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PubMed1989

Diagnosis of congenital toxoplasmosis in Scotland.

During a period of 10 years (1976-1986) 853 cases of toxoplasmosis were identified serologically in the Toxoplasma Reference Laboratory in Scotland. Suspected cases of infection in pregnancy (29 cases) and of congenital infection (27 cases) were rare but ophthalmic disease was common (224 cases). In two of the congenital cases, maternal infection was identified during pregnancy. The other 25 babies were investigated because of suspected congenital infection. Toxoplasmosis was confirmed retrospectively in 11/25 babies and excluded in two of them. The other 12 cases remain unclassified. Diagnosis of infection in babies was difficult although the introduction of an IgM capture ELISA was of some help. IgM was detected by ELISA in 3/13 congenitally infected babies but by immunofluorescence tests in only one of these. In two antenatal studies, involving 16,000 women, an additional 32 women were identified whose babies might have benefited from treatment or the availability of fetoscopy for early detection of congenital infection.

Animals↗
PubMed1985

Lymphocyte anergy specific to Toxoplasma gondii antigens in a baby with congenital toxoplasmosis.

A baby's clinical course during her first year of life documented her congenital infection with Toxoplasma gondii. Certain of her peripheral blood lymphocyte subtype numbers and functions were studied at intervals during this year: This patient's lymphocytes did not respond to Toxoplasma gondii antigens when she was 2 or 6 months old but did respond when she was 1 year old. Her lymphocyte anergy appeared to be a specific impairment or delay in lymphocyte blastogenic response to T. gondii antigens as her peripheral blood lymphocytes responded normally to the T-cell mitogen Concanavalin A and to allogeneic lymphocytes in mixed lymphocyte cultures. She had normal numbers of total peripheral blood lymphocytes and normal proportions of peripheral blood T cells with T4 and T8 surface antigens.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1993

Toxoplasmosis - congenital and in immunocompromised patients: a parallel.

Toxoplasmosis is a protei form disease that is particularly severe in congenitally infected foetuses, after transplant surgery and in patients with AIDS. In this review, Pierre Ambroise-Thomas and Hervé Pelloux describe and compare the epidemiology, pathophysiology and clinical features of these three different forms of the disease.

Journal Article↗
PubMed1989

[Expected risk of congenital toxoplasmosis in Florence and its province. Statistical research in 1984].

Research has been carried out to determine the prevalence of toxoplasma infection in 1176 women of fertile age in Florence and province for 1984 so as to calculate expected congenital foetal risk of toxoplasmosis. Prevalence proved to be 22% in women aged from 15 to 20 and 60% in the 41-45 group, with an average annual sero-conversion rate of 1.5%. As pregnancy lasts 9 months, this rate is cut by 1/4, namely it drops from 1.5% to 1.125%. Transmission of the infection from mother to foetus occurs in about 1/3 of cases. 9256 pregnancies were reported in Florence and province. The expectation was therefore 104 primary infections and 35 infected newborns of whom 11-12 clinically diagnosable at birth. The estimated rate of toxoplasmosis in pregnancy is therefore 11% for Florence and foetal infection is about 4%. Two-thirds of the newborns with toxoplasma infection are asymptomatic but, if left untreated, they may develop serious neurological and behavioural sequelae. It is therefore necessary to learn the immune state with respect to toxoplasma for all fertile women before pregnancy and study negative findings during gestation.

Animals↗
PubMed1987

[Value of the immunosorbent agglutination assay (ISAGA) in the early diagnosis of congenital toxoplasmosis].

An IgM immunosorbent agglutination assay (ISAGA) test was evaluated for detection of IgM antibodies in diagnosis of congenital toxoplasma infection, and compared with IgM IFI test. Of 36 sera from infants with congenital infection, the IgM ISAGA test was positive in 19 cases (52%), whereas the IgM IFI test was positive in only 4 cases (11%). Of those sera obtained during the first 90 days of life from the infected infants, 70% were positive in the IgM ISAGA test whereas only 23% in the IgM IFI test. Neonatal sera from 10 infants suspected, but in whom this diagnosis was ruled out, were also evaluated: one false positive was found with the ISAGA test, but without control 15 days later. The ISAGA test is a simple, sensitive and probably highly specific test for diagnosis of congenital toxoplasma infection.

Agglutination Tests↗
PubMed1990

Study of congenital toxoplasmosis in Egyptian newborns.

Five hundred cord blood samples of normal, full term, apparently healthy newborns of both sexes and of different social classes were studied for Toxoplasma antibodies. Eighty nine cases (17.8%) showed a seropositivity for IgG antibodies while specific IgM antibodies were found in 3 cases. A significant higher percentage of seropositivity was found among newborns whose mothers had a previous history of abortion (p less than 0.01), still birth, prematurity or delivery of infants with congenital anomalies (p less than 0.001). The relation between seropositivity and maternal lymphadenopathy and/or fever during pregnancy was highly significant (p less than 0.001). Also, a highly significant (p 0.001) relationship was observed between mothers' contact with cats and seropositivity for toxoplasmosis. No statistical differences were found in the seropositivity between the 2 social classes studied, nor between the sexes. The study ensured that the problem of congenital toxoplasmosis in Egypt should be seriously considered and emphasized the importance of serological screening before and during pregnancy for those women who are at greater risk and of newborns.

Egypt↗
PubMed2006

Kinetic analysis of the humoral immune response against 3 Toxoplasma gondii-recombinant proteins in infants with suspected congenital toxoplasmosis.

The reactivity values of Toxoplasma gondii ROP2, GRA4, and GRA7 recombinant antigens (rAgs) were analyzed by immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) in 23 congenitally infected (I) and 36 noninfected (NI) infants. The reactivity values observed from the serum samples of I versus NI infants for each recombinant protein were 91% versus 67% for rROP2 (P = .05), 86% versus 29% for rGRA4 (P < .001), and 56% versus 11% for rGRA7 (P = .003). The follow-up showed that serum samples from NI infants became negative for specific IgG at 5.8 months (95% confidence interval [CI], 4.9-6.7) using a commercial assay; meanwhile, by specific recombinant protein ELISA, the samples became negative at 3.7 months with rROP2 (95% CI, 2.8-4.6), at 1.3 months with rGRA4 (95% CI, 0.8-1.8), and at 0.9 months with rGRA7 (95% CI, 0.5-1.3). Kinetic analysis also showed that serum samples from group I presented different IgG-profiles among rAgs. The rROP2 IgG profile was similar to that of the commercial assay, whereas rGRA4 and rGRA7 profiles showed a gradual decrease along the period of the study. The potential of the utility of rAgs to develop a diagnostic system that discriminates congenitally I infants from NI is discussed.

Aging↗
PubMed1998

Active control of congenital toxoplasmosis in the population.

Repeated serological investigations (CFT, IFT, ELISA) of 50,000 pregnant women revealed that 5.1/1000 pregnancies in the Karviná district, Czech Republic are threatened by toxoplasmosis. In 2.8/1000 pregnancies the infection was contracted shortly before pregnancy, one third of them ended by spontaneous abortion. In this group the birth of a congenitally infected infant is rare. Primary infections of women who are already pregnant (2.3/1000 of pregnancies) are much more serious. This number comprises 1.2/1000 pregnancies with a spontaneous abortion and 1.2/1000 pregnancies leading to the delivery of a congenitally infected infant. By early detection, i.e. repeated serological examinations in all pregnancies, and by treatment of patients with Toxoplasma infections this hazard can be reduced substantially, i.e. to one eighth.

Animals↗
PubMed1976

Congenital toxoplasmosis in Indonesia.

An 18-month-old male Indonesian with blindness, microphthalmia and bilateral cataracts was found to have antibody titers against Toxoplasma gondii of 1:512, 1:1024 and 1:1024 respectively by the indirect hemagglutination, indirect fluorescent antibody and Sabin-Feldman dye test. Serum from the child's mother by the same test also demonstrated antibody titers of 1:1024, 1:512 and 1:512 respectively. The clinical manifestations in the child and the presence of anti-toxoplasma antibodies in both mother and child suggest that the disease was congenitally acquired.

Adult↗
PubMed1996

Congenital toxoplasmosis transmitted from an immunologically competent mother infected before conception.

Congenital transmission of Toxoplasma gondii from a mother who was apparently immunologically competent and who had toxoplasmic lymphadenitis 2 months before conception is described. Since no T. gondii-specific serological data were available for this mother from the time her lymph node biopsy specimen was obtained, the specimen was studied by polymerase chain reaction (PCR) to determine whether the T. gondii B1 gene was present. The predictive diagnostic value of histologic findings previously considered to be classic signs of T. gondii lymphadenitis also was studied. This was done by correlation of serological tests diagnostic of acute acquired T. gondii infection and presence of characteristic findings in biopsy specimens from persons without known immunocompromise. Both PCR and review of the characteristic features of her lymph node biopsy specimen confirmed the diagnosis of preconceptual infection in the mother. We also discuss two other cases in which apparently immunologically competent mothers with preconceptually acquired infection transmitted this parasite to their fetuses.

Animals↗
PubMedDate not supplied

[Analysis of neonatal and fetal blood for the diagnosis of congenital toxoplasmosis infection].

A total of 175 serum samples, including 35 obtained from neonates and 5 from fetuses in whom connatal toxoplasma infection was suspected, were simultaneously tested for toxoplasma-specific IgA and IgM antibodies by immunosorbent agglutination assay (ISAGA). If sufficient serum was available, IgM-IIFT (Remington test) was also performed prior to and following IgG absorption. All the control samples from children not infected with toxoplasma (SFT negative, or titers less than or equal to 1:256) were negative in the IgA and IgM ISAGA. Of the 35 congenitally infected children, results were positive in 91.4% in the IgA and/or the IgM ISAGA. Of 5 fetuses with positive results in animal experiments 3 were positive in the IgM ISAGA. The serum from the fourth fetus was low positive in the IgM IIFT, while that from the fifth fetus was both IgM- and IgA-negative. The results of this study show that several methods should always be used simultaneously to detect connatal toxoplasma infection.

Antibodies, Protozoan↗
PubMed1996

Ascending paralysis due to myelitis in a newborn with congenital toxoplasmosis.

We present a female neonate in her second week of life with borderline microcephaly, microphthalmia and progressive ascending sensory and motor deficit leading to complete paralysis with respiratory failure and death at 27 days of age. Neurological imaging revealed, in addition to cerebral atrophy, marked hydrocephalus, ependymal basal ganglia calcification, leptomeningeal enhancement, and patchy myelitis throughout the entire spinal cord. CSF cytological examination revealed the presence of a mononuclear pleocytosis with Toxoplasma gondii trophozoites free in the CSF and within the cytoplasm of some macrophages, and a 100-fold raised protein content. To our knowledge, this is the first reported case of clinical acute spinal cord involvement in congenital toxoplasma infection, proven by the presence of toxoplasma trophozoite in the CSF.

Atrophy↗
PubMed1995

Congenital toxoplasmosis: 10-year follow up.

A long-term follow up was begun in 1982 on offspring of mothers who acquired toxoplasmosis during gestation. The 114 newborns were subdivided into 3 groups: (1) 26 born to mothers with certain infection; (2) 51 born to mothers with probable infection, and (3) 37 born to mothers with doubtful infection. There were five infections in the first group (19.2%), three in the second (5.8%) and none in the third. For purposes of data elaboration we considered only the 77 offspring of mothers with certain or probable infection. Of these, 2 infected cases out of 52 (3.8%) were born to mothers with infection in the first trimester of pregnancy, 4 out of 21 (19%) in the second trimester, and two out of four in the third. There were a total of 8 congenital infections (10.4%). Specific IgM antibodies were revealed in five out of eight infected children (62.5%). Infection was symptomatic in two children (2.6% of newborns at risk, 25% of infected cases), both born to mothers with infection in the second trimester. In the other six cases diagnosis was reached by evaluating trends in antibody levels: the percentage of infected newborns was higher in the group of maternal infections untreated (50%) or improperly treated (15.4%), compared to those receiving adequate treatment (6.9%). We suggest considering as infected children presenting specific IgM antibodies and/or antibody titres which do not become negative, even when symptoms are absent. Therapy with spiramycin should be started in all newborns at risk, while the use of sulphamides and pyrimethamine is justified only after the presence of infection is confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Protozoan↗