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首页> 外文期刊>Journal of Clinical Microbiology >Toxoplasma Seroconversion with Negative or Transient Immunoglobulin M in Pregnant Women: Myth or Reality? A French Multicenter Retrospective Study
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Toxoplasma Seroconversion with Negative or Transient Immunoglobulin M in Pregnant Women: Myth or Reality? A French Multicenter Retrospective Study

机译：弓形虫血清转化与阴性或暂时性免疫球蛋白M孕妇：神话还是现实？法国多中心回顾性研究

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Classically, Toxoplasma infection is associated with high levels of specific IgM antibody and a rise in specific IgG levels 1 to 3 weeks later. Atypical IgG seroconversion, without IgM detection or with transient IgM levels, has been described during serologic follow-up of seronegative pregnant women and raises difficulties in interpreting the results. To evaluate the frequency and the characteristics of these atypical cases of seroconversion, an investigation was conducted within the French National Reference Center for Toxoplasmosis, from which 26 cases collected from 12 laboratories belonging to the network were identified. The aim of this work was to retrospectively analyze the results of serologic testing, the treatments administered, and the results of prenatal and postnatal follow-up for these women. In each case, IgG antibodies were detected using both screening and confirmatory tests. IgM antibodies were not detected in 15 cases, and the levels were equivocal or low-positive in 11 cases. The IgG avidity results were low in 16 cases and high in one case. Most of the pregnant women (22/26) were treated with spiramycin from the time that IgG antibodies appeared until delivery. Amniotic fluid was analyzed for Toxoplasma gondii DNA by PCR in 11/26 cases, and the results were negative in all cases. Congenital toxoplasmosis was ruled out in 12/26 newborns. There was no abnormality observed at birth for 10 newborns and no information available for 4 newborns. In conclusion, when the interpretation of serological results is so difficult, it seems cautious to initiate treatment by spiramycin and to follow the pregnant women and their newborns.
机译：通常，弓形虫感染与高水平的特异性IgM抗体和1至3周后特异性IgG水平升高有关。在血清阴性孕妇的血清学随访中，未检测到IgM或具有短暂IgM水平的非典型IgG血清转换已被描述，这增加了解释结果的难度。为了评估这些非典型血清转化病例的频率和特征，在法国国家弓形虫病参考中心内进行了一项调查，从该网络的12个实验室中鉴定出26例。这项工作的目的是回顾性分析这些妇女的血清学检查，所用治疗方法以及产前和产后随访的结果。在每种情况下，均使用筛查和确证测试检测IgG抗体。在15例中未检测到IgM抗体，在11例中该水平是模棱两可或低阳性的。 IgG亲和力结果低16例，高1例。从IgG抗体出现到分娩为止，大多数孕妇（22/26）都接受了螺旋霉素治疗。通过PCR分析羊水中弓形虫DNA的11/26例，结果均为阴性。先天性弓形虫病被排除在12/26新生儿中。 10例新生儿出生时未观察到异常，4例新生儿无可用信息。总之，当很难解释血清学结果时，开始使用螺旋霉素治疗并随访孕妇及其新生儿似乎是谨慎的。

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