In that study, ophthalmological assessment was decisive in 15 7%

In that study, ophthalmological assessment was decisive in 15.7% of infants who no longer showed positive Toxo-IgM see more at the confirmatory serology, similar to the situation observed in the present study.20 Melamed et al.,27 evaluating 44 infants with congenital toxoplasmosis, some of whom belonged to the present cohort, observed 31 (70.4%) cases of eye lesion, 29 (65.9%)

of which were retinochoroiditis. Eye lesions may become evident within the months following birth, not only due to the appearance of new lesions, but also due to greater facility to visualize the peripheral retina. Differences in clinical presentation of congenital toxoplasmosis among populations can be explained by genetic factors of the host and parasite.20, 28 and 29 This reason adds importance to studies in different geographical areas. In the study by Vasconcelos-Santos et al.,20 the prevalence of cerebral calcifications was 20.5%; neuroimaging studies included radiographs and ultrasound. Other studies that also detected

a lower prevalence of cerebral calcifications than that of the present study generally included skull radiographs among the neuroimaging tests, which have known low sensitivity to detect calcifications.26 and 30 In the present study, neuroimaging studies were performed by computed tomography and/or ultrasound, a characteristic that was taken into account when including part of this same cohort in comparative studies with European children, demonstrating that most Brazilian Stem Cell Compound Library mw patients had undergone skull CT, which can increase the detection of calcifications.15, 24 and 31 This study observed no association between Toxo-IgM positivity in the newborn and clinical manifestations of congenital toxoplasmosis, as did studies

by other authors.1, 11, 13 and 15 A higher prevalence of negative Toxo-IgM in symptomatic children would be expected, as there is a greater tendency toward almost negativity in newborns in whom fetal infection occurred at earlier times of gestation, and who tend to be more severely affected and show evident changes on physical examination. Wallon et al.,11 Bessières et al.,12 and Gilbert et al.13 demonstrated that the detection of Toxo-IgM in newborns was lower in cases of maternal seroconversion that occurred in the first and second trimesters of gestation. There are two possible reasons for the gestational age of maternal infection to influence the presence of Toxo-IgM in the newborn: first, in earlier infection cases, the time between placental and fetal infection is longer, allowing increased passage of maternal antibodies to the fetus and inhibiting fetal production of these antibodies. Second, the early infection would allow time for fetal Toxo-IgM to have reached its peak during intrauterine life and already be negative at birth.

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