Document Detail


Early neonatal diagnosis of congenital toxoplasmosis: value of comparative enzyme-linked immunofiltration assay immunological profiles and anti-Toxoplasma gondii immunoglobulin M (IgM) or IgA immunocapture and implications for postnatal therapeutic strategies.
MedLine Citation:
PMID:  8904418     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diagnostic strategies for congenital toxoplasmosis have changed profoundly in recent years. Immunological diagnostic methods, long considered disappointing, can now be used at a very early stage. Over a 3-year period, 1,050 infants at risk of congenital toxoplasmosis (born to 1,048 mothers infected during pregnancy) were monitored for a minimum of 12 months and a maximum of 7 years. More than 6,000 serum specimens were analyzed by comparative mother-infant immunological profiles (CIPs) based on an enzyme-linked immunofiltration assay (ELIFA) and an immunocapture method for the detection of specific immunoglobulin M (IgM) and IgA. IgG antibodies were also titrated. One hundred three cases of congenital toxoplasmosis were demonstrated. The CIP-ELIFA method had a better diagnostic yield (sensitivity, 90%) than specific IgM and/or IgA detection by immunocapture assay (sensitivity, 77%). By using a combination of these tests, congenital infection was diagnosed in the first month and the first 3 months of life in 90 and 94% of infants with toxoplasmosis, respectively, with a specificity of 99.8% and a positive predictive value of 99% at 8 months of age. This dual diagnostic approach (ELIFA and IgM-IgA immunocapture) is highly efficient and has important implications for therapy. Indeed, early postnatal diagnosis based on objective evidence enables therapy with pyrimethamine-sulfadoxine to be started immediately for 24 months, while spiramycin (which used to be given preventively for 9 to 12 months to all infants at risk) can be stopped after the first 3 months of life.
Authors:
J M Pinon; C Chemla; I Villena; F Foudrinier; D Aubert; D Puygauthier-Toubas; B Leroux; D Dupouy; C Quereux; M Talmud; T Trenque; G Potron; M Pluot; G Remy; A Bonhomme
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  34     ISSN:  0095-1137     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1997-02-25     Completed Date:  1997-02-25     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  579-83     Citation Subset:  IM    
Affiliation:
Services de Parasitologie, Centre Hospitalier Universitaire, Reims, France.
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MeSH Terms
Descriptor/Qualifier:
Animals
Antibodies, Protozoan / blood*
Child
Child, Preschool
Humans
Immunoenzyme Techniques
Immunoglobulin A / blood*
Immunoglobulin M / blood*
Infant
Infant, Newborn
Toxoplasma / immunology*
Toxoplasmosis, Congenital / diagnosis*,  drug therapy
Chemical
Reg. No./Substance:
0/Antibodies, Protozoan; 0/Immunoglobulin A; 0/Immunoglobulin M
Comments/Corrections

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