Intravenous Immunoglobulin Therapy: Confounding Effects on Serological Screening for Toxoplasmosis during Pregnancy

Abstract

The serological diagnosis of toxoplasmic infection during pregnancy is intended to prevent congenital infection of the fetus. However, in the context of recurrent pregnancy loss intravenous immunoglobulin therapy can create a biological trap for the interpretation of serological results, with potentially serious consequences for the outcome of the pregnancy.

False‐positive serology following intravenous immunoglobulin and plasma exchange through transfusion of fresh frozen plasma in a patient with pemphigus vulgaris

“…2 Rossi et al reported a pregnant patient who passively acquired anti-treponemal Ab through IVIG therapy, which could lead to social scrutiny. 3 Pelloux et al reported false-positive Toxoplasma serology through IVIG therapy in a pregnant woman, 4 which could result in mistaken antenatal diagnosis. In most reports, the phenomena were caused by highdose IVIG, but false-positive results of endotoxemia caused by low-dose IVIG (120-240 mg/kg/day) were also reported.…”

“…Pelloux et al . reported false‐positive Toxoplasma serology through IVIG therapy in a pregnant woman, which could result in mistaken antenatal diagnosis. In most reports, the phenomena were caused by high‐dose IVIG, but false‐positive results of endotoxemia caused by low‐dose IVIG (120–240 mg/kg/day) were also reported .…”

“…1 However, passive acquisition of various clinically important antibodies (Ab) through IVIG therapy and PE could lead to false serology results and negatively impact patients' clinical care. [2][3][4][5][6] This potential problem needs to be more widely publicized among dermatologists because there have been few reports in the literature. 2 Herein, we report false-positive serology following IVIG therapy and PE through transfusion of FFP in a patient with refractory PV.…”

“…For patients with refractory pemphigus vulgaris (PV), intravenous immunoglobulin (IVIG) therapy and plasma exchange (PE) through transfusion of fresh frozen plasma (FFP) are therapeutic options . However, passive acquisition of various clinically important antibodies (Ab) through IVIG therapy and PE could lead to false serology results and negatively impact patients' clinical care . This potential problem needs to be more widely publicized among dermatologists because there have been few reports in the literature .…”

An unusual case of anti-Borrelia burgdorferi immunoglobulin G seroconversion caused by administration of intravenous gammaglobulins

“…However, in our case diagnosis of Lyme borreliosis was definitely ruled out because the seroconversion of the specific IgG antibody was demonstrated as being due to passive immunization by the gammaglobulins. Such a serological pitfall has been more frequently observed in toxoplasmosis, from which one case reported in the literature involved a pregnant woman [18].…”