[Congenital toxoplasmosis. 5 cases of mother-to-child transmission of pre-pregnancy infection].
Five cases of congenital toxoplasmosis consecutive to a maternal toxoplasma infection that had preceded pregnancy were observed. One woman with normal immune system had developed a well-documented lymph node toxoplasmosis 2 months before conceiving. Four women had chronic toxoplasmosis diagnosed in the course of an immunosuppressive disease: Hodgkin's disease in 1 case, systemic lupus erythematosus in 2 cases and pancytopenia in 1 case. Toxoplasmosis had been recognized 3, 5 and 10 years respectively before conception in 3 women, and at an uncertain date in 1 woman. Three women had received corticosteroids during pregnancy, and 2 had undergone splenectomy. Among the 6 children (2 were twins), 1 presented with severe foetal disease at birth, 1 developed lethal systemic toxoplasmosis after birth, 1 showed hydrocephalus with therapeutically well-controlled chorioretinitis, 1 had isolated eye lesion and 2 had asymptomatic infection. The parasite seems to have been transmitted after the 20th week of pregnancy in all cases. The physiopathology of mother-to child toxoplasma transmission, the role played by maternal immunodeficiency and the practical implications of these exceptional cases are discussed.
Desmonts
G
G
Laboratoire de la Toxoplasmose, Institut de Puériculture, Paris.
Couvreur
J
J
Thulliez
P
P
D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007111:Immunity, Cellular; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012698:Serologic Tests; D014125:Toxoplasmosis, Congenital / Q000150:complications / Q000175:diagnosis / Q000635:transmission*
Toxoplasmose congénitale. Cinq cas de transmission à l'enfant d'une infection maternelle antérieure à la grossesse.