A case of a pregnant woman with persistence of high levels of anti-Toxoplasma IgM antibody tests: Implications for interpretation of the results obtained with different kits

DOI Open Access
  • Ueda Natsuki
    Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center
  • Tada Katsuhiko
    Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center
  • Norose Kazumi
    Department of Infection and Host Defense, Graduate School of Medicine, Chiba University
  • Nakamura Makoto
    Department of Neonatology, National Hospital Organization, Okayama Medical Center
  • Kumazawa Kazumasa
    Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center

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Other Title
  • 検査キットにより検査値の差が大きかったトキソプラズマIgM抗体持続陽性の妊婦症例

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Abstract

<p> The fetal infection rates and clinical manifestations of Toxoplasma infection during pregnancy vary widely depending on the stage of pregnancy at the time of infection. Estimating the timing of infection is important because the infection rate is lower in earlier pregnancy, but symptoms are more severe. We herein report a case of a 26-year-old primipara who had difficulty estimating the time of Toxoplasma gondii infection. Specific anti-Toxoplasma IgG and IgM antibodies both were strongly positive at 10 weeks of gestation and the woman was referred to our facility at 11 weeks of gestation with suspicion of recent Toxoplasma infection. Our facility used different IgG and IgM kits than those used at the referring clinic. Our results for both antibodies showed high titers, as did those obtained at the clinic, though ours were relatively lower. After we explained our interpretation of the test results, the patient opted to terminate the pregnancy without waiting for the IgG avidity results. The high-avidity IgG index, additional to the subsequent course with serologic tests taken 5 months after termination of the pregnancy, indicated a high possibility of persistent IgM. This case underscored the impossibility of comparing findings obtained with different kits. This, in turn, indicates the need to establish a nationwide system for collecting information regarding Toxoplasma infection, including IgG avidity, to estimate the time of infection.</p>

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