Clinical relevance of placenta examination for the diagnosis of congenital toxoplasmosis
| Autor: | Jean-Pierre Gangneux, Florence Robert-Gangneux, Claude Guiguen, Dorothée Quinio, Patrice Poulain, Peggy Dupretz, Chantal Yvenou |
|---|---|
| Přispěvatelé: | CHU Pontchaillou [Rennes], Service de Pédiatrie, Laboratoire de Parasitologie et Mycologiede [CHRU Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes] |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
postnatal diagnosis
Pathology Polymerase Chain Reaction Toxoplasmosis Congenital Mice 0302 clinical medicine MESH: Pregnancy Pregnancy MESH: Animals 030212 general & internal medicine 0303 health sciences biology Obstetrics MESH: Toxoplasma MESH: Infant Newborn MESH: Placenta 3. Good health Infectious Diseases medicine.anatomical_structure PCR [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology congenital toxoplasmosis Gestation Female medicine.symptom Toxoplasma Animal Experimentation Microbiology (medical) medicine.medical_specialty placenta Toxoplasma gondii MESH: DNA Protozoan Prenatal diagnosis mouse assay Sensitivity and Specificity Asymptomatic 03 medical and health sciences Placenta medicine Animals Humans Clinical significance MESH: Mice [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics MESH: Humans 030306 microbiology business.industry Infant Newborn MESH: Polymerase Chain Reaction DNA Protozoan medicine.disease biology.organism_classification MESH: Toxoplasmosis Congenital Toxoplasmosis MESH: Sensitivity and Specificity Pediatrics Perinatology and Child Health MESH: Animal Experimentation business MESH: Female |
| Zdroj: | Pediatr Infect Dis J Pediatr Infect Dis J, 2010, 29 (1), pp.33-8. ⟨10.1097/INF.0b013e3181b20ed1⟩ |
| DOI: | 10.1097/INF.0b013e3181b20ed1⟩ |
| Popis: | International audience; BACKGROUND: Neonates with congenital toxoplasmosis, even asymptomatic at birth, should be treated early to reduce long-term sequelae. Postnatal diagnosis of congenital toxoplasmosis is essential because prenatal diagnosis fails to detect approximately 15% of cases or cannot be performed when maternal infection is acquired in late pregnancy. Detection of parasites in the placenta is one diagnostic approach to the early neonatal diagnosis of congenital toxoplasmosis. METHODS: The parasitic analyses of 102 placentas from cases of toxoplasmosis acquired during gestation were reviewed, with complete biologic follow-up of neonates. The value of quantitative PCR and mouse inoculation was assessed, and results are discussed in light of prenatal treatment and postnatal outcome. RESULTS: Congenital toxoplasmosis was diagnosed in 28 of the 102 cases. A prenatal diagnosis was obtained in only 16 cases. Specific IgM was detected in 57% of the babies at birth. A positive placental examination by PCR and mouse inoculation was the only evidence of infection in 3 neonates (11%) who were asymptomatic at birth. The sensitivities of PCR and mouse inoculation were 71% and 67%, respectively, and the specificities were 97% and 100%. Parasites were detected more often when maternal infection was acquired during the third trimester of pregnancy (P < 0.01), regardless the type of treatment. The sensitivity of IgM detection appeared to be related to maternal treatment since IgM was positive in 43% and 75% when mothers were treated or not, respectively (P < 0.01). Though 5/7 symptomatic infants had a positive placenta examination, there was no correlation between a positive placenta and the presence of clinical signs during the first year of life. The positive and negative predictive values of placental examination were 91% and 90%, respectively. CONCLUSION: Placental examination is an efficient tool for the early diagnosis of congenital toxoplasmosis. |
| Databáze: | OpenAIRE |
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