Comparison of immunoblotting (IgA and IgG) and the Goldmann-Witmer coefficient for diagnosis of ocular toxoplasmosis in immunocompetent patients

Mathis, Thibaud; Beccat, Sylvain; Sève, P.; Peyron, François; Wallon, Martine; Kodjikian, Laurent

doi:10.1136/bjophthalmol-2017-311528

Cited by 14 publications

(4 citation statements)

References 39 publications

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“…It has been used not only in OT but also in other ocular diseases. [29][30][31][32][33][34] Robert-Gangneux tested the GWC for biological diagnosis of toxoplasmic retinochoroiditis with 53% sensitivity; when using the GWC combined with immunoblotting, sensitivity increased to 71%. 29 Similar results were reported by Fekkar and Mathis, who combined the GWC with other diagnostic tools, reporting significantly higher sensitivity than when using the GWC alone.…”

Section: Discussionmentioning

confidence: 99%

“…29 Similar results were reported by Fekkar and Mathis, who combined the GWC with other diagnostic tools, reporting significantly higher sensitivity than when using the GWC alone. 30,32 The GWC has also been used for the diagnosis of cytomegalovirus, herpes simplex virus, and varicella zoster virus infection of the ocular. 33 However, to date, there has been no systematic evaluation of the use of the GWC for the immunological diagnosis of OT.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of Ocular Toxocariasis by Serum and Aqueous Humor IgG ELISA

Huang

Sun

Liu

et al. 2021

Trans. Vis. Sci. Tech.

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Ocular toxocariasis (OT) is a worldwide ocular parasitic infection and is especially sight-threatening in children. Because of the clinical manifestation diversity, OT has frequently been misdiagnosed. The purpose of this study was to evaluate the diagnostic value of anti-toxocara immunoglobulin G (IgG) in intraocular fluid (IF) and serum in OT.Methods: IF and serum were collected from patients with clinically diagnosed OT and non-OT uveitis. The level of anti-toxocara IgG was detected by enzyme-linked immunosorbent assay. The data were statistically analyzed in anti-toxocara IgG and the Goldmann-Witmer coefficient (GWC) between groups. The area under the receiver operating characteristic curve (AUC ROC) was performed to assess the diagnostic value of serum and IF anti-toxocara IgG and the GWC.Results: A total of 290 participants, 128 (44.1%) with OT and 162 (55.9%) with non-OT uveitis, were included in this study. The default serum anti-toxocara IgG cutoff value of 11 U had 72.1% sensitivity and 95.5% specificity. With the optimized cutoff value of 8.2 U, the AUC was 0.886 (95% confidence interval [CI] = 0.830-0.929, P < 0.0001), sensitivity increased to 80.2%, and specificity was 94.0%. With an IF anti-toxocara IgG cutoff value of 1.8 U, the AUC was 0.934 (95% CI = 0.892-0.963, P < 0.0001), sensitivity was as high as 88.4%, and specificity was 96.4%. Conclusions:Our study proposes novel diagnostic cutoff values of serum and IF antitoxocara IgG for OT, which are 8.2 U and 1.8 U, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnosis of Ocular Toxocariasis by Serum and Aqueous Humor IgG ELISA

Huang

Sun

Liu

et al. 2021

Trans. Vis. Sci. Tech.

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“…Nevertheless, the sensitivity depends on the interval between symptom onset and paracentesis. In a recent retrospective study, when the aqueous humor was taken in the first three weeks after symptom onset, the sensitivity of WB was significantly higher than GWS (64.7% vs 23.5%), while the sensitivity rates were not remarkably differentiated in cases with an interval > 3 weeks (76% and 64%, for WB and GWC, respectively [ 107 ]. Antibodies may be detected in bands between 20- and 120-kDa on immunoblotting assays [ 108 ].…”

Section: Methodsmentioning

confidence: 99%

Ocular toxoplasmosis: a review of the current diagnostic and therapeutic approaches

et al. 2021

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Purpose This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up and therapeutic approach of ocular toxoplasmosis focusing mainly on the postnatally acquired form of the disease. Methods A meticulous literature search was performed in the PubMed database. A supplementary search was made in Google Scholar to complete the collected items. Results Ocular toxoplasmosis is one of the most frequent infectious etiologies of posterior uveitis. It typically presents with retinochoroiditis. Setting an accurate diagnosis depends to a considerable degree on detecting characteristic clinical characteristics. In addition to the evaluation of clinical features, the diagnosis of toxoplasmosis relies at a large degree on serologic testing. The detection of the parasite DNA in the aqueous or vitreous humor can provide evidence for a definitive diagnosis. The current mainstay for the treatment, if necessary, is the use of oral antibiotic with systemic corticosteroids. Recent evidence suggests other therapeutic approaches, such as intravitreal antibiotics can be used. Conclusion Recent developments in the diagnostic and therapeutic approach have contributed to preventing or limiting vision loss of patients suffering from ocular toxoplasmosis. Further studies are required to provide a better understanding of epidemiology, pathogenesis, diagnosis, and treatment with a significant impact on the management of this challenging clinical entity.

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“…The Goldmann-Witmer coefficient is used to define the ratio between specific antibodies (for a pathogen) in two different environments. It is usually used to diagnose parasitic uveitis with antibody assays in the aqueous humour (AH), especially for ocular toxoplasmosis [17][18][19]. The Goldmann-Witmer coefficient is the ratio [specific IgG in AH/specific IgG in serum]/[total IgG in AH/total IgG in serum].…”

Section: Illustrative Case Reportmentioning

confidence: 99%

Schistosomiasis and Recurrent Arthritis: A Systematic Review of the Literature

et al. 2022

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Background. Schistosomiasis is an endemic parasitic infection found in many tropical countries and is highly prevalent in sub-Saharan Africa. It can follow different and atypical clinical patterns. In these unusual cases, diagnosis may be difficult, as symptoms are unspecific. Arthropathy can appear in parasitic infections, but making a connection between arthritis and parasitic aetiology is difficult. This review aims to summarise all cases that have reported schistosomiasis associated with arthropathy, and the different ways authors have diagnosed this disease. Method. We present a systematic literature review of schistosomiasis associated with joint impairments, with a focus on the difficulty of differentiating between reactive arthritis and its parasitic presence in situ. Results. Joint impairments mimicking polyarthropathy are not rare in parasitic infections. Diagnosis is difficult. On the one hand, some patients have arthritis with parasite eggs found in situ, particularly in synovial biopsy. These situations are less common and antiparasitic treatment is straightforward. On the other hand, arthritis can be associated with parasitic infections in the form of reactive arthritis due to an immunological reaction. In such cases, pathogenicity due to circulating immune complex should be suspected. Anti-inflammatory treatments such as corticosteroids or immunosuppressive therapies are ineffective in cases of schistosomal arthropathy. A joint fluid puncture appears to be necessary and parasitic examination as well as in situ immunological techniques appear to be important in order to confirm the diagnosis of schistosomal arthropathy. Conclusions. The frequency of articular schistosomiasis is probably underestimated and should be sought when patients have unexplained polyarthropathy, as it can be an alternative diagnosis when patients have concomitant parasitic infections. These situations are common, whereas the association between unexplained inflammatory arthritis and a concomitant parasitic infection is rarely made. Unspecific rheumatism can lead to probabilistic treatments with many side effects, and looking for a parasitic aetiology could lead to repeated antiparasitic treatments and may avoid other immunosuppressive or corticosteroid therapies. With increasing travel and global migration, physicians need to be more aware of nonspecific symptoms that may reveal an atypical presentation of a tropical disease that can be treated easily, thus avoiding inappropriate immunosuppressive treatments.

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Comparison of immunoblotting (IgA and IgG) and the Goldmann-Witmer coefficient for diagnosis of ocular toxoplasmosis in immunocompetent patients

Abstract: IB seems to be more useful than the GWC if only one of these methods can be performed, especially during the first three weeks after symptom onset.

Cited by 14 publications

References 39 publications

Diagnosis of Ocular Toxocariasis by Serum and Aqueous Humor IgG ELISA

Diagnosis of Ocular Toxocariasis by Serum and Aqueous Humor IgG ELISA

Ocular toxoplasmosis: a review of the current diagnostic and therapeutic approaches

Schistosomiasis and Recurrent Arthritis: A Systematic Review of the Literature

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