Toxoplasmosis quantitative analysis. Analysis for toxoplasmosis - indications and interpretation of the results

23.02.2021

At the stages of pregnancy preparation, and, of course, during the pregnancy itself, the gynecologist recommends undergoing a series of studies and passing some laboratory blood tests. In the test results, the doctor pays attention to certain indicators - antibodies that will help diagnose acute or chronic infections. One of the most significant infections will be toxoplasmosis.

What is toxoplasmosis and why is it dangerous?

These protozoa have a complex cycle of life and development, a host change pattern, and cats and other felines will be the final host.

The main route of infection with Toxoplasma is through the mouth, for example, with underdone meat, vegetables and berries that have been contaminated with infected soil.

In most healthy people, toxoplasmosis does not cause a severe clinical picture and specific symptoms, and proceeds as a mild cold.

Toxoplasma poses the greatest danger to pregnant women, tk. the pathogen enters the fetus through the placenta. When infected before 12 weeks of gestation, the disease is recorded in 15-20% of newborns, with a severe clinical course: miscarriage, stillbirth, severe consequences in the baby (mental retardation, blindness, enlarged liver or spleen).

When the mother is infected in the third trimester, the infection of the fetus occurs in 65% of cases. Often, after birth, children are healthy, but a couple of years later, severe damage to the organs of vision, hearing, and mental retardation can be diagnosed.

Toxoplasma infection will be diagnostically significant, i.e. carriage and disease itself. To differentiate these conditions, a laboratory blood test will help, which allows you to clarify whether it is a carrier or a disease, by detecting certain antibodies. When a person comes into contact with Toxoplasma, the immune system reacts by producing antibodies against it, and two types of immunoglobulins IgM and IgG can be detected in venous blood (material for research).

Deciphering the result of the analysis for toxoplasmosis: the norm of IgG and IgM

In the blood test, it is necessary to pay attention to the presence of IgM and IgG antibodies, which make it possible to exclude or confirm a preliminary diagnosis.

Normally, IgM immunoglobulin is absent in the blood serum. It appears only in the acute period of the disease, in the first week of the disease its titer is 1:10, the maximum concentration is reached within 4 weeks, as a rule, it is 2-3 weeks of the disease, and completely disappears after a few months.

Immunoglobulins of this class are diagnosed in 75% of newborns. Negative IgM refutes the presence of an acute infection that lasts less than two weeks, but does not rule out an infection of a longer course. When re-infected, the IgM titer rises again.

Early diagnosis of toxoplasmosis is extremely important for pregnant women due to the high risk of intrauterine infection of the fetus, which can cause death, spontaneous abortion or birth with serious congenital pathologies and developmental anomalies. In the case of timely diagnosis and treatment, the risk of fetal damage is reduced by 60%. Since IgM cannot cross the placenta, its detection in the venous blood of the newborn indicates a congenital infection.

Toxoplasma IgG class is diagnosed in the blood a couple of weeks after the initial infection to provide long-term protection. Its level increases during the active course of the infection.

The determination of this immunoglobulin in the blood is carried out in order to determine the period of recovery of toxoplasmosis and assess the formation of immunity.

Women tested for toxoplasmosis with positive IgM and positive and IgG should be retested in a couple of weeks, in order to analyze the dynamics of the disease. If the titer does not increase, then this indicates chronic toxoplasmosis, therefore, with an increase in titer, the process is acute.

Indications for the appointment of additional serological studies will be:

pregnant women, to clarify the results;

patients with toxoplasmosis receiving specific treatment;

newborns born from infected mothers with aggravated anamnesis;

epidemically significant contingents: veterinarians, cat breeders;

patients with clinical symptoms that are characteristic of the disease.

Why is the result positive or negative?

In order to achieve a reliable result of the analysis, it is necessary to follow a number of rules and achieve certain conditions. Firstly, examination for toxoplasmosis, in addition to laboratory testing of venous blood for the level of antibodies, should include other research methods - serological ones, which can be prescribed by a leading gynecologist, infectious disease specialist, therapist or pediatrician. Secondly, smoking is prohibited half an hour before the study. Only under these conditions will the results be reliable.

Negative IgG for toxoplasmosis will indicate the absence of infection in the past. But still, a second study is recommended in order to completely exclude the infection, since, perhaps, the antibodies simply did not have time to develop. In the presence of immunodeficiencies, it is necessary to be extremely careful about the decoding of the analyzes.

Negative IgM and positive IgG in toxoplasmosis may indicate activation of latent or chronic infection.

If, if toxoplasmosis is suspected, the test results show IgG negative and IgM negative, then the diagnosis is removed - it has not been confirmed. This is the norm for a healthy woman planning a pregnancy.

To prevent the development of toxoplasmosis, it is necessary to avoid contact with cats, in particular with cat trays and the ground. All foods that a woman eats must be sufficiently heat treated. Elementary hygiene rules, especially for pregnant women, should be at the highest level.

Tests for toxoplasmosis: normal indicators. The danger of toxoplasmosis for pregnant women

The disease toxoplasmosis is a hidden enemy that can cause great harm to a pregnant woman and her fetus. In humans, toxoplasmosis manifests itself in different ways. As a rule, the diagnosis of the disease is carried out in the laboratory. Since the pathogen is quite resistant to environmental influences, widespread infection is possible. In this article we will consider a disease such as toxoplasmosis, normal indicators, symptoms and methods of its treatment.

Children, agricultural workers, hunters, villagers, summer residents and gardeners, as well as all those who have cats at home, are primarily at risk of contracting this disease.

Toxoplasmosis, the norms of which are discussed below, are caused by conditionally pathogenic protozoa (toxoplasma) that settle in the cells of the human body. In this case, the pathogen can affect any organ and penetrate into any cell, with the exception of erythrocytes. The main cause of this disease is infection of the body with protozoa.

Toxoplasmosis: how to determine?

In humans, in most cases, toxoplasmosis occurs in a mild and almost imperceptible form. However, symptoms such as general weakness, fatigue, subfebrile temperature, slight enlargement of the cervical and occipital lymph nodes, and headache may be observed.

The conditions listed above are observed in the case of the classic cold. Quite often, people do not even have a clue that they have had a disease such as toxoplasmosis. Indicators of the norm of this disease allow you to start treatment in a timely manner.

In severe disease, patients experience joint and muscle pain, a spotted rash, and fever. Damage to the nervous system (development of meningoencephalitis) is considered very dangerous. In a cat, toxoplasmosis can be suspected only in those cases when she has nasal discharge, redness of the eyes, diarrhea, and swollen lymph nodes. However, in most cases, both in cats and in humans, the pathological process does not have obvious symptoms.

Everywhere they say that toxoplasmosis is dangerous during pregnancy. Hence the recommendation to throw away your beloved pet, as well as the worries about any cat scratch. It is important to know that for the developing fetus, it is the primary infection of the expectant mother that poses a particular risk. Accordingly, if you have previously had toxoplasmosis, then this will not have a negative effect on the fetus.

Infection of the fetus with a disease such as toxoplasmosis (normal indicators are indicated below) is observed both with primary infection and with reactivation of the pathogen in the body of seropositive women.

It is worth noting that with a primary infection during pregnancy, the risk to the fetus is 100%. During the first trimester, it is in the range of 15-20%, the second - 30%, the third - 60%. Although the risk increases with increasing gestational age, the severity of clinical manifestations decreases. In other words, if a woman in the first trimester becomes infected with toxoplasmosis, then the baby in most cases develops defects that are incompatible with life. If infection occurred towards the end of pregnancy, then pronounced symptoms may be absent altogether.

In a disease such as toxoplasmosis, the norm is determined by the laboratory. The following transmission routes are possible:

A pregnant woman with a high rate of toxoplasmosis does not pose an epidemiological danger either to medical personnel or to those around her. This allows the patient to be treated both in a somatic hospital and on an outpatient basis.

When leaving the cysts, the pathogen spreads. In tissues, its concentration is associated with the ability to penetrate transplacentally, which can provoke the development of intrauterine pathology at any stage of pregnancy.

Toxoplasmosis: diagnosis

The causative agent can be determined in the body only by the presence of antibodies in the blood. This disease cannot be detected in any other way, since Toxoplasma is hiding inside other cells. As mentioned earlier, the incubation period of toxoplasmosis is almost asymptomatic. Protozoa, for example, can be found in the muscles, brain, spleen, liver, and lymph nodes.

Thus, it is possible to take material for analysis only surgically. When a lumbar puncture is done for meningoencephalitis, the cerebrospinal fluid is necessarily examined for toxoplasma.

Due to the fact that the incubation period of toxoplasmosis is asymptomatic in most cases, it is difficult to detect it in the early stages. Therefore, the treatment of this disease is long - 2 courses with immune correction (mandatory). The first course is 10 days, then the same break is made, and the therapy is repeated again (21 days - in especially difficult cases).

Ocular toxoplasmosis is very severe. Diagnosis in this case should be as accurate as possible, since the disease can be confused with tuberculosis. Therapy is carried out under the strict supervision of a phthisiatrician. With lesions of the brain and organs of vision, toxoplasmosis is treated only permanently. You will have to stay in the hospital for at least a month. After treatment, repeated laboratory tests are required.

The presence in the blood of antibodies of the IgM type in the normal state is completely excluded. If, as a result of the tests, they were identified, then we are talking about infection with an infection such as toxoplasmosis. lgG antibodies found in the blood indicate that the body was once affected by an infection, while the time frame can be stretched up to 10 years.

The best option is if none of these types of antibodies will be present in the blood. Only in this case it will be possible to say with certainty that there has never been an infection in the body, and at a particular moment it is also absent. However, this means that a woman has absolutely no immunity to the disease, which would help to avoid infection. We'll have to work hard not to get infected with such a disease. If toxoplasmosis lgG was detected, and IgM is absent, then the woman once encountered an infection, but at the moment she does not threaten her. And most importantly, immunity has already developed, and therefore the possibility of re-infection is minimal.

According to statistics, this situation is the most common. Thus, in a disease called toxoplasmosis, the norm is the presence of IgG and the absence of IgM.

If IgM antibodies were found in the blood, and the IgG type is completely absent, then we are talking about a recent infection in the absence of immunity. This is what creates a threat to the child and his mother.

If both antibodies were detected, this indicates that the infection has been present in the body for a long time. After 2-3 weeks, the specialist will again ask you to donate blood for toxoplasmosis.

To prevent the development of this disease actively, and also in order to prevent the danger threatening the unborn child, it is necessary to conduct a special examination for infection. It is desirable to determine the indicator of toxoplasmosis either in the process of planning pregnancy, or in its early stages. You should not be afraid of the treatment of such a pathology - if you turn to specialists in a timely manner, then it occurs with minimal risk to the child.

With a disease such as toxoplasmosis, blood counts are fundamental, since bacteria are found in the internal organs. The amount of antibodies produced by the body is analyzed. In addition, it is determined how long ago the infection was introduced into the body, as well as how dangerous toxoplasmosis itself is for a person. Laboratory indicators do not always allow to determine the exact picture of the disease, therefore, after 2-3 weeks, a second test is prescribed.

Sometimes toxoplasmosis can be diagnosed by blood polymerase chain reaction (PCR). It is important to note that this method is considered inaccurate, as it cannot determine the period when the infection occurred.

If infection has been confirmed in a pregnant woman, a similar analysis should be performed for the baby. In most cases, amniocentesis (a sample of amniotic fluid) is used for these purposes. To determine whether the spleen or liver is enlarged, whether intracranial calcifications and ventricles of the brain are in a normal state, ultrasound can be performed.

Danger during pregnancy

Most women do not even realize that they could have suffered this disease. Since the disease often occurs in a latent form, this guarantees the formation of immunity in the body. If you are one of these women, then you are lucky - if you become infected during pregnancy, there will be no risk to the fetus.

If you are infected for the first time, the child can be very seriously affected, especially during the third trimester. Nevertheless, it is better not to change your lifestyle, throw away your pet, refuse to eat meat. Try to live life to the fullest, but limit contact with animals, and also monitor the degree of readiness of meat dishes. If you feel worse, contact a specialist, only he can determine the indicators of chronic toxoplasmosis.

There are some precautions that prevent this infection. Let's consider them in more detail.

Nonspecific prevention of this infection is possible. Try to exclude semi-finished products, follow the rules of hygiene, wash your hands more often, buy meat and minced meat in trusted stores, carefully process vegetables and fruits. If there is a cat in the house, you should use special fillers and wash the tray regularly.

Women who are planning a pregnancy should be tested for toxoplasmosis even before conception. How to determine the presence of this infection, it was said above. If the result is negative, then during pregnancy it is very important for the expectant mother to take tests every 3 months.

If there are pets in the house, it is also necessary to conduct a thorough examination of them. It is recommended to regularly disinfect the cat litter box. If a pet gets sick, no matter how sad it may be, you will have to get rid of it. To protect your beloved cat, do not let him out alone on the street, do not give raw meat, do not let him hunt for birds and mice. Also, pregnant women are not recommended to contact with pets of strangers, strangers, as well as stroke stray cats.

All these measures will help to some extent prevent this disease. In most cases, our health depends on ourselves.

Analysis for toxoplasmosis

What tests are used to diagnose toxoplasmosis

Diagnosis of toxoplasmosis is carried out taking into account the patient's history and the results of laboratory tests. Various serological methods are used as laboratory tests to detect the presence of specific immunoglobulins (IgM and IgG classes) against Toxoplasma. A blood test for toxoplasmosis can be done by one or more of the methods listed below.

ELISA blood test (ELISA);

The reaction of indirect (passive) hemagglutination (RNGA / RPGA);

Immunofluorescent analysis (MFA);

Upon contact with Toxoplasma, the human body produces specific protein compounds (immunoglobulins, also called "antibodies"), which are active against one or another harmful life form. Toxoplasmosis produces IgM and IgG antibodies.

Note. A general blood test for toxoplasmosis is uninformative and does not reveal the disease. With toxoplasmosis, specific changes occur in the blood, which, taking into account the anamnesis, suggest the presence of an infection. One of these indicators is an increased number of lymphocytes in the blood. With toxoplasmosis, relative lymphocytosis is recorded (over 35%). The norm of lymphocytes varies within 19-37%.

How to get tested for toxoplasmosis in humans

There are no specific restrictions on donating blood or urine. Blood for toxoplasmosis is taken from the cubital vein, urine for research is taken in the morning (morning portion). If it is impossible to take blood from the cubital vein, it is taken from other venous vessels (for example, from the back of the hands or feet).

However, observance of elementary restrictions before donating blood is the key to the quality of serum. 24 hours before the venous blood sampling procedure, the consumption of meat products and fatty foods should be minimized as much as possible, and alcohol products should be completely excluded. It is also necessary to exclude the use of medications that promote blood thinning, as this increases the breakdown of red blood cells and the release of hemoglobin. Such blood is not suitable for research. Half an hour before donating blood, you must stop smoking.

As for urine, the procedure is also standard and does not require a special approach. After getting up in the morning, we carry out hygienic procedures of the genitals, take a pre-prepared clean container, empty 1/3 of the bladder into the toilet bowl, then fill the container with the necessary volume, and empty the rest into the toilet bowl.

Deciphering a blood test for toxoplasmosis

IgM antibodies are fairly large immunoglobulins and appear first in toxoplasmosis. They contribute to the activation of phagocytosis and have an effect on gram-positive bacteria. The normal indicator varies from 0.4 to 2.6 units. A decrease in this indicator indicates suppressed humoral immunity due to chronic viral infection and other pathological processes that contribute to the depletion of immunity.

The decoding of a blood test for toxoplasmosis is as follows:

What can affect the accuracy of analyzes

It should be understood that serological research methods are highly sensitive and accurate, however, false positive and false negative results may well be.

Note. False-negative and false-positive ELISA results are extremely rare, however, small deviations from the real picture occur in ¼ of cases.

A key component of accuracy in the conduct of the study is a specialist, since the identification and determination of immunoglobulins depends on his experience and skills. Violation of the requirements for the collection of biological material can also cause inaccurate results.

The presence of any rheumatic diseases in the patient should be reported to the attending physician and before blood sampling. Metabolism is another reason for the increased likelihood of inaccurate data.

In case of non-compliance with the established requirements for restriction before donating blood, there is also a possibility of obtaining inadequate data. This is especially true when taking medications. Long-term use of medications can significantly affect the accuracy of the result.

Since about 3rd part of the adult population of the whole world had contact with toxoplasma and in most cases did not have any consequences or manifestations of the disease, we can safely say that toxoplasmosis is not a dangerous disease for a person who has a normal immune system status.

Toxoplasmosis is extremely dangerous during pregnancy, so it is wise to do a blood test for toxoplasmosis when planning a pregnancy.

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Toxoplasmosis during pregnancy is the norm in the analyzes

An analysis for toxoplasmosis in pregnant women is mandatory, since it is necessary to know if there are antibodies to toxoplasmosis in a woman's body during pregnancy. Blood for toxoplasmosis during pregnancy must be taken by all expectant mothers, because this disease occurs without specific symptoms, and you may not know if you have had this disease before. In most cases, toxoplasmosis causes fever, fatigue, and headache. The cervical and occipital lymph nodes are slightly enlarged.

All these symptoms can be confused with the common cold and not given much importance. Severe cases of the disease are rare. They are accompanied by fever, pain in the muscles and joints, and a spotty rash appears.

Is toxoplasmosis during pregnancy normal?

It is known that 90% of cat owners once had toxoplasmosis and already have antibodies to it. If during pregnancy laboratory indicators confirm the presence of toxoplasmosis, it is necessary to study the ratio of immunoglobulins of two classes: M and G.

If no immunoglobulins were found in the blood, then this indicates a negative toxoplasmosis during pregnancy. In this case, the expectant mother should make every effort to prevent infection during pregnancy, especially avoid contact with cats with toxoplasmosis. It is important to know that toxoplasmosis in pregnant women is a variant of the norm.

The norm of toxoplasmosis during pregnancy: a positive and negative value

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How to decipher the results of the analysis for toxoplasmosis during pregnancy, what is its norm? information of interest to many patients.

To interpret the received form with the indicators of the enzyme immunoassay conducted in the laboratory, it is necessary to understand two things:

whether antibodies to toxoplasmosis were found in the blood of the examined patient, indicating that her body is already familiar with this infection;
Which of the groups of immunoglobulins G or M do these antibodies belong to, and in what quantity are they present in the bloodstream in a given period of time.

Many specialists prefer to call such an indicator of the norm relative, often using the term toxoplasmosis - IgG is the norm during pregnancy.

The presence of IgG and the absence of IgM titers in the examination protocol indicates that the expectant mother has already had the infection before, and she has developed lifelong immunity. Therefore, toxoplasmosis during pregnancy does not threaten either her health or the full development of the baby. Moreover, the indicator of the IgG titer, whether it is higher or lower than 200 (the generally accepted average norm of the IgG titer in the protocol of a serological blood test) cannot indicate the activity of an infection that can harm the full bearing of a child.

Sometimes a doctor, in order to completely remove the issue of toxoplasmosis in pregnant women, recommends that, in addition to ELISA, take a blood test for PCR, which allows you to determine the activity of the detected infection. With negative tests, a woman is automatically excluded from the risk group for the disease.

The rate of toxoplasmosis in the blood of pregnant women as a percentage is indicated by the avidity index, in other words, an indicator of the relationship between antigen and antibody. An index expressed as a percentage that exceeds sixty is considered high. This informs the patient that there is an immune response to the disease and that there is no danger of a primary infection.

ELISA is the most informative diagnosis for the disease. During pregnancy, a positive result of the analysis titers in one case inspires confidence and calmness, in the other, anxiety. In order to independently understand the results of a laboratory study, it is necessary to have knowledge of the processes occurring in the body after infection.

Having this information, even at the level of the layman, it becomes clear that positive toxoplasmosis IgM during pregnancy and IgG - negative. indicates a primary infection (infection has occurred recently) and the absence of an immune response.

There is a more complex option when IgG toxoplasmosis during pregnancy as well as IgM titers are positive. This situation is transient, therefore uninformative and requires re-diagnosis after a couple of weeks.

Toxoplasmosis negative during pregnancy, what does it mean? This result is considered the norm, which tells that the woman's body is not familiar with the infection, immunity is not formed, the threat of primary infection exists.

It is for antibodies of various classes to toxoplasma that there are certain reference indicators that can be conditionally called norms. These concentrations of antibodies to toxoplasma make it possible to determine their presence or absence in a person’s blood, and then, based on the decoding of the tests, find out if the person had toxoplasmosis and how long ago he had this infection.

Currently, the concentrations of the following types of antibodies to toxoplasma are determined:

After determining the amount of antibodies in the blood, an analysis result is issued, which can be of three varieties - positive, negative or questionable. A positive result means that the person has antibodies in their blood. A negative result means that the person has no antibodies in their blood. And a dubious result does not allow you to say for sure whether there are antibodies in the blood or not. For clarification, it is necessary to retake the analysis again in 2 to 4 weeks.

The conclusion about a positive or negative result is made on the basis of the standards adopted in each particular laboratory. The standards of laboratories depend on which set of reagents is used to determine the concentration of antibodies. For example, the following standards are adopted in Synevo laboratories:

1. IgG - less than 9.0 - a negative result, and more than 12 - a positive result;

2. IgM - less than 0.8 - a negative result, and more than 1.1 - a positive result.

A positive IgM result indicates that the person is currently suffering from toxoplasmosis. A positive IgG result indicates that a person has had toxoplasmosis in the past and is now immune against reinfection. The presence of IgG antibodies is a kind of norm, since it indicates that a person has already had an infection once and will never get it again. Therefore, if a pregnant woman has IgG antibodies in her blood, she should be happy, not upset, because this means that she will never be able to get toxoplasmosis. Moreover, its antibodies will pass through the placenta to the baby, who will also be protected from toxoplasmosis during the first 6 to 12 months of life. If antibodies of the IgG class are not found in the blood of a person, this means that he has never had toxoplasmosis and may become infected in the future.

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Analysis for toxoplasmosis during pregnancy

Often, expectant mothers and women who are just planning to have a baby are scared by the possibility of getting toxoplasmosis. Many have heard that this disease can extremely negatively affect the development of a child in the womb, so an analysis for toxoplasmosis during pregnancy, prescribed by a doctor, literally plunges women into a state of panic. At the same time, the idea of \u200b\u200bwhat kind of disease it is and where it comes from in the vast majority is very vague.

re-examination to control the presence of infection before and during pregnancy;
an increase in lymph nodes for unknown reasons (including in pregnant women), if before that tests for toxoplasmosis were not prescribed;
immunodeficiency state;
the presence of HIV infection;
simultaneous enlargement of the liver and spleen for unknown reasons;
fever of unknown origin;
re-analysis, if the results obtained after passing the analysis for the first time are doubtful.

Preparatory stage

To prepare for the test, the patient does not need to do anything supernatural. This means that it will not be difficult to pass an analysis for toxoplasmosis during pregnancy. However, so that the result of the examination does not turn out to be blurred and a re-analysis is not required, before passing, you will have to adhere to some rules, which the doctor will definitely warn about:

if the patient was previously prescribed any antibacterial drugs, their intake is stopped two weeks before the expected test;
in two days, the patient will have to give up alcohol, coffee, and also limit the intake of excessively fatty, spicy, salty and spicy foods;
at least 12 hours before the test, it is not recommended to use perfumed products, as well as scented soaps or shower gels;
the doctor and healthcare worker who will take the blood also needs to know if the patient is taking any drugs for the treatment of acute or chronic diseases, since some of them can distort the results of the analysis;
the analysis is given in most cases in the morning and on an empty stomach, and blood is taken from a vein.

Features of carrying out in pregnant women

It should be noted that many expectant mothers have already suffered toxoplasmosis before, completely unnoticed by themselves, since in adults the disease often occurs in a latent form. In this case, the woman is provided with strong immunity, and infection during pregnancy can not be feared.

The risk of infection for the fetus increases with each trimester of pregnancy, but the first 12 weeks remain the most dangerous for it. The later the infection occurs, the less harm toxoplasmosis can cause to the baby. The severity of the manifestation of toxoplasmosis at the beginning of pregnancy, when the organs and systems of a small organism are just beginning to form, is always much higher. So infection of the fetus in the first trimester of pregnancy can lead to inflammation of the retina and iris, underdevelopment of the brain, hydrocephalus, and severe neurological defects.

The course of pregnancy in expectant mothers infected with toxoplasmosis always has its own characteristics. Additional studies are being carried out, the tactics of bearing a child can be changed, the method of delivery is determined separately. In addition, a pregnant woman with toxoplasmosis has an increased risk of miscarriage or intrauterine fetal death. However, a positive test for toxoplasmosis is not always a bad thing.

Drug therapy of toxoplasmosis in pregnant women is possible no earlier than the onset of the second trimester of pregnancy. Drugs for the treatment of the disease can cause almost more harm to the fetus than the infection itself. If a pregnant woman has severe toxoplasmosis, she may be recommended to terminate the pregnancy. This is due to the fact that even if in such a case the pregnancy can be delivered, the risk of congenital malformations of the fetus is too great.

The final diagnosis is determined by the existing signs of the disease, and in their absence - by the results of laboratory tests.

Today, there are three main types of research:

indirect immunofluorescence reaction;
complement fixation reaction;
linked immunosorbent assay.

An enzyme immunoassay for toxoplasmosis during pregnancy provides the most reliable result by detecting IgM and IgG immunoglobulins in the blood. These are antibodies that make it possible not only to detect the disease, but also to determine whether a woman has recently become infected and her child in the womb may be in danger, or whether she has been infected with toxoplasmosis for a long time. In the second case, the expectant mother and her baby are provided with immunity to this disease.

Allergic skin tests can be used as additional diagnostic methods.

Of the instrumental methods, they can prescribe a biopsy of the lymph nodes, an examination of the fundus and x-rays.

You can find out if the unborn baby has become infected by analyzing the amniotic fluid. In the amniotic fluid, Toxoplasma can be detected only a month after infection of the mother. That is why such a study cannot be classified as basic. It can be used to confirm the results of an enzyme immunoassay.

Deciphering the results

The entry of toxoplasma into the blood and internal organs of the patient causes the body to produce antibodies. When analyzing blood, the presence of two antibodies is determined: immunoglobulins of class M (IgM) and G (IgG). During the examination, it is also possible to determine whether the infection in the patient's body is "fresh" or whether he has been ill with toxoplasmosis for a long time.

The presence of IgM antibodies in the tests indicates that the patient is sick. They appear at the peak of the disease (about 2-3 weeks after infection) and disappear after about 2-3 months.

If an immunoglobulin of the IgG class is found in the blood serum, this indicates a long-term infection. These antibodies are able to persist in the patient's blood for 10 years. That is, the presence of IgG antibodies in a pregnant patient indicates a previously transferred toxoplasmosis, and also that at the moment she is the owner of a strong immunity to this disease.

Class M antibodies in the analyzes indicate a recent infection, and also that, unfortunately, the disease is in full swing and can harm the fetus.

The norm of the analysis for toxoplasmosis, that is, the complete absence of IgM and G (IgG) antibodies in the blood test, indicates that the patient is not only not sick with toxoplasmosis, but has never had it. It cannot be said that a negative result is bad. However, in this case, immunity to the disease is completely absent and in order to protect yourself from the disease in the future, some efforts will have to be made. This is especially important when it comes to expectant mothers.

Protecting yourself and your unborn child from toxoplasmosis is much easier than it seems. It is enough to simply follow the basic rules of hygiene.

Wash your hands thoroughly after cleaning your pet's litter box, feeding, or cleaning the cage regularly. The communication of the fluffy with his street relatives is better, if not completely stopped, then at least strictly limited.

Cleanliness of hands must also be taken care of after working with raw meat and minced meat. It is also advisable to work with them with gloves.

It is better to forget about the habit of slobbering fingers when counting banknotes even for completely healthy people. Otherwise, you can easily pick up not only toxoplasmosis. And in women in an interesting position, immunity is also significantly reduced.

Eat only thoroughly fried or boiled meat, avoid raw eggs, and carefully wash fruits and vegetables before eating.

If antibodies to Toxoplasma are not found in the analyzes of a pregnant woman, it is better for her not to take care of pets or walk them at all. The danger of catching an infection may well lie in wait also in children's sandboxes or on a public beach.

If there is no cat in the house of a pregnant woman, then this is definitely not the best time to start one or contact other people's pets. If you really want to start a home fluffy, then it is best to do this even before pregnancy.

The best way is to conduct an analysis for the presence of toxoplasmosis in the body even during pregnancy planning. This will enable the expectant mother to make sure that she has strong immunity to the causative agent of this infection or that in order to protect herself and her unborn baby from it, it is enough for her to adhere to elementary rules of hygiene.

Tests for toxoplasmosis

Knowledge of results tests for toxoplasmosis urgently needed for pregnant women, as timely diagnosis of toxoplasmosis helps prevent severe fetal developmental disorders

Tests for toxoplasmosis: why they are needed

Testing for toxoplasmosis is necessary because the disease in adults is usually almost asymptomatic. But for pregnant women, toxoplasma can cause a lot of trouble! So, in a mother who did not pass tests for toxoplasmosis and therefore did not discover an insidious disease on time, the risk of infection of the fetus by the end of pregnancy reaches 70%! And this threatens with damage to the eyes and central nervous system of the unborn child.

Fortunately, tests for toxoplasmosis allow us to determine not only the very fact of the presence of toxoplasma in the body, but also the time that has elapsed since the onset of the disease caused by it. But, since the human body tends to develop immunity to almost any kind of pathogenic agents, then if a woman has already had toxoplasmosis at least three months before pregnancy, then her unborn child is not in danger. By the way, the presence of immunity to the disease that we are discussing can also be determined using an analysis for toxoplasmosis.

Today, the most reliable of the numerous diagnostic methods are rightfully recognized as tests for toxoplasmosis, such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) analysis.

ELISA or enzyme immunoassay for toxoplasmosis.

In the language of science, the full name of this method sounds like “Enzyme-linked immunosorbent assay (ELISA) for the determination of IgM and IgG antibodies to toxoplasmosis in blood serum with the determination of IgG avidity” What is an analysis for toxoplasmosis with such a “scientific” name?

This is a laboratory study, during which, using special biochemical reactions, it is possible to determine the content in the blood of specific immunoglobulin proteins that the body produces to fight toxoplasmosis.

However, although now we are talking about tests for toxoplasmosis, it should be noted that such a struggle mechanism as the production of immunoglobulins is used by the body in any infectious disease! How many different microbes, viruses and toxins there are, there are so many different immunoglobulins. With the blood flow, they are carried throughout the body, and, finding "their" type of infection, they bind to it (form a complex) and neutralize it after a while.

ELISA, or enzyme immunoassay for toxoplasmosis: an idea of immunoglobulins M (Ig M)

It is noteworthy that the immunoglobulins that appeared in the body at different periods of a certain disease (in our case, toxoplasmosis) also differ. Figuratively speaking, they are "early" and "late" (denoted as Ig M and Ig G). This fact is also necessarily taken into account when conducting tests for toxoplasmosis.

For example, the human body begins to produce immunoglobulins M in the first days of the disease. At 2-3 weeks, their number reaches its maximum level, and after 1-2 months they disappear. The presence of this "breed" of immunoglobulin in the blood indicates that the disease is in an acute phase.

ELISA, or enzyme immunoassay for toxoplasmosis: what are immunoglobulins G (Ig G)?

Immunoglobulins G begin to be produced 2-3 days later than IgM, and their number increases to a maximum by a month from the onset of the disease. Unlike class M immunoglobulins, class G immunoglobulins do not disappear anywhere, they remain in the blood for a long time (usually for life) and provide specific immunity. Thanks to them, with repeated infection, the disease no longer develops. If during the tests for toxoplasmosis in the blood of the expectant mother these substances were found, you can not worry about the health of the fetus.

ELISA, or enzyme immunoassay for toxoplasmosis: what is IgG avidity for toxoplasmosis?

Since the term “avidity” is present in the full name of the analysis for toxoplasmosis ELISA, it is also necessary to explain it. Avidity (from avidity - “greedy”) is an assessment of the ability of IgG antibodies to bind to Toxoplasma to further neutralize the latter. When conducting tests for toxoplasmosis, it must be given because at the very beginning of the disease, IgG binds rather weakly to toxoplasma, that is, they have low avidity. As the immune response develops, the avidity of IgG antibodies increases.

ELISA, or enzyme immunoassay for toxoplasmosis: how to find out the normal values for all the indicators under consideration?

Each laboratory that analyzes for toxoplasmosis has its own normal indicators (the so-called reference, or threshold values). They must be indicated on the test form. If the level of antibodies is below the threshold value, they speak of a negative result of the analysis for toxoplasmosis, above the threshold value - positive.

Toxoplasmosis is a protozoan invasion characterized by a wide variety of course options and polymorphism of clinical manifestations. In 1972, WHO experts included toxoplasmosis among the zoonoses most dangerous to human health, and later, due to the spread of HIV infection, it was recognized as one of the few opportunistic infections of protozoal etiology.

Toxoplasmosis invasion has a wide, almost ubiquitous distribution: on the globe, from 500 million to 1.5 billion people are infected with toxoplasma. Infection of the population in different countries depends on sanitary and hygienic conditions, dietary habits, the influence of environmental factors, the frequency of immunodeficiency states, etc. The infection rate of the population in various regions of Russia ranges from 15 to 50%, and the frequency of congenital toxoplasmosis among newborns averages 3- 8 children per 1000 births.

The source of the causative agent of invasion is the domestic cat and many species of wild and domestic animals. However, cats excrete oocysts in faeces for a short period (1-2 weeks) and only at 4-5 months of age, so infection directly from the cat - the definitive host of the pathogen - is rare (for example, infection of a child through contact with cat feces in the sandbox and non-compliance with hygiene rules). Infection of people occurs in various ways: alimentary, contact, congenital (transplacental), parenteral, infection of medical personnel in contact with blood is possible. Often people become infected when they eat foods from meat of intermediate hosts that have not undergone sufficient heat treatment (grilled chicken, shawarma, shish kebab, raw minced meat), poorly washed vegetables, etc. Depending on the mechanism of infection, acquired and congenital toxoplasmosis is distinguished.

Acquired toxoplasmosis in adults, it is more often asymptomatic - in 9095% of infested persons, no significant manifestations are observed. Approximately 5-7% of women are first infected during pregnancy, in these cases, toxoplasmosis is especially dangerous: it causes early termination of pregnancy, stillbirth, the birth of children with developmental abnormalities, CNS damage, etc. When women are infected during the entire period of pregnancy, on average 61% of healthy children and 39% of children with congenital toxoplasmosis are born. In case of primary infection during pregnancy, the transmission of the pathogen to the fetus during acute toxoplasmosis is carried out in 40-50% of cases, when the fetus is infected in the first trimester, a severe form occurs in 40%, when infected in the second or third trimester - in 17.7% and 2.7 % of cases, respectively. Toxoplasmosis has a high pathogenetic significance for HIV-infected individuals, when the clinical forms of the disease develop as a result of reactivation of a latent infection. In Russia, at present, toxoplasmosis encephalitis is the main cause of CNS damage in AIDS patients (usually when the number of CD4 lymphocytes is less than 0.1 x 10 9 /μl).

Congenital toxoplasmosis- an acute or chronic disease of newborns that occurs when the fetus is infected with toxoplasma during fetal development. It requires special attention due to the difficulty of diagnosis and the possibility of severe consequences of the disease. The only method of prevention of congenital toxoplasmosis is the examination of pregnant women to identify specific antibodies.

The clinical manifestations of infection in the fetus are determined mainly by the gestational age at which the infection occurred and by the path of penetration of the pathogen (adverse outcome is mainly associated with the hematogenous route of infection). There are three clinical forms of congenital toxoplasmosis, which are successive stages in the development of the infectious process: acute generalized form (with hepatosplenomegaly and jaundice), subacute (with symptoms of encephalitis) and chronic (with symptoms of postencephalic defect).

When infected in the I and II trimesters of pregnancy, when the stage of generalization of the process ends in utero, spontaneous miscarriages, severe developmental anomalies that are incompatible with the life of the fetus and child, as well as the most severe damage to the central nervous system and eyes, occur more often. In the subacute stage of the disease, a child is born with severe symptoms of CNS damage - the phenomena of meningitis or meningoencephalitis, with a clinical picture of focal or diffuse lesions of the meninges. In cases where the acute and subacute stages have passed in utero, a child is born with a chronic form of toxoplasmosis in the presence of gross damage to the central nervous system (a picture of a postencephalitic state) and eyes (from chorioretinitis to microphthalmia).

When infected in the III trimester in newborns, asymptomatic forms predominate more often. However, if infection occurred shortly before the birth of a child, then the stage of generalization that began in utero continues after birth and is manifested by a variety of clinical symptoms.

The acute form of congenital toxoplasmosis is detected most often in premature babies, it proceeds very severely according to the type of sepsis. The lethality of infected newborns ranges from 1 to 6%. Surviving children suffer from mental retardation or other manifestations of CNS disorders.

Indications for examination

Planning for pregnancy;
pregnant women, including those with a burdened obstetric history or pathology during the current pregnancy;
newborns with suspected intrauterine infection (congenital toxoplasmosis);
the presence of an infectious syndrome (prolonged low-grade fever; lymphadenitis, especially cervical and occipital; hepatosplenomegaly; hepatitis and myocarditis of unknown origin; subacute or chronic encephalitis; chorioretinitis, uveitis, progressive myopia; acute febrile illness with a rash of unknown origin);
secondary immunodeficiencies;
patients in the late stages of HIV infection with signs of damage to the central nervous system, retina, lungs, septic condition.

Differential Diagnosis

With the pathology of pregnancy, fetal death, stillbirth - with herpesvirus infections, parvovirus B19 infection, rubella;
in newborns and children of the first year of life - with herpesvirus infections;
in the presence of an infectious syndrome (fever, lymphadenopathy, hepato- and (or) splenomegaly), hepatitis of unknown etiology, chorioretinitis, posterior uveitis, brain damage (encephalitis) - with herpesvirus infections, HIV infection with other secondary lesions (CMVI, fungal infections, progressive leukoencephalopathy , CNS tumors, etc.).

Research material

Venous and umbilical blood, CSF, BAL, amniotic, pleural, subretinal fluid, vitreous body, punctates of lymph nodes and bone marrow, chorionic villi, placenta, biopsy specimens - visual identification of the pathogen using microscopy, isolation of pathogens in cell culture, bioassay on laboratory animals, toxoplasma DNA detection;
venous and umbilical blood, CSF, BAL, amniotic, pleural, fluid, punctates of lymph nodes, vitreous body, bone marrow - detection of toxoplasma AG;
venous and umbilical cord blood - detection of antibodies to toxoplasma AG.

Etiological laboratory diagnostics includes visual identification of the pathogen using microscopy, isolation of the pathogen in cell culture, detection of AG or pathogen DNA, determination of specific antibodies to Toxoplasma AG.

Comparative characteristics of methods of laboratory diagnostics. Microscopy of smears, smears, prints, histological sections, bioassay on laboratory animals, isolation of the pathogen in cell culture allow identification of Toxoplasma in tissues or biological fluids of the patient. Sometimes in severe cases of toxoplasmosis in patients with AIDS (septic condition), it is possible to see the pathogen with direct microscopy in a blood smear. Named detection methods T. gondii for routine diagnosis of toxoplasmosis are rarely used due to the complexity and duration of execution.

To detect Toxoplasma AG in the test material, RIF is used. The presence of hypertension, characteristic of the acute phase of toxoplasmosis, is determined by the presence of a specific glow detected using a fluorescent microscope, the study is especially useful for early diagnosis.

Of high diagnostic value, mainly in acute and congenital toxoplasmosis, is the detection of Toxoplasma DNA in the blood, CSF or biopsy specimens by PCR, which has the highest sensitivity and specificity. The diagnostic value of pathogen DNA determination increases when combined with the determination of specific antibodies.

AT-toxo IgM to AG T. gondii belong to the biomarkers of the acute phase of the disease, they appear first in response to the introduction of the pathogen (in the first two weeks after infection), their number reaches a maximum after 4–8 weeks. Within a few months, these antibodies disappear, but in some cases they can persist up to 18 months from the moment of infection. They are not transmitted through the placenta.

AT-toxo IgA appear 2–3 weeks after infection, reach a maximum concentration in a month, in 90% of cases disappear after 6 months, but sometimes they can be detected up to a year. When reactivated, their concentration increases, which allows us to consider IgA as a criterion for the activity of the infectious process. They are not transmitted through the placenta (they are the newborn's own antibodies).

AT-toxo IgG appear from 6–8 weeks of infection, reach a maximum after 1–2 months and persist (at a high level in some individuals) for several years, providing long-term immunity. Transmitted through the placenta, provide "maternal" immunity.

The detection of AT-toxo by ELISA is widely used for epidemiological studies and perinatal screening. The study has high sensitivity and specificity, allows you to identify AT-toxo of different classes. The standard approach is aimed at detecting AT-toxo IgM and IgG in serum/plasma. Detection of IgM antibodies allows to differentiate an active infection from a latent one. Widely used in routine studies, a single detection of IgG has a low diagnostic value for determining the form of infection. Determination of the avidity of AT IgG is carried out to clarify the period of infection, differentiation of acute and chronic toxoplasmosis. IgG Abs with low avidity are found in the early stage of infection, while Abs with high avidity are characteristic of a previous infection. If there are clinical indications for examination or to confirm / exclude congenital toxoplasmosis, it is advisable to include in the laboratory algorithm the detection of IgA antibodies to T. gondii. The presence of AT-toxo IgA testifies in favor of an active process, allows you to establish a subacute course and relapse of the disease. The test can be effectively used for early diagnosis of both congenital and acquired toxoplasmosis.

The presence of a high avidity index does not exclude the reactivation of toxoplasmosis (especially against the background of immunodeficiency), since the possibility of persistence has been established T. gondii. In this case, it is advisable to determine specific IgA. The use of combined studies - determining the avidity of IgG Abs and detecting Ig A Abs - allows, upon detection of Ab-toxo IgG, to complete the examination as soon as possible (within 2-3 days) and confirm (exclude) the primary infection, subacute course or exacerbation of chronic infection.

Parallel determination of AT-toxo in the blood and CSF provides additional information about the specific progressive brain damage (including in congenital pathology). The presence of antibodies in the CSF suggests a specific progressive brain lesion. With damage to the central nervous system, especially with meningoencephalitis and encephalitis, in newborns with suspected congenital toxoplasmosis, the test has an important diagnostic and prognostic value. In patients with immunodeficiency, an increase in the level of IgG antibodies in the CSF and the detection of specific IgM is rarely observed.

Indications for the use of various laboratory tests and features of the interpretation of the results in different categories of subjects

Screening during pregnancy planning and in pregnant women is aimed at detection of AT-toxo IgM, IgA, IgG. The diagnosis of recent exposure to toxoplasmosis is usually made when specific antibodies appear in a patient with previously negative results of such studies (seroconversion). Negative test results rule out toxoplasmosis.

Detection of AT-toxo IgM indicates primary infection with toxoplasma, however, in pregnant women and in individuals with autoimmune pathology (the presence of rheumatoid factor), a false-positive result of the study is possible.

If AT-toxo IgM is detected, additional studies are advisable to confirm the diagnosis and determine the phase of the infectious process: a) detection of toxoplasma DNA in blood plasma; b) determination of AT-toxo IgA, the presence of which indicates a current infection; c) examination of the patient in dynamics (the appearance of AT IgG confirms the diagnosis of acute toxoplasmosis); d) determination of the avidity index of AT IgG; the presence of low-avid antibodies indicates in favor of infection during the last 3–6 months.

The detection of AT-toxo IgA indicates a primary infection with toxoplasma or reactivation of the infection. The appearance of a negative result of the presence of IgA antibodies in the study in dynamics indicates the completion of the active process and effective therapy. Long-term detection of IgA antibodies is possible in people with severe immunodeficiency, usually with mixed infection (active CMVI).

A positive result of a single determination of IgG antibodies indicates infection with Toxoplasma, but does not allow determining the phase of the infectious process. It is recommended to re-examine the patient in dynamics after 3–4 weeks: with an actively ongoing infection, an increase in the titer of antibodies is observed. With this approach, the time for establishing a diagnosis is delayed. It is more advisable to conduct a study of the avidity of AT IgG and / or the determination of AT-toxo IgA.

Low avid IgG antibodies to antigens T. gondii can be detected up to 3-6 months. Their presence indicates an acute infection, high-avid ones indicate a chronic infection (more than 6 months).

Diagnostic examination of a pregnant woman includes the determination of AT-toxo IgM, IgA, IgG and, if possible, toxoplasma DNA. The examination is carried out in the presence of an infectious syndrome (lymphadenopathy, prolonged subfebrile condition of unknown origin, hepato- and splenomegaly) or when signs of intrauterine infection are detected by ultrasound.

The presence of Toxoplasma DNA and/or AT-toxo IgM and/or IgA indicates a current infection; to assess the stage of infection, it is necessary to determine the avidity of AT IgG.

To determine the cause of perinatal losses at different gestational ages, taking into account the effect of mixed infection on the outcome of pregnancy, it is advisable to conduct a parallel study of the tissue of dead fetuses and placenta to identify the NC group of potential pathogens (Toxoplasma, Listeria, HSV types 1 and 2, CMV, EBV) by PCR .

Diagnostic examination of newborns and young children with signs of intrauterine infection or born to mothers with acute or chronic (in the presence of reactivation during pregnancy) toxoplasmosis.

A negative result of detection of Toxoplasma DNA by PCR does not exclude a previous infection or the presence of a lesion in the brain away from the liquor-carrying pathways. To diagnose toxoplasmosis, an additional study of blood serum (plasma) is required to detect AT-toxo IgM and ATtoxo IgA, with brain damage - a parallel study of CSF and serum (plasma) of blood to detect AT-toxo IgA and IgG.

If it is not possible to conduct a PCR study in a child, it is necessary to determine AT-toxo IgM and IgA.

The absence of AT-toxo IgM in the presence of AT-toxo IgG does not give grounds to exclude intrauterine infection and requires the determination of toxoplasma DNA or ATtoxo IgA.

Detection of AT-toxo IgA has a high diagnostic value and indicates infection of the child.

The detection of IgG antibodies in a newborn may be due to their transfer through the placenta from the mother, which makes it difficult to diagnose congenital toxoplasmosis. By 4 months after birth, the concentration of AT-toxo IgG sharply decreases due to the breakdown of maternal AT. In case of infection shortly after birth, the concentration of IgG antibodies produced by the child's body increases, but in the first half of life it is "masked" by the level of maternal antibodies. An increase in the level of IgG AT in the second half of life can be considered as an indicator of infection in a child, but in some cases (in premature and immunodeficient children), even with the onset of symptoms (most often from the central nervous system), a sharp rise in AT is not observed.

Recurrent perinatal infection (chorioretinitis, CNS damage with hydrocephalus formation) can occur at any age and are accompanied by increased production of IgA antibodies (rarely - IgM) to Toxoplasma.

With brain damage (meningoencephalitis, encephalitis, progressive hydrocephalus, calcifications, brain cysts), it is advisable to determine AT-toxo IgG simultaneously in CSF and blood serum. With local brain damage, the level of antibodies in the CSF is much higher, and by calculating the ratio of the level of antibodies, it is possible to confirm (or exclude) damage to the brain by toxoplasma.

Diagnostic examination of patients with HIV infection indicated in the early stages before the appointment of primary prevention of toxoplasmosis, which is carried out with a CD 4+ number of less than 0.1.109 and includes the determination of AT-toxo AT IgG. Examination of patients with HIV infection in the later stages is indicated for the development of symptoms of CNS damage (preferably MRI) and for suspected cerebral toxoplasmosis (the most common CNS lesion in AIDS patients). In these cases, the presence of AT-toxo IgG in the blood in high and medium titers (or their increase in dynamics) is of diagnostic importance. The detection of AT-toxo in the blood serum without determining their titer allows us to judge only about infection and cannot be recommended to confirm the diagnosis.

In cerebral toxoplasmosis in patients with HIV infection, the clinical sensitivity of detecting IgM antibodies in the blood and IgG antibodies in the CSF is very low. IgM antibodies in the blood are rarely detected (only with fresh infection, which happens only in 1-2% of cases), IgG antibodies in the CSF are determined in no more than 5% of cases. Diagnostic value is the presence of specific IgG antibodies in the blood in high and medium titers (or their increase in dynamics). However, against the background of very deep immune suppression, these antibodies are not detected in about 5% of patients. However, a negative test result or low IgG antibody titers does not exclude the diagnosis of cerebral toxoplasmosis and should not be a reason for not starting empiric treatment. The use of PCR in the diagnosis of cerebral toxoplasmosis has demonstrated that the diagnostic sensitivity of DNA detection T. gondii in CSF is 30% with 100% specificity. Thus, a positive PCR result only states that the individual is infected, but cannot reliably confirm the toxoplasmic etiology of CNS damage.

Currently, the concentrations of the following types of antibodies to toxoplasma are determined:

1. IgG - less than 9.0 - a negative result, and more than 12 - a positive result;

2. IgM - less than 0.8 - a negative result, and more than 1.1 - a positive result.

You need to get tested if you have the following symptoms:

elevated body temperature for no apparent reason;
pain in muscle tissues;
migraine;
increased weakness and fatigue;
anemia;
enlargement of the lymph nodes.

An analysis for toxoplasmosis is prescribed for anemia

These symptoms are considered early and with timely access to a specialist and treatment of pathology, you can easily get rid of them. With further lesions, the symptoms of helminthic invasion worsen, and may appear:

ulcer;
decreased visual acuity;
memory impairment and speech impairment;
decreased appetite and sudden weight loss;
insomnia;
the appearance of allergies and skin rashes.

The specifics of toxocariasis in humans

The main methods for diagnosing toxoplasmosis

Unlike intestinal invasions, Toxoplasma live mainly in the lymphatic vessels, so it is impossible to detect them in the feces. The most reliable diagnostic methods are blood tests. These methods are based on the appearance of blood antibodies to toxoplasma antigens after a certain period of time. Antibodies to toxoplasma antigens are released after 2-3 weeks, therefore, before pregnancy, it is necessary to undergo an examination in advance, since at the time of diagnosis, antibodies might not have appeared yet. The most informative diagnostic methods are:

ELISA- ELISA blood test;
PCR- polymeric chain reaction.

The concept of enzyme immunoassay

ELISA blood test for toxoplasmosis

Why are worms dangerous for humans?

Immunoglobulins IgG appear within a month. They appear when IgM has already disappeared. IgG antibodies are immunity that remains in the body for life. IgG immunity provides protection against toxoplasmosis, therefore, as a rule, a person was ill with toxoplasmosis 1 time in his life, and then the body develops immunity and can resist secondary infection.

ELISA results using antigenic proteins

The interpretation of the results depends on the stage of the infection, so it is recommended to be examined again after 3-4 weeks.

Avidity indicators

The results of the analysis for toxoplasmosis with negative IgM and positive IgG take into account indicators of avidity. Avidity is the ability of antibodies to resist foreign microorganisms.

Ways of infection with toxoplasmosis during pregnancy

When planning a pregnancy, it is necessary to pass tests for worms. Their timely detection and treatment can save your baby's life.

PCR analysis for toxoplasmosis

Polymesar chain reaction (PCR) is considered one of the most informative diagnostic methods. It is carried out to detect DNA and RNA of Toxoplasma in the human body. Any sample of human DNA is required for analysis, not necessarily blood. PCR gives the most accurate results. For the initial study of pathology, ELISA is used, and PCR is used to confirm or refute the diagnosis.

According to statistics, every third inhabitant of our country is infected with toxoplasmosis. Often, carriers of the disease do not even know about their condition, since the infection may not manifest itself in any way - the person does not have any pronounced symptoms. Due to the uncomplicated and often asymptomatic transmission of this disease, insufficient attention is paid to diagnosis and treatment methods. While in some cases, infection can lead to fatal consequences and serious complications. What does it mean if toxoplasmosis is found in the blood? The norm and deviations of indicators, how immunoglobulins of the IgG and IgM groups contribute to the diagnosis of infection, and how the disease can be managed and prevented, is described in this article.

The body's response to infection with toxoplasmosis

As with any other infection, the human body reacts to infection with toxoplasmosis by activating the immune defenses. Namely, the production of special antibodies, immunoglobulins of the protein groups IgG and IgM.

It is worth considering in more detail the functions and properties performed by immunoglobulins of the IgG group in the body when infected with a disease such as toxoplasmosis. The IgG norm is an ambiguous concept. The presence of immunoglobulins of this group can indicate both the acute phase of the disease and a long process. How do antibodies fight disease? They perform a number of functions that protect the body and adversely affect the viability of the pathogen, namely:

Interesting and important is the fact that it is the immunoglobulin of the IgG group that makes up 80% of all immunoglobulins in the body. In addition, in chronic forms of infections and autoimmune diseases, the percentage of IgG immunoglobulins increases.

Deciphering the indicators of immunoglobulin IgG

Usually, a study is not done on the quantitative measurement of immunoglobulins in the analysis for toxoplasmosis. The norm in the blood is an indicator of the detection or absence of immunoglobulins. Most often, in the results of the analysis, such designations as “positive” or “negative” are noted. But in some cases, according to indications, the doctor may prescribe a special quantitative analysis. It is rather difficult to give specific norms for IgG immunoglobulin indicators, since each laboratory has its own criteria. Such differences are due to the use of different chemicals during the analysis for toxoplasmosis in the blood. The norm differs markedly depending on the laboratory. As an example, the following indicators can be cited:

How to decipher the results of the analysis for toxoplasmosis? Normal IgG is below 700 mg/dL. A positive result of the analysis for measuring the amount of immunoglobulins of the IgG group is 700-1600 mg / dl or 7-16 g / l. Indicators below the specified limits are considered a negative result.
Using other units of measurement, the following norms of IgG immunoglobulin parameters are indicated: above 12 U / ml is considered a positive result, below 9 U / ml - negative, indicators between the indicated norms are doubtful and require additional research.

Regardless of how the indicators are labeled, they have the same meaning. Tested positive for toxoplasmosis in the blood? The norm is the presence of IgG antibodies and the absence of IgM. The presence of IgG immunoglobulins in the test material indicates that the organism met with the causative agent of toxoplasmosis. This means that a person is reliably protected from secondary infection. But at the same time, such results may indicate a primary recent infection. To confirm or refute this assumption, it is necessary to analyze the parameters of IgM immunoglobulins, which appear in the body only during the acute phase of the disease. Accordingly, the presence of such antibodies indicates a primary infection and a serious danger to the fetus. In such a situation, the doctor diagnoses "toxoplasmosis". The norm in the blood is the absence of antibodies of the IgM group. Such indicators indicate a long-term infection and the absence of any danger to the body.

If the results of the analysis indicate the absence of IgG immunoglobulins in the body, special measures should be taken to prevent infection during pregnancy, since such results indicate the absence of protective antibodies against toxoplasmosis.

Methods for diagnosing toxoplasmosis

There are the following types of diagnosis of toxoplasmosis:

Method for diagnosing toxoplasmosis ELISA

More often than others, it is used to determine toxoplasmosis. It is this method that allows you to determine the duration of infection, to establish the acute phase of the disease. Such indicators can be distinguished due to the detection of IgM immunoglobulins. If the form says: "toxoplasmosis: normal in the blood," the result means that there is no acute phase of the disease.

The decoding is standard and has no features when analyzing during pregnancy. Let us consider in more detail what the results mean: "acute phase of the disease" and "toxoplasmosis: normal in the blood." The table provided below clearly demonstrates the indicators and their designation. Namely:

Indicators of analysis for toxoplasmosis by ELISA

Immunoglobulin IgM	Immunoglobulin IgG	Characteristics of indicators
-	-	Special attention should be paid to preventive measures. Such results indicate the absence of protective antibodies in the human body.
-	+	The result indicates a long-term infection that does not pose a danger to the body. In addition, a person is protected from re-infection with toxoplasmosis.
+	-	This option is the most unfavorable. It indicates a primary infection that occurred less than 5 days ago.
+	+	It is also a negative result, as it indicates infection no later than a month ago.

Toxoplasmosis: the norm in the blood during pregnancy

Infection in the later stages leads to premature birth, stillbirth, the appearance of a child with serious developmental pathologies, such as:

inflammation of the retina, blindness;
deafness;
enlargement of the spleen and liver;
violation of the development of internal organs;
jaundice;
damage to the central nervous system (convulsions, paralysis, hydrocephalus, oligophrenia, epilepsy, encephalitis);
pneumonia;
disruption of the heart;
external deformities: splitting of the lips and palate, developmental pathologies of the limbs, hernia, hermaphroditism, strabismus, cataracts and more.

Many of the above congenital pathologies lead to infant mortality within the first few weeks of life or to profound disability. There are cases of the birth of a child without pronounced, at first glance, pathologies. But during the first year of life, symptoms of acute toxoplasmosis appear.

Considering the high level of infection risk for an unborn baby, doctors during the planning period, conception, and throughout pregnancy prescribe a comprehensive analysis for TORCH infection to women, which includes a test for toxoplasmosis. The norm of tests during pregnancy is no different from generally accepted indicators.

Timely treatment significantly increases the chances of having a healthy baby. In this case, the benefits of the drugs used outweigh the possible harm caused by them.

Indications for the treatment of toxoplasmosis

The result of “toxoplasmosis: the norm in the blood” is indicated on the analysis form - treatment in this case is not required. In most cases, the human immune system is able to cope with a pathogenic microorganism on its own. Treatment is prescribed only for various disorders of immunity in the following cases:

in acute toxoplasmosis in order to prevent serious complications in AIDS patients and pregnant women;
in the chronic form of the disease during the period of exacerbation in order to form a normal immune response;
treatment can be prescribed for chronic toxoplasmosis in case of development of chorioretinitis, infertility, miscarriage.

Treatment of toxoplasmosis in immunocompromised people who are not pregnant

People with a weakened immune system may be prescribed different drugs, depending on the symptoms and history:

Pregnant women are not allowed to take these drugs.

Treatment of toxoplasmosis in pregnant women

If the analysis confirms the presence of an acute phase of infection, one of two types of therapy can be used:

The appointment of "Rovamycin" is possible in various courses: 1.5 million units twice a day for 6 weeks; 3 million units twice a day for 4 weeks or 3 million units three times a day for 10 days. Assign such treatment for a period not earlier than 16 weeks of pregnancy.
A complex consisting of Pyrimethamine and Sulfodaxin. The dosage and duration of the course is indicated by the doctor. Treatment can be prescribed after 20 weeks of pregnancy.
With inflammation of the eyes, treatment with "Prednisolone" is necessary.
Also in uncomplicated cases, Spiramycin is used.

Prevention methods

If you are planning a baby, and the results of the tests showed the absence of antibodies to toxoplasmosis, there is no other way to protect the unborn baby from the disease, except for preventive measures. Based on knowledge about the methods of infection, the following preventive measures can be identified:

minimize contact with animals throughout the entire period of pregnancy;
do not eat raw and poorly fried meat, unwashed vegetables;
work with soil only in;
Remember to wash your hands thoroughly and often.

Based on the information presented in the article, we can conclude that toxoplasmosis is an extremely dangerous disease for a future mother and her baby. But modern medicine is able to timely detect specific antibodies that protect the body from infection. In this case, it is necessary not only to pass on time, but also to correctly interpret the results of the analysis for toxoplasmosis. The norm in pregnant women is no different from generally established indicators. Thus, the presence or absence of IgG immunoglobulins may indicate directly opposite clinical pictures. Therefore, trust the specialist - strictly follow all his recommendations, do not decipher the results yourself. In this case, the probability of a successful birth of a healthy child is very high. Be healthy!