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Clinical and Diagnostic Laboratory Immunology, July 1999, p. 514-518, Vol. 6, No. 4
Department of Medical Microbiology, Institute
of Microbiology and Infectious Diseases, University of Medical
Sciences, Pozna
Received 15 September 1998/Returned for modification 14 January
1999/Accepted 15 March 1999
Traditional serological techniques have some limitations in
evaluating the duration of Toxoplasma gondii infection in
pregnant women, patients with lymphadenopathy, and older children
suspected of having congenital toxoplasmosis. In these three groups of
patients, two variants of T. gondii immunoglobulin G (IgG)
avidity tests were used: an EIA Kit (Labsystems) and a noncommercial
enzyme-linked immunosorbent assay specially elaborated in the
laboratory. The avidity of specific IgG in sera from 23 patients with a
known recently acquired infection (mainly pregnant women) was low (less than 30%), whereas that in sera from 19 patients with toxoplasmic lymphadenopathy of 3 weeks to 6 months in duration (mean, 8.3 weeks)
covered a large range (between 0.2 and 57.8%; mean, 25.7%); high
avidity results were observed for 10 of 19 patients (52.6%). The large
range of IgG avidity in patients with toxoplasmic lymphadenopathy suggests various durations of infection in these patients, with a
tendency for a chronic phase of toxoplasmosis. According to the avidity
marker, five patients with lymphadenopathy for less than 3 months did
not have a recent Toxoplasma infection. In 6 of 19 patients
with lymphadenopathy (31.6%), low IgG avidity values persisted until 5 months after the first serological examination. In all four patients
with a documented chronic course of Toxoplasma infection (6 months to 8 years after the first positive serology), high IgG avidity
values were observed. Among sera from 10 children and young
immunocompetent adults suspected of having ocular reactivation of
congenital toxoplasmosis, all had high IgG avidity values (over 40%),
suggesting congenitally acquired ocular infection rather than
noncongenital infection. In conclusion, the avidity of IgG is a
valuable marker of recent toxoplasmosis in pregnant women, suggests the
duration of invasion in patients with lymphadenopathy, and may be
helpful for differentiation between reactivation of congenital
infection and recently acquired ocular toxoplasmosis in immunocompetent
patients. A low IgG avidity does not always identify a recent case of
toxoplasmosis, but a high IgG avidity can exclude primary infections of
less than 5 months' duration.
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Immunoglobulin G Avidity in Diagnosis of
Toxoplasmic Lymphadenopathy and Ocular Toxoplasmosis
, Poland
*
Mailing address: Department of Medical Microbiology,
Institute of Microbiology and Infectious Diseases, Karol Marcinkowski University of Medical Sciences, Wieniawskiego 3, 61-712 Pozna
, Poland. Phone: (48) 61 853 64 77. Fax: (48) 61 847 74 90. E-mail: mpaul{at}eucalyptus.usoms.poznan.pl.
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