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Krull E, Taraschi G, El Amari EB, Pellegrinelli JM, Martinez de Tejada B. Congenital toxoplasmosis after adalimumab treatment before pregnancy. J Obstet Gynaecol Res 2021; 47:4055-4059. [PMID: 34382299 PMCID: PMC9292430 DOI: 10.1111/jog.14973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/11/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
We present a case of congenital toxoplasmosis (TXP) in a woman with Toxoplasma gondii infection more than 6 months before conception. The woman has been treated with adalimumab for ankylosing spondylitis for 4 years until 5 months before conception. TXP serology at the first trimester was compatible with infection prior pregnancy. An ultrasound performed at 26 weeks gestation (WG) showed cerebral echogenic lesions compatible with intrauterine infection. Amniocentesis was performed which confirmed TXP fetal infection. Termination of the pregnancy was performed upon parent's requests and the fetal autopsy confirmed the diagnosis. Here, we discuss the potential role of immunosuppressive treatments, such as adalimumab, in the risk of congenital toxoplasmosis and the importance of counseling before pregnancy.
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Affiliation(s)
- Eloïse Krull
- Obstetrics Service, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals, Geneva, Switzerland
| | - Gianmarco Taraschi
- Obstetrics Service, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals, Geneva, Switzerland
| | | | - Jean-Marie Pellegrinelli
- Obstetrics Service, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Obstetrics Service, Department of Pediatrics, Gynecology, and Obstetrics Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Yu PA, Tran EL, Parker CM, Kim HJ, Yee EL, Smith PW, Russell Z, Nelson CA, Broussard CS, Yu YC, Meaney-Delman D. Safety of Antimicrobials During Pregnancy: A Systematic Review of Antimicrobials Considered for Treatment and Postexposure Prophylaxis of Plague. Clin Infect Dis 2020; 70:S37-S50. [PMID: 32435799 PMCID: PMC10867625 DOI: 10.1093/cid/ciz1231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The safety profile of antimicrobials used during pregnancy is one important consideration in the decision on how to treat and provide postexposure prophylaxis (PEP) for plague during pregnancy. METHODS We searched 5 scientific literature databases for primary sources on the safety of 9 antimicrobials considered for plague during pregnancy (amikacin, gentamicin, plazomicin, streptomycin, tobramycin, chloramphenicol, doxycycline, sulfadiazine, and trimethoprim-sulfamethoxazole [TMP-SMX]) and abstracted data on maternal, pregnancy, and fetal/neonatal outcomes. RESULTS Of 13 052 articles identified, 66 studies (case-control, case series, cohort, and randomized studies) and 96 case reports were included, totaling 27 751 prenatal exposures to amikacin (n = 9), gentamicin (n = 345), plazomicin (n = 0), streptomycin (n = 285), tobramycin (n = 43), chloramphenicol (n = 246), doxycycline (n = 2351), sulfadiazine (n = 870), and TMP-SMX (n = 23 602). Hearing or vestibular deficits were reported in 18/121 (15%) children and 17/109 (16%) pregnant women following prenatal streptomycin exposure. First trimester chloramphenicol exposure was associated with an elevated risk of an undescended testis (odds ratio [OR] 5.9, 95% confidence interval [CI] 1.2-28.7). Doxycycline was associated with cardiovascular malformations (OR 2.4, 95% CI 1.2-4.7) in 1 study and spontaneous abortion (OR 2.8, 95% CI 1.9-4.1) in a separate study. First trimester exposure to TMP-SMX was associated with increased risk of neural tube defects (pooled OR 2.5, 95% CI 1.4-4.3), spontaneous abortion (OR 3.5, 95% CI 2.3-5.6), preterm birth (OR 1.5, 95% CI 1.1-2.1), and small for gestational age (OR 1.6, 95% CI 1.2-2.2). No other statistically significant associations were reported. CONCLUSIONS For most antimicrobials reviewed, adverse maternal/fetal/neonatal outcomes were not observed consistently. Prenatal exposure to streptomycin and TMP-SMX was associated with select birth defects in some studies. Based on limited data, chloramphenicol and doxycycline may be associated with adverse pregnancy or neonatal outcomes; however, more data are needed to confirm these associations. Antimicrobials should be used for treatment and PEP of plague during pregnancy; the choice of antimicrobials may be influenced by these data as well as information about the risks of plague during pregnancy.
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Affiliation(s)
- Patricia A Yu
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Emmy L Tran
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
- Eagle Global Scientific, LLC, San Antonio, Texas, USA
| | - Corinne M Parker
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
- Chenega Professional and Technical Services, LLC, Atlanta, Georgia, USA
| | - Hye-Joo Kim
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
- Chenega Professional and Technical Services, LLC, Atlanta, Georgia, USA
| | - Eileen L Yee
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
- Chenega Professional and Technical Services, LLC, Atlanta, Georgia, USA
| | | | - Zachary Russell
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education CDC Fellowship Program, Atlanta, Georgia, USA
| | - Christina A Nelson
- Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado, USA
| | - Cheryl S Broussard
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
| | - Yon C Yu
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Dana Meaney-Delman
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
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Shariat Bahadory E, Dalir Ghaffari A, Namrood S, Mosavipour SS, Sadraie J. Electrochemiluminescence Epidemiologic Detection of Toxoplasma gondii Infection in Pregnant Women With Direct and Indirect Diagnostic Techniques (ELISA Avidity Plus Biochemical Assay), Tehran, Iran. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2019. [DOI: 10.15171/ijer.2019.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Toxoplasmosis is a very common disease in the world and has two types, including chronic and acute toxoplasmosis. In the chronic toxoplasmosis, the abnormality of tissue function is negligible, but in acute toxoplasmosis, the function of the reticuloendothelial system is interrupted and the assessment of Toxoplasma antibody with tissue enzymes is very essential in this stage. In addition, in some conditions, serum ferritin increases in the acute phase of the infectious disease. In congenital toxoplasmosis, the evaluation of biochemical factors and IgG avidity test is important for detecting the acute congenital toxoplasmosis in pregnant women. Based on the above-mentioned explanations, the present study aimed to evaluate the biochemical factors in patients with acute toxoplasmosis (congenital toxoplasmosis) among the Iranian population using electrochemiluminescence and IgG ELISA avidity. Methods: The study was based on a comparative abundance study and was conducted from March to June 2017. Material included 980 serum and amniotic fluid samples collected from human blood with a high level of IgG antibody against Toxoplasma gondii in Rajaie Center, Tehran, Iran. The standard and the main tests included the ELISA assay and the measurement of the liver transaminases (i.e., SGOT and SGPT), along with/namely bilirubin and ferritin used to detect IgG antibodies and to evaluate the acute toxoplasmosis, respectively. Finally, the results were analyzed by SPSS software. Results: The results showed that the level of liver transaminases, namely, serum bilirubin and ferritin increase in some patients with a high level of IgG avidity antibody against Toxoplasma gondii. For example, the mean serum levels of SGOT was 108 IU/L in 120 patients with acute toxoplasmosis and the mean serum bilirubin was about 5 mg/dL in 80 patients. Conclusion: Overall, in acute congenital toxoplasmosis, the evaluation of IgG AVIDITY is regarded as the first step and then the measurement of biochemical factors such as serum transaminases, serum bilirubin, and serum ferritin is important.
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Affiliation(s)
- Ehsan Shariat Bahadory
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, Iran
| | - Ali Dalir Ghaffari
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, Iran
| | - Somayyeh Namrood
- Assistant Professor, Department of Environmental Sciences, Faculty of Fisheries and Environmental Sciences, University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | | | - Javid Sadraie
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, Iran
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Piao LX, Cheng JH, Aosai F, Zhao XD, Norose K, Jin XJ. Cellular immunopathogenesis in primary Toxoplasma gondii
infection during pregnancy. Parasite Immunol 2018; 40:e12570. [DOI: 10.1111/pim.12570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Lian Xun Piao
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
| | - Jia Hui Cheng
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
| | - Fumie Aosai
- Department of Infection and Host Defense; Graduate School of Medicine; Chiba University; Chiba Japan
- Department of Infection and Host Defense; Graduate School of Medicine; Shinshu University; Matsumoto Japan
| | - Xu Dong Zhao
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
| | - Kazumi Norose
- Department of Infection and Host Defense; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Xue Jun Jin
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
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Alvarado-Esquivel C, Rascón-Careaga A, Hernández-Tinoco J, Corella-Madueño MAG, Sánchez-Anguiano LF, Aldana-Madrid ML, Almada-Balderrama GJ, Nuñez-Aguirre AD, Liesenfeld O. Seroprevalence and correlates of Toxoplasma gondii infection in Yoremes (Mayos) in Mexico: a cross-sectional study. BMJ Open 2016; 6:e010218. [PMID: 27173808 PMCID: PMC4874141 DOI: 10.1136/bmjopen-2015-010218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES We sought to determine the prevalence of anti-Toxoplasma gondii antibodies in Yoremes and to identify associations of T. gondii exposure with sociodemographic, clinical and behavioural characteristics of Yoremes. DESIGN A cross-sectional survey. SETTING Yoremes were enrolled in the locality of Tierra Blanca in the municipality of Navojoa in Sonora State, Mexico. PARTICIPANTS We studied 200 Yoremes (Mayos); they are an indigenous ethnic group living in a coastal region in northwestern Mexico. PRIMARY AND SECONDARY OUTCOME MEASURES We assessed the prevalence of anti-Toxoplasma IgG and IgM antibodies in participants using enzyme-linked immunoassays. We used a standardised questionnaire to obtain the characteristics of Yoremes. The association of T. gondii exposure and Yoremes' characteristics was assessed by bivariate and multivariate analyses. RESULTS Of the 200 Yoremes studied (mean age: 31.50±18.43 years), 26 (13.0%) were positive for anti-T. gondii IgG antibodies and 19 (73.1%) of them were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection did not vary with sex, educational level, occupation or socioeconomic status. In contrast, multivariate analysis of sociodemographic and behavioural characteristics showed that T. gondii exposure was associated with increasing age (OR=1.02; 95% CI 1.00 to 1.04; p=0.03) and consumption of squirrel meat (OR=4.99; 95% CI 1.07 to 23.31; p=0.04). Furthermore, seroprevalence of T. gondii infection was significantly higher in Yoremes with a history of lymphadenopathy (p=0.03) and those suffering from frequent abdominal pain (p=0.03). In women, T. gondii exposure was associated with a history of caesarean sections (p=0.03) and miscarriages (p=0.02). CONCLUSIONS We demonstrate, for the first time, serological evidence of T. gondii exposure among Yoremes in Mexico. Results suggest that infection with T. gondii might be affecting the health of Yoremes. Results may be useful for an optimal design of preventive measures against T. gondii infection.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Faculty of Medicine and Nutrition, Biomedical Research Laboratory, Juárez University of Durango State, Durango, Mexico
| | - Antonio Rascón-Careaga
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Sonora, Mexico
| | - Jesús Hernández-Tinoco
- Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juárez University of Durango State, Durango, Mexico
| | | | | | | | | | | | - Oliver Liesenfeld
- Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charité Medical School, Berlin, Germany
- Roche Molecular Diagnostics, Pleasanton, California, USA
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