Diagnostic Value of Positive Findings of<i>Toxoplasma gondii</i>-Specific Immunoglobulin M Serum Antibody in Uveitis Patients to Confirm Ocular Toxoplasmosis

Park, Sung Who; Kim, Sohee; Kwon, Han Jo; Lee, Seung Min; Byon, Ik Soo; Lee, Ji Eun

doi:10.1080/09273948.2018.1433303

Cited by 9 publications

(7 citation statements)

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“…In our population, the IgG value in patients with ocular toxoplasmosis was about nine-fold higher than in patients not diagnosed with ocular toxoplasmosis (3953 IU/ml vs 428 IU/ml, respectively). This result is in accordance with previous studies in South Korea (Park et al) [ 39 ] and Switzerland (Papadia et al) [ 40 ] populations; nonetheless, the IgG value in our study is found to be much higher than those two previous reports. In Park et al study, they found that the average toxoplasma IgM and IgG titers were 2.29 IU/mL and 223.4 IU/mL, respectively [ 39 ].…”

Section: Discussionsupporting

confidence: 94%

“…This result is in accordance with previous studies in South Korea (Park et al) [ 39 ] and Switzerland (Papadia et al) [ 40 ] populations; nonetheless, the IgG value in our study is found to be much higher than those two previous reports. In Park et al study, they found that the average toxoplasma IgM and IgG titers were 2.29 IU/mL and 223.4 IU/mL, respectively [ 39 ]. We presumed that different populations in different geographic areas might be attributed to this phenomenon.…”

Section: Discussionsupporting

confidence: 94%

“…A negative result for toxoplasmosis antibodies is generally believed to be more informative than a positive result [ 37 , 38 ]. However, more than a merely positive or negative result of the test, a high IgG serum antibody titer (3–4 times higher than normal level or increased titer in three weeks intervals) was reported to indicate an active infection [ 16 , 39 ]. In our population, the IgG value in patients with ocular toxoplasmosis was about nine-fold higher than in patients not diagnosed with ocular toxoplasmosis (3953 IU/ml vs 428 IU/ml, respectively).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience

Putera

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience

Putera

Nora

Utami

et al. 2022

Heliyon

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“…mehrerer fokaler nekrotisierender Netzhautläsionen -typischerweise in der Nähe einer vorbestehenden chorioretinalen Narbe -erreicht eine diagnostische Spezifität von etwa 93 %. Fehlen diese Narben, wird nach SUN der Erregernachweis mittels Polymerasekettenreakti- [11]. Der Nachweis von Toxoplasma-IgG bestätigt die Durchseuchung, aber weder das Vorhandensein von Antikörpern noch die Titerhöhe sind ausreichend spezifisch, um etwas über die Rolle der Toxoplasmose bei einer aktiven Uveitis auszusagen [14].…”

Section: » Der Klinische Befund Wird Als Wichtigstes Diagnostisches K...unclassified

Diagnostik und Behandlung der okulären Toxoplasmose

2022

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Zusammenfassung Hintergrund Die okuläre Toxoplasmose (OT) ist die häufigste infektiöse Ursache einer posterioren Uveitis. Diese Erhebung soll das derzeitige diagnostische und therapeutische Vorgehen bei OT in Deutschland evaluieren. Material und Methoden Ein detaillierter Fragebogen mit spezifischen Patientenbeispielen wurde im Juli 2021 an die Mitglieder der Sektion Uveitis der Deutschen Ophthalmologischen Gesellschaft (DOG) und der Retinologischen Gesellschaft (RG) versandt. Ergebnisse Der Fragebogen wurde von 53 (29 RG und 24 DOG) Ophthalmologen beantwortet. Sechzehn (30 %) Befragte arbeiten in einer Praxis, 18 (34 %) in einer Klinik und 19 (36 %) in einer Universitätsklinik. Neun (17 %) Augenärzte (AÄ) betreuen weniger als 50, 28 (53 %) 50 bis 200 und 16 (30 %) mehr als 200 Uveitispatienten pro Jahr. Der klinische Befund gilt weiterhin als Goldstandard (87 %) für die Diagnose der OT und wird bei Erstmanifestation in 60 % durch spezifische serologische Antikörperuntersuchungen unterstützt. Eine Diagnose allein anhand des klinischen Befundes stellen 10 von 53 (19 %) AÄ, 25 (47 %) Befragte stützen sich auf einen Ig(Immunglobulin)M-Test, 6 (11 %) erwarteten einen IgG-Titer-Anstieg und einer (2 %) den Nachweis spezifischer IgA-Antikörper. Die Mehrheit (n = 28 [53 %]) der AÄ würde die Diagnose im Zweifelsfall durch eine Vorderkammerpunktion sichern; dabei präferieren 20 (38 %) die Polymerasekettenreaktion (PCR), 3 (6 %) die Bestimmung des Goldmann-Witmer-Koeffizienten und 5 (9 %) eine Kombination beider Verfahren. Zur Therapie wurde am häufigsten Clindamycin eingesetzt (n = 21 [40 %]), gefolgt von Pyrimethamin/Sulfadiazin (n = 17 [32 %]) und Trimethoprim + Sulfamethoxazol (TMP/SMX) (n = 10 [19 %]); Letzteres wird auch (n = 40 [75 %]) zur Sekundärprophylaxe eingesetzt. Schlussfolgerungen Die Ergebnisse lassen neben dem klinischen Befund als „Goldstandard“ zur Diagnosestellung kein einheitliches Vorgehen zu Diagnose und Therapie der OT erkennen. Die hohe Nachfrage nach Serum-IgM-Antikörpern weist auf eine weitverbreitete Unsicherheit über die Bedeutung serologischer Befunde hin. Dies ist angesichts der weiterhin hohen Seroprävalenz in Deutschland kritisch zu werten.

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“…[9,10] Similar to most infections, the first antibodies to appear against Toxoplasma are Immunoglobulin M (IgM), usually within the first week following infection. IgM levels rise until their peak at 1-3 months, [11] then slowly decrease over the following 6 months, generally becoming undetectable after 6-9 months. However, IgM may remain detectable by Elisa linked immunosorbent assay (EIA) for up to 18 months.…”

Section: Introductionmentioning

confidence: 99%

Ocular toxoplasmosis: phenotype differences between toxoplasma IgM positive and IgM negative patients in a large cohort

et al. 2020

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PurposeTo investigate the differences in demographics and clinical characteristics of patients diagnosed with ocular toxoplasmosis according to their IgM status.MethodsRetrospective case note analysis was carried out on patients who tested positive for serum Toxoplasma gondii-specific IgM antibodies (IgM+) as well as a comparator group who tested negative for serum IgM (IgM-), but positive for serum IgG. Patient demographics and clinical features were compared between the two groups to evaluate for any significant differences.ResultsOne hundred and six patients were included in the study between March 2011 and June 2018, consisting of 37 in the IgM +group and 69 in the IgM- group. Patients in the IgM +group were significantly older (51.1 vs 34.1 years, p<0.0001), more likely to present with central macular lesions (32% vs 12%, p=0.012), and more likely to develop rhegmatogenous retinal detachment (11% vs 1%, p=0.049). In contrast, patients in the IgM- group were more likely present with pain (20% vs 3%, 0.017) and exhibit more severe inflammation of the anterior chamber and vitreous (p<0.05). Overall, retinal lesions were more likely to be superotemporal (55%) and superonasal (31%). Furthermore, age was associated with larger (p=0.003) and more peripheral lesions (p=0.007).ConclusionsThis study demonstrated significant differences in clinical characteristics of ocular toxoplasmosis according to serum IgM status. IgM+ patients were older, less likely to report pain, had lower levels of intraocular inflammation, but were more likely to have macular involvement. We also found age to be correlated with larger and more peripheral lesions.

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Diagnostic Value of Positive Findings ofToxoplasma gondii-Specific Immunoglobulin M Serum Antibody in Uveitis Patients to Confirm Ocular Toxoplasmosis

Abstract: The T. gondii IgM serum Ab is a specific biomarker for diagnosis of primary OT. Epidemiological studies are warranted to investigate the non-classic transmission routes of T. gondii in OT.

Cited by 9 publications

References 14 publications

The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience

The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience

Diagnostik und Behandlung der okulären Toxoplasmose

Ocular toxoplasmosis: phenotype differences between toxoplasma IgM positive and IgM negative patients in a large cohort

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