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Test Code TOXGP; SQ: TOXOG Toxoplasma gondii Antibody, IgG, Serum

Reporting Name

Toxoplasma Ab, IgG, S

Useful For

Determining whether a patient has had previous exposure to or recent infection with Toxoplasma gondii

 

This test is not useful for diagnosing infection in infants younger than 6 months of age. In that age group, IgG antibodies usually are the result of passive transfer from the mother.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Ordering Guidance


IgG antibodies in patients younger than 6 months of age are typically the result of passive transfer from the mother. To assess possible Toxoplasma gondii infection in patients younger than 6 months, order TXM / Toxoplasma gondii Antibody, IgM, Serum.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reference Values

Toxoplasma ANTIBODY, IgG

Negative

 

Toxoplasma IgG

≤9 IU/mL (Negative)

10-11 IU/mL (Equivocal)

≥12 IU/mL (Positive)

Reference values apply to all ages.

Day(s) Performed

Monday through Saturday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86777

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TOXGP Toxoplasma Ab, IgG, S 88746-3

 

Result ID Test Result Name Result LOINC Value
TOXG Toxoplasma Ab, IgG, S 40677-7
DEXG6 Toxoplasma IgG Value 8039-0

Clinical Information

Toxoplasma gondii is an obligate intracellular protozoan parasite capable of infecting a variety of intermediate hosts, including humans. Infected definitive hosts (cats) shed oocysts in feces that rapidly mature in the soil and become infectious.(1) Toxoplasmosis is acquired by humans through ingestion of food or water contaminated with cat feces or through eating undercooked meat containing viable oocysts. Vertical transmission of the parasite through the placenta can also occur, leading to congenital toxoplasmosis. Following primary infection, T gondii can remain latent for the life of the host; the risk for reactivation is highest among individuals who are immunosuppressed.

 

Seroprevalence studies performed in the United States indicate approximately 9% to 11% of individuals between the ages of 6 and 49 have antibodies to T gondii.(2)

 

Infection of immunocompetent adults is typically asymptomatic. In symptomatic cases, patients most frequently present with lymphadenopathy and other nonspecific constitutional symptoms, making definitive diagnosis difficult to determine.

 

Severe-to-fatal infections can occur among patients with AIDS or individuals who are otherwise immunosuppressed. These infections are thought to be caused by reactivation of latent infections and commonly involve the central nervous system.(3)

 

Transplacental transmission of the parasites resulting in congenital toxoplasmosis can occur during the acute phase of acquired maternal infection. The risk of fetal infection is a function of the time at which acute maternal infection occurs during gestation.(4) The incidence of congenital toxoplasmosis increases as pregnancy progresses; conversely, the severity of congenital toxoplasmosis is greatest when maternal infection is acquired early during pregnancy. A majority of infants infected in utero are asymptomatic at birth, particularly if maternal infection occurs during the third trimester, with sequelae appearing later in life. Congenital toxoplasmosis results in severe generalized or neurologic disease in about 20% to 30% of the infants infected in utero; approximately 10% exhibit ocular involvement only, and the remainder are asymptomatic at birth. Subclinical infection may result in premature delivery and subsequent neurologic, intellectual, and audiologic defects.

Interpretation

A positive Toxoplasma IgG result is indicative of current or past infection with Toxoplasma gondii. A single positive Toxoplasma IgG result should not be used to diagnose recent infection.

 

Equivocal Toxoplasma IgG results may be due to very low levels of circulating IgG during the acute stage of infection. A second specimen should be submitted for testing if clinically indicated.

 

Individuals with negative Toxoplasma IgG results are presumed to not have had previous exposure to T gondii. However, negative results may be seen in cases of remote exposure with subsequent loss of detectable antibody.

 

Seroconversion from negative to positive IgG is indicative of T gondii infection subsequent to the first negative specimen.

 

Recent or acute infection with T gondii can be evaluated with TXM / Toxoplasma gondii Antibody, IgM, Serum. A suspected diagnosis of acute toxoplasmosis should be confirmed by detection of T gondii DNA by polymerase chain reaction (PCR) analysis of cerebrospinal fluid or amniotic fluid specimens (PTOX / Toxoplasma gondii, Molecular Detection, PCR, Varies).

 

For additional confirmation of a diagnosis, the US Food and Drug Administration issued a Public Health Advisory (07/25/1997) suggesting that sera found to be positive/equivocal for T gondii IgM antibody be sent to a Toxoplasma reference laboratory.

Method Description

The BioPlex 2200 Toxoplasma IgG assay uses multiplex flow immunoassay technology. Briefly, Toxoplasma antigen-coated fluorescent beads are mixed with an aliquot of patient sample and sample diluent and incubated at 37° C. During this time, IgG anti-Toxoplasma antibodies in the specimen bind to the Toxoplasma antigen on the beads. After a wash cycle, a fluorescently-labeled antihuman IgG-antibody conjugate is added to the mixture and incubated at 37° C. Following a wash step to remove unbound conjugate, the bead mixture is passed through a detector that identifies the bead based on dye fluorescence and determines the amount of antibody captured by the antigen based on fluorescence of the antihuman IgG conjugate. Raw data is calculated in relative fluorescence intensity and converted to an antibody index for interpretation.

 

Three additional dyed beads, an internal standard bead, a serum verification bead, and a reagent black bead are present in each reaction mixture to verify detector response, the addition of serum to the reaction vessel, and the absence of significant nonspecific binding in serum, respectively.(Package insert: BioPlex 2200 System, ToRC IgG. Bio-Rad Laboratories; 03/2012)

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject
Heat-inactivated specimen Reject

Method Name

Multiplex Flow Immunoassay (MFI)

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.