| Neonatal serologic screening and early treatment for congenital Toxoplasma gondii infection. The New England Regional Toxoplasma Working Group. | |
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MedLine Citation:
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PMID: 7818637 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Most infants with congenital Toxoplasma gondii infection have no symptoms at birth, but many will have retinal disease or neurologic abnormalities later in life. Early detection and treatment of congenital toxoplasmosis may reduce these sequelae. METHODS: In Massachusetts since January 1986, and in New Hampshire since July 1988, newborns have been screened for intrauterine infection with T. gondii by means of an IgM capture immunoassay of blood specimens routinely collected for screening for metabolic disorders. Congenital infection is confirmed by assays for specific IgG and IgM antibodies in serum from infants and their mothers. For this study, infants with serologic evidence of infection underwent extensive clinical evaluation and received one year of treatment. RESULTS: Through June 1992, 100 of 635,000 infants tested had positive screening tests. Congenital infection was confirmed in 52 infants, 50 of whom were identified only through neonatal screening and not through initial clinical examination. However, after the serologic results became available, more detailed examinations revealed abnormalities of either the central nervous system or the retina in 19 of 48 infants evaluated (40 percent). After treatment, only 1 of 46 children had a neurologic deficit (hemiplegia attributable to a cerebral lesion present at birth). Thirty-nine treated children had follow-up ophthalmologic examinations when one to six years old; four (10 percent) had eye lesions that may have developed postnatally (a macular lesion in one child and minor retinal scars in three). CONCLUSIONS: Routine neonatal screening for toxoplasmosis identifies congenital infections that are subclinical, and early treatment may reduce the severe long-term sequelae. |
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Authors:
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N G Guerina; H W Hsu; H C Meissner; J H Maguire; R Lynfield; B Stechenberg; I Abroms; M S Pasternack; R Hoff; R B Eaton |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The New England journal of medicine Volume: 330 ISSN: 0028-4793 ISO Abbreviation: N. Engl. J. Med. Publication Date: 1994 Jun |
Date Detail:
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Created Date: 1994-06-30 Completed Date: 1994-06-30 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1858-63 Citation Subset: AIM; IM |
Affiliation:
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Division of Infectious Diseases, Children's Hospital, Boston, Mass. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies, Protozoan
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analysis Central Nervous System Diseases / diagnosis, etiology Follow-Up Studies Humans Immunoglobulin G / analysis Immunoglobulin M / analysis Infant, Newborn Leucovorin / therapeutic use Neonatal Screening* Pyrimethamine / therapeutic use Retinal Diseases / diagnosis, etiology Spiramycin / therapeutic use Sulfadiazine / therapeutic use Toxoplasmosis, Congenital / complications, diagnosis*, drug therapy* |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Protozoan; 0/Immunoglobulin G; 0/Immunoglobulin M; 58-05-9/Leucovorin; 58-14-0/Pyrimethamine; 68-35-9/Sulfadiazine; 8025-81-8/Spiramycin |
| Comments/Corrections | |
Comment In:
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N Engl J Med. 1994 Nov 24;331(21):1459
[PMID:
7969294
]
N Engl J Med. 1994 Nov 24;331(21):1458 [PMID: 7969293 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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