[Retrospective study of the implementation of the qualitative PCR technique in biological samples for monitoring toxoplasmosis in pediatric patients receiving hematopoietic stem cell transplantation].
Toxoplasmosis is an opportunistic infection caused by the parasite Toxoplasma gondii. The infection is severe and difficult to diagnose in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Twelve patients receiving HSCT were monitored post-transplant, by qualitative PCR at the Children's Hospital S.A.M.I.C. "Prof. Dr. Juan P. Garrahan". The monitoring of these patients was defined by a history of positive serology for toxoplasmosis in the donor or recipient and because their hematologic condition did not allow the use of trimethoprim-sulfamethoxazole for prophylaxis. During the patients' monitoring, two of them with positive PCR results showed signs of illness by T. gondii and were treated with pyrimethamine-clindamycin. In two other patients, toxoplasmosis was the cause of death and an autopsy finding, showing negative PCR results. Four patients without clinical manifestations received treatment for toxoplasmosis because of positive PCR detection. In four patients there were no signs of toxoplasmosis disease and negative PCR results during follow-up. The qualitative PCR technique proved useful for the detection of toxoplasmosis reactivation in HSCT recipients, but has limitations in monitoring and making clinical decisions due to the persistence of positive PCR over time and manifestations of toxicity caused by the treatment.
Departamento de Parasitología, Laboratorio de Toxoplasmosis, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina.
Mónica G
MG
Nigro
Servicio de Trasplante de Médula Ósea, Hospital de Pediatría S.A.M.I.C. "Profesor Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
Carlos
C
Figueroa
Departamento de Parasitología, Laboratorio de Toxoplasmosis, Instituto Nacional de Enfermedades Infecciosas "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: bibilede@anlis.gov.ar.
Bibiana A
BA
Ledesma
D000293:Adolescent; D064591:Allografts; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000627:therapeutic use; D000075202:Contraindications; D016054:DNA, Protozoan / Q000097:blood*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000209:etiology / Q000469:parasitology / Q000635:transmission; D016133:Polymerase Chain Reaction / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000469:parasitology; D011237:Predictive Value of Tests; D011292:Premedication; D011739:Pyrimethamine / Q000627:therapeutic use; D012189:Retrospective Studies; D014019:Tissue Donors; D014122:Toxoplasma / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000175:diagnosis* / Q000209:etiology / Q000469:parasitology / Q000635:transmission; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D000890:Anti-Infective Agents; D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D007166:Immunosuppressive Agents; D002981:Clindamycin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011739:Pyrimethamine
Hematopoietic stem cell transplant; PCR; Toxoplasma gondii; Trasplantes de células progenitoras hematopoyéticas