. For the prevention of congenital toxoplasmosis, this sensitive, specific and inexpensive skin test can be widely used for the detection of immunity to Toxoplasma in women before their first pregnancy. During pregnancy, the detection of specific IgM is very important for the diagnosis of a recently acquired toxoplasmosis and allows for an immediate treatment. For this detection and for the diagnosis of congenital toxoplasmosis, five different serological tests were compared: Indirect Fluorescent Antibody-test (IFA), ELISA test, ELISA test After Capture of IgM (ACCAs), Reverse Enzyme Immuno Assay R-EIA), Double-Sandwich Enzyme Linked ImmunoSorbent Assay (DS-ELISA) and ImmunoSorbent AGglutination Assay (ISAGA). For 37 sera of recently acquired toxoplasmosis, IgM were detected in 98.7% with ISAGA, in 89.5% with DS-ELISA and ELISA in 83% with R-EIA and in 59% with IFA test. The best specificity is obtained with ISAGA, DS-ELISA and R-EIA, from controls with non immune patients (99 cases), patients with chronic toxoplasmosis (77 sera), rheumatoid factors (35 sera) or anti-nuclear antibodies (7 sera). In 21 sera from infants with congenital toxoplasmosis, ISAGA was positive in 13 cases (62%), IFA in 5 cases (24%), ELISA and R-EIA in 2 cases (9.5%) and DS-ELISA in 9 cases (43%).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1986

[Toxoplasmosis and lupus. A review of the literature apropos of 4 cases].

The authors report 4 cases of toxoplasmosis in patients with acute disseminated lupus erythematosus (ADLE). In one case, a pregnant patient with serology indicative of chronic infection, infected the neonate who died of subacute toxoplasmosis. Although ADLE is a classical cause of immunodepression, toxoplasmosis is a rare complication; only 5 cases were found in a review of the literature. Toxoplasmosis infection may resemble an exacerbation of lupus; an accurate diagnosis is essential as the treatment of the two conditions is radically different. The problems of diagnosis of toxoplasmosis in immunodepressed patients are reviewed and the therapeutic approach, especially in pregnant patients, is discussed. In ADLE, the authors recommend checking toxoplasmosis serology before starting and during treatment with corticosteroids. Special attention should be paid to pregnant women with apparently chronic serological changes as neonatal infection may occur.

Adolescent↗