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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.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Pinon, Jean Michel Chemla, Cathy Villena, Isabelle Foudrinier, Frédérique Aubert, Didier Puygauthier-Toubas, D. LeRoux, Brian Dupouy, Dominique Quéreux, Christian Talmud, M. J. Trenque, Thierry Potron, Gérard Pluot, Michel M. Rémy, Gérard Bonhomme, Annie |
| Copyright Year | 1996 |
| Abstract | 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. |
| File Format | PDF HTM / HTML |
| DOI | 10.1128/jcm.34.3.579-583.1996 |
| PubMed reference number | 8904418 |
| Journal | Medline |
| Volume Number | 34 |
| Issue Number | 3 |
| Alternate Webpage(s) | http://jcm.asm.org/content/34/3/579.full.pdf |
| Alternate Webpage(s) | https://doi.org/10.1128/jcm.34.3.579-583.1996 |
| Journal | Journal of clinical microbiology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
