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Analysis for toxoplasmosis igg 241 norm 125. Features of the analysis for toxoplasmosis

Toxoplasmosis is a disease that is rarely accompanied by pronounced symptoms. Most people do not even realize that this infection is present in their body. This is found out only after the person has passed the test for toxoplasmosis. The diagnosis of the disease is given great importance. Cases have been recorded when its progression led to dangerous consequences.

The disease affects the nervous, visual, cardiovascular, lymphatic systems, muscles, spleen and liver. It is extremely dangerous for pregnant women, because. can provoke a miscarriage or cause the development of various pathologies in the child. That is why the importance of tests for toxoplasmosis is very high. Timely diagnosis is the key to successful treatment.

Methods of infection

In most cases, human infection occurs after contact with cat feces (for example, when cleaning their toilet). Also, the disease is transmitted from mother to child during pregnancy (i.e. in utero).

Factors that increase the risk of infection are:

Eating eggs and meat that are raw or have not been thoroughly cooked. This is especially true of pork, lamb and venison.
Violation of the integrity of the skin. The pathogen can enter the body through wounds, abrasions, cuts, etc.
Contact with the ground, after which the person touches the mouth.
Organ transplantation or transfusion of fluid connective tissue or its components (extremely rare).

Toxoplasmosis is diagnosed in people of any gender and age, but most often in children.

Forms and symptoms

There are 2 types of the disease: acquired and congenital.

The first, in turn, can be:

Sharp. It is characterized by many pronounced symptoms: a deterioration in general well-being, pain in muscles and joints, fever, swollen lymph nodes, a rash all over the body (except for the feet, hands and head). In addition, there are signs of pneumonia, hepatitis, lesions of the nervous and cardiovascular systems.
Chronic. Its feature is a long course, periods of exacerbation pass into the stage of remission and vice versa. The main symptoms of toxoplasmosis in humans with this form are: muscle and joint pain, memory impairment, irritability, swollen lymph nodes, constipation, intestinal colic, palpation reveals seals in the muscles, eye damage, and disruption of the cardiovascular system.
Latent. This form is the most common and proceeds, as a rule, without any signs indicating an existing disease. It is diagnosed only after the person has been tested for toxoplasmosis. Severe course occurs in people with HIV. They affect almost all organs, which can lead to death.

Congenital toxoplasmosis is a form of the disease in which the child is infected in utero from the mother. If the infection occurred in the first half of pregnancy, the fetus in most cases dies, in the second - the baby is born with serious pathologies of the brain. In this case, the child has: convulsions, epilepsy, tremor, nystagmus, increased head size, tense fontanels, thinned skull bones, atrophy of the optic nerves, mental retardation, psycho-emotional disorders, jaundice. Accession of a secondary infection provokes an increase in the degree of brain damage, which can lead to death.

Thus, the symptoms of toxoplasmosis in humans can either be absent or have a pronounced character. A few years ago, children with a congenital form died, as a rule, in the first years of life. At present, the timely delivery of an analysis for toxoplasmosis plays a decisive role - if an infection is detected, it is possible to stabilize it or get rid of it altogether (but some residual effects may be observed).

Indications

An analysis for toxoplasmosis is prescribed:

when examining women planning a pregnancy, as well as those who have already had it;
if a person has enlarged lymph nodes for no apparent reason;
HIV-infected;
with a simultaneous increase in the liver and spleen for an unclear reason;
with a painful condition of unknown origin, which is accompanied by chills and fever;
if a previous test result for toxoplasmosis was questionable.

It is not always possible to find among the directions that which is necessary, but it is. What is the test for toxoplasmosis called? The form should indicate: "TORCH infection." This study involves donating blood for toxoplasmosis, rubella, cytomegalovirus and herpes.

Types of analyzes

To date, the most popular methods for detecting the disease are:

ELISA. This abbreviation stands for enzyme immunoassay. With its help, immunoglobulins G and M (IgG and IgM) are detected in the blood. These are antibodies that are produced by the body in response to the penetration of pathogen antigens into it. In this case, immunoglobulins accumulate in the blood in certain concentrations, called titers. The difference between IgG and IgM is that the latter are produced by the defense system at the onset of the disease. Their maximum concentration is reached in 2-3 weeks, then it declines and soon the antibodies disappear. Immunoglobulins G begin to be produced a few days later (about 3 days) and remain in the blood for a long time, in some people for life. It is thanks to this that, having been ill once, a person is protected from toxoplasmosis when the pathogen re-enters the body.
PCR (polymerase chain reaction). As a rule, this method is used if a previous blood test for toxoplasmosis gave a questionable result. PCR is a more accurate method, but its cost is higher. Its essence lies in the identification of DNA and RNA molecules of Toxoplasma. A sample of blood, urine, or saliva may be taken for testing. The analysis is not quantitative, it can only have 2 results - positive or negative.

Other, less common methods for determining toxoplasmosis are:

Diagnosis of the congenital form in newborns involves the collection of anamnesis of the mother and the study of the results of serological studies.

Preparation

Before donating the biomaterial, no special rules are required. Regarding how to take an analysis for toxoplasmosis, the doctor who issued the referral should inform.

As a rule, it is enough to follow the standard recommendations:

12 hours to exclude meat dishes and fatty foods from the diet;
48 hours to refrain from drinking alcohol-containing drinks.

This is due to the fact that the above products affect the properties of blood serum. Due to this, the results may be inaccurate, and their interpretation will be difficult.

Biomaterial sampling

In most cases, the analysis requires blood from a vein.

Its sampling is carried out according to the standard algorithm:

the nurse applies a tourniquet to the area above the bend of the elbow;
within a few seconds, the veins fill with blood;
a puncture is made with a thin needle;
blood enters the test tube, the nurse removes the tourniquet;
the puncture site is clamped with a sterile napkin.

If, for some reason, blood sampling from the cubital vein is not possible, another vessel is selected, located, for example, on the hand.

The procedure can be carried out at any time of the day.

Interpretation of results

The doctor who issued the referral should study the conclusion received. Nevertheless, deciphering the analysis for toxoplasmosis is not difficult for the patient himself. As a rule, the form contains appropriate explanations regarding the norm and deviations from it.

If they are not available, the following information will be needed to decipher the blood test for toxoplasmosis by ELISA:

IgM and IgG were not found. This result is considered good. It means that the analysis for toxoplasmosis is negative, i.e. the person is not currently infected and has never been infected before.
IgM negative, IgG positive. A controversial result, which may indicate both a chronic form and the presence of persistent immunity to the disease. In this case, the indicator of avidity is important.
IgM positive, IgG negative. This result indicates a primary infection occurring in an acute form. It is necessary to additionally donate blood for analysis by PCR and conduct another study in 1-2 weeks.
IgM positive, IgG positive. A controversial result, which can indicate both primary infection and the fact that the body is in the recovery stage. It is necessary to donate blood for analysis by PCR and study the avidity index.

The latter provides information on how strongly the antibodies are associated with the pathogen, in response to the penetration of which they are formed.

Avidity can be:

< 40 % - первичное инфицирование;
41-59% - it is necessary to retake the analysis (transitional state);
> 60% - the disease was transferred in the past, at present the body has strong immunity.

With regard to titers, their normal values are established by each laboratory. This is due to the use of different reagents.

If the result is positive

The defense system can fight the disease on its own. If the body cannot cope with the infection, the doctor individually draws up a medication regimen.

If during pregnancy the test for toxoplasmosis turned out to be positive, this may be an indication for its interruption. Additionally, a study of amniotic fluid is prescribed. If DNA of the pathogen is detected in them, the decision is made based on the results of ultrasound. If there are no abnormalities in the development of the fetus, the pregnancy can be saved, but the child will be treated after birth to reduce the number of complications.

Where to submit?

Biomaterial sampling is carried out in any laboratory on a paid basis. According to the medical policy, pregnant women can take blood for analysis at the antenatal clinic. The possibility of conducting an analysis in a polyclinic at the place of residence must be clarified at the registry.

Price

The price of analysis for toxoplasmosis is an average of 1200 rubles. It does not include the cost of blood sampling.

Finally

Toxoplasmosis is a disease that can have several forms and occur both with pronounced symptoms and without it. The disease is especially dangerous for women during pregnancy, because. it increases the chance of miscarriage and the risk of serious complications in the baby. Timely delivery of tests will help reduce their number or completely avoid.

Symptoms of toxoplasmosis

If toxoplasmosis is acquired, then the disease is asymptomatic or with minimal clinical signs from mild forms to generalization of the process, or acquires a primary chronic course. The incubation period is usually within 3 weeks. In the acute course of the disease, body temperature rises to 38-39 ° C, weakness, severe headache, muscle and joint pain, and weight loss appear. Perhaps the appearance of a maculopapular rash, which merges, spreads over the entire surface of the body, with the exception, however, of the palms and soles. Typical signs are enlargement of the liver and spleen, regional lymph nodes, which are painful to the touch. In generalized forms, there are, among other things, myocarditis with cardiac arrhythmias and signs of heart failure, changes in the central nervous system in the form of encephalitis or meningitis, or a combination of both. Acquired toxoplasmosis in the vast majority ends with convalescence or less often acquires a chronic course, which is characterized mainly by signs of prolonged intoxication and asthenovegetative syndrome.

For congenital toxoplasmosis in newborns infected in the first trimester of pregnancy, the classic triad of hydrocephalus, chorioretinitis and intracranial calcifications is characteristic, as well as jaundice, pneumonia, or a clinical picture of sepsis. Newborns infected at the end of pregnancy usually have no clinical signs of the disease at birth.

Diagnosis of toxoplasmosis

The diagnosis is based on a thorough medical history, clinical symptoms and the results of serological tests (ELISA, PCR), as well as an additional examination confirming organ damage (ECG, EEG, skull X-ray, CT), consultations of an ophthalmologist, cardiologist and neurologist.

Differential diagnosis is carried out with lymphogranulomatosis, tuberculosis, rheumatism, infectious mononucleosis and herpetic infection.

Treatment of toxoplasmosis

Essential drugs

There are contraindications. Specialist consultation is required.

Pyrimethamine (an antiprotozoal). Dosage regimen: inside, 0.1-0.2 g per day in 2 doses for 2 days, then 0.025 g inside 1 time per day for 4-5 weeks.
Sulfadiazine (antimicrobial agent). Dosage regimen: inside, 4-6 g per day in 4 divided doses for 4-5 weeks.
Spiramycin (antibacterial agent). Dosage regimen: inside 1 g (3,000,000 IU) 3 times a day for 2-3 weeks.
(antibacterial agent). Dosage regimen: inside, 0.45 g 3 times a day or 0.6 g intravenously 4 times a day. IV infusions are prescribed only for adults.

Let's analyze the widely used tests for toxoplasmosis, when the patient simply donated blood in the laboratory. And the first of them is PCR.

PCR

Antibodies, class M immunoglobulins

If class M antibodies are found in the blood of a pregnant woman and class G antibodies gradually increase, which will be discussed below, then this indicates a primary infection, a fresh process. It is in this case, even if a woman feels normal, she needs to be urgently treated to prevent infection of the fetus and the appearance of congenital malformations.

Also, the detection of these immunoglobulins makes it possible to diagnose acute toxoplasmosis in newborn babies. The fact is that class G immunoglobulins are common in both the mother and the baby.

Therefore, when they are found in a child, he himself may be healthy, but the antibodies came to him from an ill, and even a recovered mother. But class M immunoglobulins cannot pass through the placenta in any way, and therefore, if they are found in the blood of a child, then the decoding of the analysis indicates that he is sick with toxoplasmosis and received it in utero. The detection of class M immunoglobulins in a baby allows not only making an early diagnosis, but also starting urgent treatment, even in the case of a low antibody titer.

Class G antibodies to toxoplasma

We have already said enough about pregnant women, a blood test for toxoplasmosis is mandatory for them, and more than once. But in what cases should the analysis for toxoplasmosis be prescribed to other categories of the population? What are the indications for the appointment of PCR and the study of immunoglobulins for toxoplasmosis?

Indications for a blood test

In addition to the study of pregnant women, as well as women who wish to become pregnant, examination for toxoplasmosis is required for the following categories of the population:

enlargement of the liver and spleen of an unclear nature, or hepatosplenomegaly syndrome;
prolonged and vague fever;
acquired immunodeficiency, as well as HIV infection;
chronic damage to muscle tissue, or myositis, (after all, toxoplasmosis can affect muscles);
Lymphadenopathy (enlarged lymph nodes), including generalized, in the absence of other causes;
habitual miscarriage (this is a separate case);
severe neurological disease, such as encephalitis, in the absence of other causes.

Finally, a blood test for toxoplasmosis should be taken from those family members who have all of the above conditions, or simply chronic infections, fever and malaise in the presence of cats in the house.

How to donate blood for toxoplasmosis?

In order to donate blood for toxoplasmosis, no special preparations are needed. Ordinary venous blood is given, which is taken from the cubital vein. The analysis should be carried out in the morning on an empty stomach, and on the eve of the analysis it is desirable to limit physical activity, not to drink alcoholic beverages, and it is advisable not to smoke at least an hour before blood sampling. No other special preparations are required.

How can one interpret the results of all the analyzes mentioned above?

PCR

In the event that we are talking about antibodies, or immunoglobulins, then they have their own norm in the blood, or titer. If the patient is talking about class M immunoglobulins, then the threshold value is 1.1 c.u. (conventional unit). Above this value and inclusive, it is considered that specific antibodies have been detected.

If the patient's antibody titer is less than 0.9 conventional units, then there are no antibodies. Of course, this range is too narrow. But here you have to focus on additional information from the anamnesis. In the case of positive values, we can talk about both acute infection and its indefinite period (up to a year), as well as congenital toxoplasmosis, but only if the study was done in the first weeks of the baby's life. If class M immunoglobulins to toxoplasma are not detected, then this may indicate not only that the person is healthy, but also that he is sick, only the duration of the disease is insignificant, for example, less than 3 weeks, and antibodies of this class simply did not have time to develop.

Class G immunoglobulins have slightly different reference values. If the plasma is 1.6 cu and less, then the conclusion is made - “negatively”. More than 3 at. e is positive.

If a patient has more than 3 cu in the blood serum. That is, including repeated studies, this indicates the activation of the infection and its spread in the body, and a decrease in antibody titer indicates, for example, successful treatment.

What can the doctor conclude in case of negative values? Firstly, that a person is healthy if at the same time he has negative PCR and immunoglobulins M. Secondly, a patient against a toxoplasmosis infection may simply have very weak immunity, which prevents the production of normal antibodies. And, as in the previous case, we can talk about an acute infection - up to two weeks after infection.

Toxoplasmosis is a serious infection. It should be remembered that, along with cytomegalovirus and rubella, it is included in the so-called group, which is especially dangerous for pregnant women and for the development of the child. And this means that a consultation and laboratory examination for this group of infections must be done 3 months before the planned pregnancy, because if anything is revealed, it will be possible to take measures for diagnosis and treatment, to prevent infection of the unborn baby.

Content

After penetration into the human body, Toxoplasma colonizes its intestines. With the flow of blood and lymph, they spread throughout the body. Toxoplasma affects the spleen, liver, organs of vision, nervous, lymphatic and cardiovascular systems. The disease is dangerous for people with weakened immune systems. Indications for the study:

enlargement of the liver and spleen for an unknown reason;
planning pregnancy and the period of bearing a child;
chills and fever of unknown origin;
enlarged lymph nodes (without an identified cause);
doubts after a previous analysis for this infection;
immunodeficiency states.

Types of tests for toxoplasmosis

The purpose of the analysis is to identify the presence of toxoplasma in the body. The study is carried out in several ways. They have different sensitivity, give qualitative or quantitative results. Types of research on toxoplasmosis:

Name	a brief description of	Cost, rubles
Common types of research
ELISA blood test for toxoplasmosis (ELISA)	ELISA sensitivity reaches 90%. The study helps to track the dynamics of the development of the disease. The essence of the analysis is to identify the immune response of the body, and not the pathogen itself. In human blood, the level of specific antibodies is determined: Immunoglobulin M (IgM). Produced by the immune system at the onset of the disease. The concentration reaches a maximum after 2-3 weeks. Then the number decreases and soon the antibodies disappear. Immunoglobulin G (IgG). Appear after 3 days as a secondary response to infection. They remain in the blood for a long time, in some patients - for life. Due to antibodies, a person remains protected from toxoplasmosis, which he had been ill with. Antibodies are specific proteins. They are produced by immune cells lymphocytes in response to the penetration of pathogens into the body. ELISA allows you to compare the amount of antibodies at different time intervals. The study also determines the avidity index (strength of antibody binding to pathogen proteins).
Polymerase chain reaction (PCR)	It is carried out if the ELISA gave questionable results. Gives more accurate results. The essence of the analysis is the detection of Toxoplasma DNA and RNA in biological material: blood, urine, saliva. PCR does not detect the number of pathogens, but only determines their presence. The sensitivity of the study is 10-1000 cells in a taken sample. For microscopic and immunological methods, this figure is 103-105. From one biological sample, several pathogens can be detected at once.
Less Popular Studies
swab from tonsils	Detects the presence, type and number of pathogens that cause infection.
Smear from the sediment of cerebrospinal fluid	The study helps to identify lesions of the central nervous system. In the study, the color of the cerebrospinal fluid and the presence of blood cells in it are studied.
Intradermal test with toxoplasmin	A person is given an injection, after which the reaction of the body is monitored. It is studied after 24-48 hours. A positive result is redness and swelling at the site of the test.

Preparation

No special preparation is required for PCR analysis. The patient should not eat fried food the day before. In the morning before the analysis, you can not eat or drink. To pass urine into a clean sterile container, collect its first morning portion. Features of preparation for ELISA:

How to take an analysis

For PCR research, biological fluids and human media are used. If toxoplasmosis is suspected, urine or blood may be taken from a vein.

The latter is taken on an empty stomach, as in enzyme immunoassay. Blood is taken from a vein as follows:

A tourniquet is applied to the area above the bend of the elbow. Within a couple of seconds, the vein fills with blood.
A thin needle is used to puncture a vein and draw blood.
The tourniquet is removed, and a sterile napkin is applied to the puncture site.

Deciphering enzyme immunoassay

After the study, the patient is given a form, which indicates the decoding of the analysis for toxoplasmosis. Sometimes it describes norms and deviations from it. When conducting an ELISA, 4 options for the results are possible:

Result	What does
IgM and IgG negative	The body has no natural immunity to infection, the person did not get sick with it. Pregnant women are at risk. They get tested for toxoplasmosis during pregnancy every trimester.
IgM positive, IgG negative	The patient has acute toxoplasmosis. During pregnancy, there is a high risk of intrauterine infection of the fetus, the occurrence of congenital toxoplasmosis, or malformations. A pregnant woman is prescribed PCR of urine and blood. After 2-3 weeks, the level of IgG and IgM is checked again.
IgM negative, IgG positive	It occurs in 65% of the population. It indicates chronic toxoplasmosis or persistent immunity to the disease. Take into account the indicator of avidity. At high values, the risk of infection is minimal. During pregnancy, a PCR study and determination of avidity are prescribed. A woman donates blood or urine.
IgM and IgG positive	This is an indicator of recent or acute toxoplasmosis. IgM antibodies are present in the blood for another 3-4 months after recovery. To clarify the results, the doctor prescribes PCR for toxoplasmosis. The avidity index is re-determined.

Deciphering the results of antibody avidity

Avidity refers to the ability of IgG to bind and eliminate foreign microorganisms from the blood. The higher this indicator, the higher the immunity to toxoplasmosis. As a result of the ELISA, the following avidity indicators are obtained:

Less than 40, or low. This is an indicator of acute primary toxoplasmosis. Pregnant women are prescribed a second analysis, and if infection is confirmed, treatment.
Within 41-59. These are values of the transition period of infection, so they are not considered reliable. The analysis must be taken again after 3 weeks.
Over 60 or high. The patient has good immunity to toxoplasmosis. Another possibility is that the person has a chronic or indolent infection. Acute toxoplasmosis is excluded.

PCR decoding

The PCR method is considered more accurate, but its cost is slightly higher. Such research is subject to increased demands. In this regard, PCR is more often prescribed after ELISA. Polymerase chain reaction is a study that gives only a qualitative result. It may be as follows:

positive. This indicates an acute infectious process in the body.
Negative. There are no traces of infectious agents in the material. The patient is healthy.

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