2018, Number 6
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Acta Pediatr Mex 2018; 39 (6)
Congenital toxoplasmosis in the Valley of Mexico. Results of a series of cases
Gómez-Toscano V, Linares-López KA, Arce-Estrada GE, Figueroa-Damián R, Barrios-Bautista DM, Hernández-Luengas L, Bonilla-Ríos CA, Tecuátl-Herrada BL, Luna-Pastén H, Macías-Parra M, Cañedo-Solares I, Saltigeral-Simentel P, Ortiz-Alegría LB, Bosch-Canto V, Rico-Torres CP, Ordaz-Favila JC, Vargas-Villavicencio JA, López-Candiani C, Xicoténcatl-García L, Hernández-Antúnez BG, Ruiz-García M, Escobedo-Torres MP, Rivera-González IR, González-González LO, Mora-González JC, Paredes-Alonzo IE, Flores-Lechuga AM, Hernández Delgado L, Correa D
Language: Spanish
References: 24
Page: 321-333
PDF size: 1977.17 Kb.
ABSTRACT
Background: In Mexico “virulent” strains of
Toxoplasma gondii prevail, so the clinical
picture may be different to that reported for regions where non-virulent strains are
present, such as Europe, United States and Canada.
Methods: We report a series of children with congenital toxoplasmosis recruited since
2005 by prenatal or postnatal screening, or because they arrived as clinical cases at
the INP.
Results: All the patients presented clinical manifestations, but the prenatal screening
group presented a more localized and less severe infection, mainly with spasticity and
mild psychomotor retardation. The postnatal screen group presented intermediate clinical
characteristics, with mild, moderate or severe psychomotor retardation, low birth
weight, micro or hydrocephalus, jaundice, hepatomegaly, splenomegaly, intracranial
calcifications and spasticity. The most affected patients were those that presented as
clinical cases, with a wide variety of clinical manifestations and the worst prognosis,
including death. Six patients presented comorbidities. Twenty cases were positive for
two or more laboratory tests; the rest only for one.
Conclusions: Our results support that congenital toxoplasmosis in Mexico is more
serious than in other countries, and that it is urgent to implement effective prenatal
screening for prevention and prophylaxis.
REFERENCES
Dunn D, Wallon M, Peyron F, Petersen E, Peckham C, Gilbert R. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. The Lancet. 1999;353(9167):1829-33.
Vela-Amieva M, Cañedo-Solares I, Gutiérrez-Castrellón P, Pérez-Andrade M, González-Contreras C, Ortíz-Cortés J, et al. Short report: neonatal screening pilot study of Toxoplasma gondii congenital infection in Mexico. Am J Trop Med Hyg.2005;72(2):142-4.
Ambroise-Thomas P, Petersen E. Congenital toxoplasmosis: scientific background, clinical management and control. Copenhagen, Denmark: Springer; 2000.
Wallon M, Garweg JG, Abrahamowicz M, Cornu C, Vinault S, Quantin C, et al. Ophtalmic outcomes of congenital toxoplasmosis followed until adolescence. Paediatrics.2014;133(3):e601-8.
Martín-Hernández I. Toxoplasmosis congénita: una mirada al problema. Rev Biomed. 2004;15:181-90.
Baquero-Artigao F, del Castillo-Martín F, Fuentes-Corripio I, Goncé-Mellgren A, Fortuny-Guasch C, de la Calle Fernández-Miranda M, et al. Guía de la Sociedad Española de Infectología Pediátrica para el diagnóstico y tratamiento de la toxoplasmosis congénita. An Pediatr. 2013; 79(2): 116.e1-116.e16.
Gómez JE, Ruiz B, Silva P, Beltrán S, Cortés J, Montoya J, et al. Guía de práctica clínica para toxoplasmosis durante el embarazo y toxoplasmosis congénita en Colombia. Infectio 2007;11(3): 129–41.
Durlach R, Kaufer F, Carral L, Freuler C, Ceriotto M, Rodríguez M, et al. Consenso argentino de toxoplasmosis congénita. Medicina (Buenos Aires). 2008; 68 (1): 75-87.
Rosso F, Agudelo A, Isaza A, Montoya JG. Toxoplasmosis congénita: aspectos clínicos y epidemiológicos de la infección durante el embarazo. Colomb Med. 2007; 38 (3): 316-37.
Rico-Torres CP, Vargas-Villavicencio JA, Correa D. Is Toxoplasma gondii type related to clinical outcome in human congenital infection? Systematic and critical review. Eur J Clin Microbiol Infect Dis. 2016; 35(7):1079-88.
Rico-Torres CP, Figueroa-Damián R, López-Candiani C, Macías-Avilés HA, Cedillo-Peláez C, Cañedo-Solares I, Luna-Pastén H, Tecuatl-Herrada BL, Correa D. Molecular diagnosis and genotyping of human cases of perinatal toxoplasmosis in Mexico. Ped Infect Dis. J. 2012; 31(4):411-3.
Rico-Torres CP, Valenzuela-Moreno LF, Luna-Pastén H, Figueroa-Damián R, Gómez-Toscano V, Hernández-Delgado L, Escobedo-Torres MP, Correa D. High heterogeneity, mixed infections and new genotypes in human congenital toxoplasmosis cases in the mega-metropolis of Central Mexico. Acta Trop. 2018; 178:124-9.
Feigin Cherry, Demmler-Harrison, Kaplan. Toxoplasmosis Chapter 235. En: Feigin & Cherry’s Textbook of Pediatric Infectious Diseases. 6th ed. Philadelphia: Saunders Elsevier; 2009. Pp. 2954-71.
Delhaes L, Ajzenberg D, Sicot B, Bourgeot P, Dardé ML, Dei-Cas E, et al. Severe congenital toxoplasmosis due to a Toxoplasma gondii strain with an atypical genotype: case report and review. Prenatal Diagnosis 2010; 30 (9): 902-905.
Cañedo-Solares I, Ortiz-Alegría LB, Figueroa-Damián R, Bustos-Bahena ML, González-Henkel H, Calderón-Segura E, Luna-Pastén H, Correa D. Toxoplasmosis in pregnancy: determination of IgM, IgG and avidity in filter paperembedded blood. J Perinatol. 2009; 29(10):668-72.
Caballero-Ortega H, Castillo-Cruz R, Murrieta S, Ortiz- Alegría LB, Calderón-Segura E, Conde-Glez CJ, et al. Diagnostic-test evaluation of immunoassays for anti- Toxoplasma gondii IgG antibodies in a random sample of Mexican population. J Infect Dev Ctries. 2014;8(5):642-7.
Cedillo-Peláez C, Rico-Torres CP, Salas-Garrido CG, Correa D. Acute toxoplasmosis in squirrel monkeys (Saimiri sciureus) in Mexico. Vet Parasitol. 2011;180(3-4):368-71.
Caballero-Ortega H, Ortíz-Alegría LB, Rico-Torres CP, Cedillo-Peláez C, Cañedo-Solares I, Besné-Mérida A, et al. Toxoplasmosis. En: Infecciones congénitas y perinatales. Estado del Arte. Primera edición. Correa D , Figueroa R (eds). México DF: Editorial Médica Panamericana, 2014. pp. 167-73.
Arce-Estrada GE, Gómez-Toscano V, Cedillo-Peláez C, Sesman-Bernal AL, Bosch-Canto V, Mayorga-Butrón JL, Vargas-Villavicencio JA, Correa D. Report of an unsual case of anophthalmia and craniofacial cleft in a newborn with Toxoplasma gondii congenital infection. BMC Infect Dis. 2017;17(1):459. doi: 10.1186/s12879-017-2565-8.19,20.
Tan DH, Asztalos E, Douglas D, Read S, Biltnum A. Congenital transmission of human inmunodeficiency virus, cytomegalovirus, and toxoplasmosis in premature infant. Pediatr Infect Dis J. 2009; 28 (12):1129-1131
Wallon M, Peyron F. Congenital Toxoplasmosis: A Plea for a Neglected Disease. Pathogens. 2018; 7: 25; doi:10.3390/ pathogens7010025.
Gras L, Wallon M, Pollak A, Cortina-Borja M, Evengard B, Hayde M, Petersen E, Gilbert R. Association between prenatal treatment and clinical manifestations of congenital toxoplasmosis in infancy: a cohort study in 13 European Centres. Acta Paediatr. 2005; 94: 1721–31.
Cañedo-Solares I, Galván-Ramírez M de L, Luna-Pastén H, Rodríguez-Pérez LR, Ortiz-Alegría LB, Rico-Torres CP, et al. Congenital toxoplasmosis: specific IgG subclases in mother/ newborn pairs. Pediatr Infect Dis J. 2008; 27(5): 469-74.
De Souza-e-Silva CH, Vasconcelos-Santos DV, Queiroz de Andrade G, Machado Carellos EV, de Castro Romanelli RM, Macedo de Resende L, et al. Association between IgG subclasses against Toxoplasma gondii and clinical signs in newborns with congenital toxoplasmosis. Pediatr Infect Dis J. 2013; 32: 13-16.