Indications for laboratory tests for toxoplasmosis.
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OBJECTIVE: To determine the incidence of acute symptomatic toxoplasma retinochoroiditis presenting to ophthalmologists for patients born in Britain and elsewhere. DESIGN: Population based, cross sectional study. SETTING: 11 districts in south Greater London. SUBJECTS: All patients presenting to NHS ophthalmologists with symptoms due to acute toxoplasma retinochoroiditis in 1992-3. MAIN OUTCOME MEASURE: Intraocular inflammation in association with a retinochoroidal scar, active adjoining retinitis, and IgG serum antibodies to toxoplasma. RESULTS: The estimated incidence of acute symptomatic retinochoroiditis for all people born in Britain was 0.4/100,000/year. If a mean of two symptomatic episodes per lifetime is assumed, 100 people born in Britain may be affected each year, about a fifth of the estimated 500-600 congenitally infected people born each year. CONCLUSIONS: A substantial proportion of people with acute symptomatic toxoplasma retinochoroiditis were born outside the country, and the number born in Britain was smaller than the number previously estimated to develop retinochoroidal lesions due to congenital toxoplasmosis. These findings suggest that prenatal screening for toxoplasmosis in Britain may be of limited benefit.
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The production of a toxoplasma-sensitized cell preparation stable for at least one year at 5 degrees C and its performance in the diagnosis of toxoplasmosis is described.
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One case of a syndrome simulating a systemic disease is reported. An HLA-B, patient presented with apparent toxoplasmosis, retinal vein occlusion, autoantibodies against cephalin, contact factors and lipoproteins, immune complexes, rheumatoid factor, and cryoprecipitate. A representation of the immunological mechanisms involved is proposed.
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