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Infants Potentially at Risk for Congenital Toxoplasmosis: A Prospective Study

Infants Potentially at Risk for Congenital Toxoplasmosis: A Prospective Study Abstract • Fifty-two children were selected as being potentially at risk for congenital toxoplasmosis by serologic testing of 8,043 pregnant women in the Oslo area. These infants were then studied during the neonatal period and subsequently followed up for three years. Three were found to be congenitally infected with Toxoplasma gondii, and one infant was dysmature at birth. The diagnosis was confirmed by persistent dye-test antibodies and by recovery of parasites in placenta and/or amniotic fluid. The Toxoplasma indirect fluorescent IgM-antibody test remained negative, while measurements of cord IgM and IgA levels and serial estimations of specific antibody load supported an early diagnosis. The specific cell-mediated immunity, as measured by the in vitro lymphocyte stimulation test, turned positive at 1 year of age and then increased markedly during the second and third years. The lymphocyte responses of the uninfected children, however, remained negative. The infected children received pyrimethamine/sulfadiazine treatment during their first year, with no clinical signs of congenital toxoplasmosis. (Am J Dis Child 134:638-642, 1980) References 1. Wolf A, Cowen D, Paige B: Human toxoplasmosis (occurrence in infants as an encephalomyelitis: Verification by transmission to animals) . Science 89:226-227, 1939.Crossref 2. Sabin AB: Toxoplasmosis , in DeSanctis AG (ed): Advances in Pediatrics . New York, Interscience Publishers Inc, 1942, pp 1-56. 3. Desmonts G, Couvreur J: Congenital toxoplasmosis . N Engl J Med 290:1110-1116, 1974.Crossref 4. Alford CA, Stagno S, Reynolds DW: Toxoplasmosis: Silent congenital infection , in Krugman S, Gershon AA (eds): Infections of the Fetus and the Newborn Infant . New York, Alan R Liss, 1975, pp 133-157. 5. Eichenwald HF: A study of congenital toxoplasmosis , in Siim JC (ed), Human Toxoplasmosis . Copenhagen, Munksgaard, 1960, pp 41-49. 6. Couvreur J, Desmonts G: Congenital and maternal toxoplasmosis: A review of 300 congenital cases . Dev Med Child Neurol 4:519-530, 1962.Crossref 7. Thalhammer O: Prevention of congenital toxoplasmosis . Neuropaediatrie 43:233-237, 1973.Crossref 8. Stagno S, Reynolds DW, Amos CS, et al: Auditory and visual defects resulting from symptomatic and subclinical congenital cytomegaloviral and Toxoplasma infections . Pediatrics 59:669-678, 1977. 9. Saxon SA, Knight W, Reynolds DW, et al: Intellectual deficits in children born with subclinical congenital toxoplasmosis . J Pediatr 82:792-797, 1973.Crossref 10. Stray-Pedersen B, Pedersen JO, Omland T: Estimations of incidences of Toxoplasma infections among pregnant women from different areas in Norway . Scand J Infect Dis 11:247-252, 1979. 11. Stray-Pedersen B, Lorentzen-Styr AM: The prevalence of Toxoplasma antibodies among 11,736 pregnant women in Norway . Scand J Infect Dis 11:159-165, 1979. 12. Stray-Pedersen B: A prospective study of acquired toxoplasmosis among 8,043 pregnant women in the Oslo area . Am J Gynecol Obstet 136:399-406, 1980. 13. Remington JS, Miller MJ, Brownlee I: IgM antibodies in acute toxoplasmosis: II. Prevalence and significance in acquired cases . J Lab Clin Med 71:855-866, 1968. 14. Remington JS, Desmonts G: Toxoplasmosis , in Remington JS, Klein JO (eds): Infectious Diseases of the Fetus and Newborn Infant . Philadelphia, WB Saunders Co, 1976, pp 191-332. 15. Closs O, Stray-Pedersen B: In vitro lymphocyte stimulation with specific antigen in congenital toxoplasmosis. Scand J Infect Dis, to be published. 16. Closs O: In vitro lymphocyte response to purified protein derivate BCG, and Mycobacterium leprae in a population not exposed to leprosy . Infect Immun 11:1163-1169, 1975. 17. Desmonts G, Couvreur J: L'isolement du parasite dans la toxoplasmose congenitale . Arch Fr Pediatr 31:157-166, 1974. 18. Stray-Pedersen B, Lorentzen-Styr AM: Uterine Toxoplasma infection and repeated abortions . Am J Obstet Gynecol 128:716-721, 1977. 19. Werner H, Schöning C, Neuhaus B, et al: Interpretation des Nachweises spezifischer IgM-Antikörper bei Verdaeht auf connatale Toxoplasmose . Z Geburtshilfe Perinatol 180:438-444, 1976. 20. Remington JS, Desmonts G: Congenital toxoplasmosis: Variability in the IgM-fluorescent antibody response and some pitfalls in diagnosis . J Pediatr 83:27-30, 1973.Crossref 21. Cederquist LL, Kimball AC, Ewool LC, et al: Fetal immune response following congenital toxoplasmosis . Obstet Gynecol 50:200-204, 1977. 22. Kimball AC, Kean BH, Fuchs F: Congenital toxoplasmosis: A prospective study of 4,048 obstetric patients . Am J Obstet Gynecol 111:211-218, 1971. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Infants Potentially at Risk for Congenital Toxoplasmosis: A Prospective Study

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130190006003
Publisher site
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Abstract

Abstract • Fifty-two children were selected as being potentially at risk for congenital toxoplasmosis by serologic testing of 8,043 pregnant women in the Oslo area. These infants were then studied during the neonatal period and subsequently followed up for three years. Three were found to be congenitally infected with Toxoplasma gondii, and one infant was dysmature at birth. The diagnosis was confirmed by persistent dye-test antibodies and by recovery of parasites in placenta and/or amniotic fluid. The Toxoplasma indirect fluorescent IgM-antibody test remained negative, while measurements of cord IgM and IgA levels and serial estimations of specific antibody load supported an early diagnosis. The specific cell-mediated immunity, as measured by the in vitro lymphocyte stimulation test, turned positive at 1 year of age and then increased markedly during the second and third years. The lymphocyte responses of the uninfected children, however, remained negative. The infected children received pyrimethamine/sulfadiazine treatment during their first year, with no clinical signs of congenital toxoplasmosis. (Am J Dis Child 134:638-642, 1980) References 1. Wolf A, Cowen D, Paige B: Human toxoplasmosis (occurrence in infants as an encephalomyelitis: Verification by transmission to animals) . Science 89:226-227, 1939.Crossref 2. Sabin AB: Toxoplasmosis , in DeSanctis AG (ed): Advances in Pediatrics . New York, Interscience Publishers Inc, 1942, pp 1-56. 3. Desmonts G, Couvreur J: Congenital toxoplasmosis . N Engl J Med 290:1110-1116, 1974.Crossref 4. Alford CA, Stagno S, Reynolds DW: Toxoplasmosis: Silent congenital infection , in Krugman S, Gershon AA (eds): Infections of the Fetus and the Newborn Infant . New York, Alan R Liss, 1975, pp 133-157. 5. Eichenwald HF: A study of congenital toxoplasmosis , in Siim JC (ed), Human Toxoplasmosis . Copenhagen, Munksgaard, 1960, pp 41-49. 6. Couvreur J, Desmonts G: Congenital and maternal toxoplasmosis: A review of 300 congenital cases . Dev Med Child Neurol 4:519-530, 1962.Crossref 7. Thalhammer O: Prevention of congenital toxoplasmosis . Neuropaediatrie 43:233-237, 1973.Crossref 8. Stagno S, Reynolds DW, Amos CS, et al: Auditory and visual defects resulting from symptomatic and subclinical congenital cytomegaloviral and Toxoplasma infections . Pediatrics 59:669-678, 1977. 9. Saxon SA, Knight W, Reynolds DW, et al: Intellectual deficits in children born with subclinical congenital toxoplasmosis . J Pediatr 82:792-797, 1973.Crossref 10. Stray-Pedersen B, Pedersen JO, Omland T: Estimations of incidences of Toxoplasma infections among pregnant women from different areas in Norway . Scand J Infect Dis 11:247-252, 1979. 11. Stray-Pedersen B, Lorentzen-Styr AM: The prevalence of Toxoplasma antibodies among 11,736 pregnant women in Norway . Scand J Infect Dis 11:159-165, 1979. 12. Stray-Pedersen B: A prospective study of acquired toxoplasmosis among 8,043 pregnant women in the Oslo area . Am J Gynecol Obstet 136:399-406, 1980. 13. Remington JS, Miller MJ, Brownlee I: IgM antibodies in acute toxoplasmosis: II. Prevalence and significance in acquired cases . J Lab Clin Med 71:855-866, 1968. 14. Remington JS, Desmonts G: Toxoplasmosis , in Remington JS, Klein JO (eds): Infectious Diseases of the Fetus and Newborn Infant . Philadelphia, WB Saunders Co, 1976, pp 191-332. 15. Closs O, Stray-Pedersen B: In vitro lymphocyte stimulation with specific antigen in congenital toxoplasmosis. Scand J Infect Dis, to be published. 16. Closs O: In vitro lymphocyte response to purified protein derivate BCG, and Mycobacterium leprae in a population not exposed to leprosy . Infect Immun 11:1163-1169, 1975. 17. Desmonts G, Couvreur J: L'isolement du parasite dans la toxoplasmose congenitale . Arch Fr Pediatr 31:157-166, 1974. 18. Stray-Pedersen B, Lorentzen-Styr AM: Uterine Toxoplasma infection and repeated abortions . Am J Obstet Gynecol 128:716-721, 1977. 19. Werner H, Schöning C, Neuhaus B, et al: Interpretation des Nachweises spezifischer IgM-Antikörper bei Verdaeht auf connatale Toxoplasmose . Z Geburtshilfe Perinatol 180:438-444, 1976. 20. Remington JS, Desmonts G: Congenital toxoplasmosis: Variability in the IgM-fluorescent antibody response and some pitfalls in diagnosis . J Pediatr 83:27-30, 1973.Crossref 21. Cederquist LL, Kimball AC, Ewool LC, et al: Fetal immune response following congenital toxoplasmosis . Obstet Gynecol 50:200-204, 1977. 22. Kimball AC, Kean BH, Fuchs F: Congenital toxoplasmosis: A prospective study of 4,048 obstetric patients . Am J Obstet Gynecol 111:211-218, 1971.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jul 1, 1980

References