Diagnostic Value of Detecting Specific IgA and IgM with Recombinant Trypanosoma cruzi Antigens in Congenital Chagas' Disease

Lorca, Myriam; Veloso, Cecilia; Muñoz, Patricia; Bahamonde, Maria Ines; García, Alejandro

doi:10.4269/ajtmh.1995.52.512

Cited by 31 publications

(24 citation statements)

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“…The serologic (anti-T. cruzi IgM by IIF and ELISA) methods failed to yield positive results, which may be due to an excess of passively transferred maternal IgG that suppresses the fetal synthesis of specific IgM and may give rise to false-negative results, as was previously observed. 23 Treatment was initiated the day confirmation of T. cruzi infection by conventional parasitologic methods was made, although the PCR results were already positive on the day of birth.…”

Section: Distribution Of Infectedmentioning

confidence: 99%

Treatment of congenital Chagas' disease diagnosed and followed up by the polymerase chain reaction.

Russomando¹,

Tomassone²,

Guillén³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

134

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Abstract. In 1991 and 1992, a prenatal screening of Trypanosoma cruzi infection was carried out using ELISA and indirect immunofluorescence techniques. A total of 840 blood samples from pregnant women, obtained at the Maternity Ward of the Hospital de Clínicas, National University of Asunción (Asunción, Paraguay), and 1,022 samples from the Regional Hospital of the San Pedro Department of Paraguay were examined. It was observed that 7.7% and 10.5%, respectively, of the pregnant women were serologically positive for infection with T. cruzi. When blood samples obtained from newborns on the day of birth or, at the most, on the first few days afterwards were examined by direct microscopic observation, an incidence of congenital transmission of 3% was found. These results are consistent with those of neighboring countries. When a serologic follow-up was conducted on the newborns until six months of age, the incidence of congenital transmission reached 10%. The same incidence rate was obtained when the samples collected during the first days after birth were examined by the polymerase chain reaction (PCR). Fiftyeight infants born to seropositive mothers were followed-up, two of which were positive by direct microscopic observation at birth, and four who were PCR-positive, but microscopy-negative at birth. None of the infants were positive for IgM at birth. The infected babies were treated with benznidazole and were followed-up by serology and PCR for four years. We conclude that the PCR has a clear advantage over conventional techniques for the early detection of congenital transmission of T. cruzi infection, and for monitoring infants undergoing chemotherapy.

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Section: Distribution Of Infectedmentioning

confidence: 99%

Treatment of congenital Chagas' disease diagnosed and followed up by the polymerase chain reaction.

Russomando¹,

Tomassone²,

Guillén³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

134

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“…52 Specific IgMs have been found in newborns with transplacental T. cruzi infection. [53][54][55] However, anti-T. cruzi IgM testing have shown false-positive and false-negative results. 3 The finding of specific IgG antibodies by enzyme immunoassay (EIA) or any other conventional test (indirect immunofluorescence [IIF] or indirect hemagglutination [IHA]) in the newborn is of no use because the antibodies may have likely been transmitted from the mother.…”

Section: Resultsmentioning

confidence: 99%

Congenital Chagas Disease: Estimating the Potential Risk in the United States

Yadón¹,

Schmuñis²

2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. Economic hardship and/or political turmoil stimulated migration of Trypanosoma cruzi -infected population from Latin American countries to the United States and Europe; originating cases of Chagas disease were transmitted through blood, organ donation, and vertical transmission. Hispanic immigrant women of reproductive age in the United States coming from Chagas disease-endemic countries accounted for 2,384,644, and 5,841,538 in 1990 and 2000, respectively. Considering the prevalence rates for T. cruzi infection in their country of origin and the risk of newborns from infected mothers to acquire congenital infection as 1.33% and 5%, we estimated that the number of T. cruzi -infected newborns was 85-318 in 1990 and 166-638 in 2000. Diagnosis of infection in the mother and newborns at risk is needed. A high rate of cure is achieved, almost 100%, when the offspring is treated early. Health authorities, professional associations, physicians, and Hispanic groups should pay more attention to the subject.

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“…According to GRILL et al 15 , fetal infection can occur at any gestational age and the fetus at birth can be in the chronic phase. More recently, LORCA et al 19 found IgM antibodies at birth in 8/12 newborns with congenital Chagas' disease and only after 1 to 2 months of life was possible to detect IgM antibodies in all children. The same authors explained this fact by the hypothesis of fetal infection in a late phase of the gestation, delaying the detection of IgM antibodies at birth.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of T. cruzi at birth substantiates the diagnosis of congenital Chagas' disease. The detection of IgM antibodies by serological methods is possible with the use of a specific acute phase protein (SAPA) in Western blotting 32 , or SAPA recombinant proteins 19 , but these antibodies are not always found at birth in spite of the presence of circulating T. cruzi 3,6,12,19 .…”

Section: Introductionmentioning

confidence: 99%

A survey of congenital Chagas’ disease, carried out at three Health Institutions in São Paulo City, Brazil

Nisida

Neto

Braz

et al. 1999

Rev. Inst. Med. trop. S. Paulo

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The congenital transmission of Chagas’ disease was evaluated in 57 pregnant women with Chagas’ disease and their 58 offspring. The patients were selected from three Health Institutions in São Paulo City. The maternal clinical forms of Chagas’ disease were: indeterminate (47.4%), cardiac (43.8%) and digestive (8.8%); 55 were born in endemic areas and two in São Paulo City. The transmission of Chagas’ disease at fetal level was confirmed in three (5.17%) of the 58 cases studied and one probably case of congenital Chagas’ disease. Two infected infants were born to chagasic women with HIV infection and were diagnosed by parasitolological assays (microhematocrit, quantitative buffy coat-QBC or artificial xenodiagnosis). In both cases the placenta revealed T. cruzi and HIV p24 antigens detected by immunohistochemistry. In one case, a 14-week old abortus, the diagnosis of congenital T. cruzi infection was confirmed by immunohistochemistry. The other probable infection, a 30-week old stillborn, the parasites were found in the placenta and umbilical cord. The Western blot method using trypomastigote excreted/secreted antigens of T. cruzi (TESA) was positive for IgG antibodies in 54/55 newborns and for IgM in 1/55 newborns. One of the two newborns with circulating parasites had no detectable IgG or IgM antibodies. The assessment of IgG antibodies in the sera of pregnant women and their newborns was performed by ELISA using two different T. cruzi antigens: an alkaline extract of epimastigotes (EAE) and trypomastigote excreted/secreted antigens (TESA). The analysis showed a linear correlation between maternal and newborn IgG antibody titers at birth.

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Diagnostic Value of Detecting Specific IgA and IgM with Recombinant Trypanosoma cruzi Antigens in Congenital Chagas' Disease

Cited by 31 publications

References 0 publications

Treatment of congenital Chagas' disease diagnosed and followed up by the polymerase chain reaction.

Treatment of congenital Chagas' disease diagnosed and followed up by the polymerase chain reaction.

Congenital Chagas Disease: Estimating the Potential Risk in the United States

A survey of congenital Chagas’ disease, carried out at three Health Institutions in São Paulo City, Brazil

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