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PubMed1985

Detection of Toxoplasma-specific IgM in cord blood sera by antibody-class capture enzyme-linked immunosorbent assay.

An antibody class capture (ACC) enzyme-linked immunosorbent assay (ELISA) utilizing an F(ab)2 conjugate was established and its specificity and reproducibility were determined. The test was further validated by comparing its results with those obtained by 2 overseas reference laboratories which used the indirect immunofluorescence antibody test (IIFT) for Toxoplasma-specific IgM. It was found that the F(ab)2ACC-ELISA was not affected by the presence of rheumatoid and antinuclear factor in serum, that it was reproducible (coefficients of variation less than 10.0%), and that it compared well with tests currently used overseas. ELISA was then used to test for the presence of Toxoplasma-specific IgM in cord blood sera. The results obtained to date are consistent with the hypothesis that the prevalence of congenital toxoplasmosis in the population of Adelaide is less than 1/2,000.

Antigens, Protozoan↗

PubMed1979

The prevalence of toxoplasma antibodies among 11,736 pregnant women in Norway.

A serologic screening for toxoplasma antibodies by dye test (DT) and IgG indirect fluorescent antibody test (IgG-IFAT) has been carried out among 10729 pregnant women in the Oslo area and 1 007 pregnant women from the county of Møre and Romsdal situated on the west coast of Norway. The frequency of toxoplasma antibodies was found to be higher in women living in rural areas and a higher prevalence was observed among women living in the western districts of Oslo than among women from the eastern districts of the city. The mean frequency of DT antibodies was found to be 12.5% in the Oslo area and 13.3% in Møre and Romsdal, whereas the yearly incidence of acquired infections in the two areas was found to be 5 and 2.3%, respectively. The predicted incidence of congenital toxoplasmosis in the Oslo area, and presumably also in the whole country, would represent 2% of all pregnancies. No serologic differences were found when women with prior histories of either sporadic or habitual abortions were compared to a total group of multigravidae among the Oslo women.

Antibodies↗

PubMed1979

Estimations of the incidences of toxoplasma infections among pregnant women from different areas in Norway.

2342 male military recruits from different parts of Norway were selected for serological screening with the dye test or the IgG-indirect fluorescent antibody test. The highest frequency of toxoplasma antibodies was observed in the south-western areas (27%), whereas the prevalence was found to be as low as 2% in the northermost areas of the country. On the basis of the prevalence values obtained in the different counties, the incidence rates for acquired infections in the pregnant population have been calculated. The annual incidence in Norway was estimated to be 4 0/00 and the incidence of congenital toxoplasmosis would be maximally 2 0/00 (or about 110 cases/year).

Adult↗

PubMedDate not supplied

Aicardi's syndrome: a report of four cases and review of the literature.

Four patients with Aicardi's syndrome (infantile flexion spasms, agenesis of the corpus callosum, and ocular anomalies) are reported, along with photographs of their characteristic fundus abnormalities. The etiology of the syndrome is unclear, but its occurrence exclusively in female patients suggests the possibility of a genetic factor. The ocular abnormalities of Aicardi's Syndrome are distinguishable from, but may be confused with, those of congenital toxoplasmosis and cytomegalic inclusion disease. The syndrome can be identified clinically with a high degree of certainty. Ophthalmologists who are familiar with the syndrome may be helpful in the differential diagnosis.

Adult↗

PubMed2002

[Toxoplasma infections in early pregnancy: consequences and management].

OBJECTIVE: To assess the consequences for the fetus of maternal toxoplasma infection acquired during the first 8 weeks of gestation and to set guidelines on how to manage these maternal infections. METHODS: Data were prospectively analyzed on 360 pregnancies followed-up in our department due to a toxoplasma infection during the 8 first weeks of pregnancy. Estimates of the risk of fetal infection were based on all cases, including those which could not be followed up until infection was ruled out or confirmed. Severity of infection was estimated based on ultrasound findings during pregnancy, neonatal and long-term postnatal clinical, neurological and ophthalmologic work up. RESULTS: Out of the 360 included women, 336 gave birth to a live born child: 7 (2%) were infected, 302 (90%) were free of infection and follow-up was insufficient to conclude about the 27 (8%) remaining infants. The estimated risk of fetal infection ranged between 2 and 10% based on live born children and between 3 and 14% when the 24 interrupted pregnancies were included. At their last clinical evaluation at 70 months of age, all 7 children, including the 2 who had inactive peripheral eye lesions and the one who had a unique intracranial calcification were free of any ophthalmologic or neurological impairment. CONCLUSION: Our study confirms that in the event of a maternal infection during the first 8 weeks of pregnancy the risk of fetal infection is low and results mainly in a spontaneous termination of pregnancy. Future parents should be assured that conversely to a common opinion, the prognosis of congenital toxoplasmosis in live-born children is good. For these early maternal infections as for those acquired later, we recommend immediate treatment with spiramycin, monthly ultrasound surveillance, amniocentesis and treatment with pyrimethamine and sulphamides if the PCR is positive. Abortion should be restricted to cases with ultrasound lesions

Amniocentesis↗

PubMed1992

Newborn screening for congenital Toxoplasma infection: five years experience in Massachusetts, USA.

Since 1986, all Massachusetts newborn filter paper blood specimens, and some from New Hampshire, have been screened for the presence of IgM antibodies to Toxoplasma gondii using an enzyme-linked IgM capture assay. Among approximately 530,000 infants screened, 40 had serologically confirmed congenital toxoplasma infection, and 4 additional infants had borderline serologies, for an overall identification and treatment rate of 1:12,000. False positive results from the newborn's filter paper specimen occurred in 22 infants (1/24,000); these were clarified by tests for IgM and IgG in serum specimens obtained 2-3 weeks later from the infant and mother. The screening program would have failed to detect 3 infants with severe infection who were diagnosed on clinical grounds prenatally or at birth and lacked IgM. No infants with a later diagnosis of congenital toxoplasmosis that was missed by screening are known to our statewide network of pediatric infectious disease consultants. Follow-up studies are in progress to evaluate more completely the sensitivity of the IgM assay in newborns and the efficacy of treatment.

Antibodies, Protozoan↗

PubMed2004

[Molecular and biological characterization of the CIBMUQ/HDC strain, a reference strain for Colombian Toxoplasma gondii].

There are few reports about characterization strains of Toxoplasma gondii that analyze the differences between isolates from Europe or United States with those obtained in South America. The current study analyzes virulence data from the mouse model, the gene SAG2 polymorphism by PCR-RFLP and microsatellite analysis in a single Colombian isolate. The strain was isolated from blood of a child with congenital toxoplasmosis, living in Armenia, Colombia. Analysis of virulence in the mouse showed that this strain has an LD100 of 10 tachyzoites. Both methods of genetic characterization demonstrated that this strain belonged to the clonal type 1 and was called HOM/CTCO/2002/CIBMUQ/BL/HDC (brief name: CIBMUQ/HDC). The CIBMUQ/HDC strain is the first Colombian strain available as a reference strain for national and international researchers.

Animals↗

PubMed2004

[Life and achievements of professor Irena Norska-Borówka the 75th birthday anniversary].

The purpose of the publication is to present the life, scientifical and social activity of the eminent pediatrician prof. Irena Norska-Borówka. The biography is based on personal data, biographical notes published in medical dictionaries, scientific publications and opinions of scientific authorities. Prof. Irena Norska-Borówka was the President of Scientific Committee of the eight previous Congresses ECOMED in Tarnów, the creator of Ecological Section of Polish Physicians Society, Polish and World precursor of Environmental Pediatrics and the UNICER expert. She has more than 300 publications, including 50 monographies. She has been awarded the I-st stage Award of the Minister of Health and Social Care for the studies on congenital toxoplasmosis. She also received SAM Rector's Awards for the publications of environmental pollution influence on the children's health and creation in 1980 the first in Poland Neonatal Pathology Clinic with an Intensive Care Department. She has become the ethical authority for her students and doctors. She has been appreciated by Upper Silesian inhabitants for her scientific work and social activity towards children and youth.

Awards and Prizes↗

PubMed1992

[Detection of Toxoplasma gondii by "Polymerase Chain Reaction" (PCR) technique in AIDS infected patients using the repetitive sequence TGR1E].

A repetitive original DNA sequence, TGR1E, was cloned and sequenced, then used to develop a polymerase chain reaction (PCR) test for detecting Toxoplasma gondii. Preliminary studies were performed using purified T. gondii DNA or a lysate of purified T. gondii cells [7], with or without a leukocyte lysate. A negative correlation was evidenced between sensitivity of the test and the amount of cellular debris contaminating the DNA to be amplified. Nevertheless, the method was tested on 100 clinical specimens subjected to lysis using the same method. Among the 88 specimens from AIDS patients, four were positive by conventional diagnostic tests and by PCR. Among the 12 specimens tested as part of evaluations for the prevention of congenital toxoplasmosis, PCR failed to detect the positive results yielded by conventional tests on two amniotic fluid specimens. No false positive result was seen with the PCR method.

Acquired Immunodeficiency Syndrome↗

PubMed2001

[Detection of Toxoplasma gondii DNA by PCR in mother's blood, amniotic fluid and child's blood in selected cases of pathological pregnancy].

Prenatal screening of Toxoplasma gondii infection is controversial. The diagnosis is based on serological tests detecting IgM and IgG antibodies against T. gondii, but interpretation of these tests results is often confusing. It is commonly made retrospectively when serological screening indicates a possibility of recent infection. Most women have antibodies against T. gondii and serial testing is required only in monitoring of pregnancies where initial screening is negative. The introduction of Polymerase Chain Reaction (PCR) assay for detection of Toxoplasma gondii DNA in selected cases of pathologic pregnancies has permitted a more accurate and faster diagnosis of congenital toxoplasmosis infections.

Adult↗

PubMed1989

[Retinitis and chorioretinitis].

Retinitis and chorioretinitis (uveitis) are usually due to an infection. By far their most frequent cause is a late recurrence of congenital toxoplasmosis, a disease which can be diagnosed clinically and which, in the absence of therapeutic errors, generally follows a favourable course. Among other types of uveitis, cytomegalovirus retinitis is fairly frequent in immunocompromised subjects.

Chorioretinitis↗

PubMedDate not supplied

[Fetomaternal therapeutic follow-up of spiramycin during pregnancy].

In the preventive treatment of congenital toxoplasmosis it is admitted that spiramycin is concentrated in the placenta and crosses the placental barrier at the end of pregnancy. However, little is known about its entry in the fetal circulation. We studied fetal spiramycin blood levels during the 2nd and 3rd trimesters of pregnancy in women who, having presented with toxoplasmosis during the 1st trimester, had been given spiramycin until delivery. Microbiological titrations of spiramycin were performed--in the maternal blood at the onset of treatment, at the time of fetal blood sampling and during delivery), in the fetal blood at the time of prenatal diagnosis of toxoplasmosis, in cord blood and placenta at birth. We were able to confirm transplacental crossing of spiramycin. Fetal blood levels during the 2nd trimester were about 47% of the maternal ones and there was no correlation between maternal and fetal levels. Levels at birth showed that (1) there was no accumulation in the course of treatment, (2) spiramycin was concentrated in placenta and (3) there was a correlation between fetal and maternal levels during the 3rd trimester.

Female↗

PubMed1987

Low prevalence of Toxoplasma infection in a Rocky Mountain prenatal population.

Congenital toxoplasmosis is rarely diagnosed in Colorado. To better determine whether this was the result of under-reporting or a valid observation, the sera of 120 consecutive prenatal patients from a lower-income clinic population were tested for antibodies to Toxoplasma gondii. Four of the patients had positive Sabin-Feldman dye tests, for a 3% incidence of past infection. None had immunoglobulin M (IgM) antibody. This rate is considerably lower than that in other populations, perhaps because the high-altitude, arid environment shortens oocyst survival in soil. A questionnaire designed to detect risk factors for Toxoplasma infection, such as exposure to cats or undercooked meat, did not indicate any differences between the antibody-positive and antibody-negative groups.

Adult↗

PubMedDate not supplied

[Acute toxoplasmic myelitis in the newborns].

The present paper describes 3 patients with congenital toxoplasmosis. The spinal cord was extremely affected. Differential diagnoses were established with poliomyelitis and neonatal hypoxia. Histopathological studies revealed toxoplasmosis.

Diagnosis, Differential↗

PubMed1995

[Toxoplasma gondii: perspectives for a vaccine].

To date no single vaccine has been commercialized in the field of human parasitology, and therefore a practical approach to a potential Toxoplasma vaccine in the field can only be discussed theoretically. The aim of such a vaccine would consist either in inhibiting endogenous parasite multiplication (tachyzoite formation) and thus dissemination, or in preventing the final formation of Toxoplasma cysts (bradyzoite formation). Immune protectivity should confer resistance to disease and parasite dissemination in pregnant women, in order to prevent congenital toxoplasmosis in the unborn infant, and prevent cyst formation in order to avoid reactivation in case of future immunosuppression of the individual. The establishment of a successful protective immunity was elucidated in the mouse model: the number of formed Toxoplasma cysts is primarily regulated by the function of Toxoplasma-specific CD8(+)-T-cells. Direct effector functions of cytotoxic CD8+ lymphocytes directly depend on local periparasitic gamma-interferon- and TNF alpha-concentrations. Immunological aberrance occurs if locally (cerebral) synthesized Il-10 and Il-6 induce anergistic immunosuppression. An experimental vaccine in the mouse demonstrated primary dependence of a protective immune response on CD8+ and CD4+ (Th) cells. Experimental vaccines within domestic animals concentrate mainly on the development of temperature-sensitive mutants of the T. gondii RH-strain, which will protect animals from disease but not from infection and cyst formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1996

[Detection of specific toxoplasma class A antibodies: a comparison of diagnostic usefulness of commercially available diagnostic kits].

Diagnostic significance of the presence of specific anti-Toxoplasma gondii IgA antibodies was discussed with particular reference to the cases of congenital toxoplasmosis and infections in pregnant women. Furthermore, the possibilities of testing for anti-Toxoplasma IgA antibodies with commercially available diagnostic kits were presented. From amongst the examined 5 diagnostic kits, Platelia Toxo IgA and ISAGA Plus IgA/IgM showed the highest sensitivity and specificity.

Animals↗

PubMed1997

[Detection of IgA antibodies as important markers of acute primary infection with Toxoplasma gondii].

The diagnosis of Toxoplasma gondii infection is currently based on immunological tests, but tests for IgM and IgG antibodies alone are often insufficient to estimate the risk of active disease, especially during pregnancy and in immunodeficient patients. Classically the study of anti-toxoplasma immunity involves titration of IgG antibodies, which reflect immunity to the parasite, and IgM antibodies which of present, reveal acute infection. However, technical advances have shown the limitations of these tests as tests for IgM can be positive because of residual specific IgM or even in subjects free of acute infection due to the existence of natural interfering IgM. In addition, IgM can be absent in children with congenital toxoplasmosis or subjects with secondary reactivation. The purpose of our study was to evaluated of IgA antibodies to T. gondii in serum samples which were positive in screening test. Our results confirm the diagnostic value of testing for anti-toxoplasma IgA antibodies. These antibodies are absent in uninfected subjects and are detected rapidly after primary infection. The determination of IgA complements IgM determination for the diagnosis of toxoplasmosis.

Adult↗

PubMed1999

Presumed congenital ocular toxoplasmosis in two successive siblings.

We present the cases of 2 consecutive siblings with bilateral macular lesions, for which there is strong clinical and laboratory evidence supporting the diagnosis of congenital ocular toxoplasmosis. These cases raise the possibility of maternal parasitemia during Toxoplasma gondii reinfection, leading to transmission to the fetus and congenital ocular toxoplasmosis despite prior immunity and lack of an immune disturbance in the mother.

Adolescent↗