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Background and Study Aims: Wilson's disease is an autosomal recessive disorder, that affects copper metabolism, leading to copper accumulation in the liver, nervous system, and cornea. Data are lacking on the epidemiology, the clinical and laboratory characteristics, treatment, and survival of Wilson's disease in Morocco. The aim of this study was to examine these features and the cause of death in a Moroccan pediatric population., Patients and Methods: The study was carried out at the University Hospital Center of Marrakesh, Morocco; 46 children were diagnosed with Wilson's disease from 2008 to 2019. The diagnosis was based on low serum ceruloplasmin, increased urinary copper concentrations, the presence of Kayser-Fleischer rings, a family history of Wilson's disease, and a Leipzig score of ≥ 4., Results: A total of 42 patients were referred to the center for hepatic or neurological manifestations; four patients were asymptomatic. Consanguineous marriage was found in 67.4% of the cases. The mean duration of illness (42 patients) was 4.9 ± 3.9 years. Kayser-Fleischer rings were found in 60.9% of 46 patients. Of the 42 symptomatic patients: 28 of 30 (93.3%) patients had low serum ceruloplasmin (<0.2 g/L), and 24 h urinary copper >100 μg/day was found in 34 of 35 (97.1%) cases. The treatment was established with D-penicillamine for 43 of the 46 patients, with zinc acetate for one patient and with zinc sulfate in for one patient, while one patient was not treated. D-penicillamine was discontinued in nine patients because of adverse effects such as thrombocytopenia, neurological deterioration, pancytopenia, severe vomiting and severe hypersensitivity. In total 28 patients were clinically and biologically stabilized, two patients experienced vision loss, and 16 patients died (38%). The main cause of death was diagnosis made at an advanced stage of disease and stopping treatment., Conclusion: Wilson's disease is a rare condition associated with treatement efficacy, but late diagnosis and stopping treatment can lead to a high mortality rate., (Copyright © 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)

Background/aim: The spectrum of ATP7B variants varies significantly according to geographic distribution, and there is insufficient data on the variants observed in the French population., Methods: Clinical data of 113 children included in the French WD national registry were gathered from March 01, 1995 to July 01, 2020. Data included epidemiological, clinical, laboratory, genetics., Results: Diagnosis was made at a mean age of 11.0 ± 4.1 years (range 1-18 years). At diagnosis, 91 patients (79.8 %) had hepatic manifestations, 18 (15.8 %) presented neurological manifestations, and 4 patients (3.5 %) were asymptomatic. Only 29 patients (25 %) were homozygous for a variant. We have found a total of 102 different variants including 14 novel variants. Recurrent variant p.His1069Gln was the most prevalent, n = 31 alleles (14,2%), with only seven homozygous; in contrast 55% of variants are identified in only one family. 45% were truncating variants. In respect of mutated exon, the three most prevalent were exon 14 (16.5%), exon 8 (13.8%), and exon 3 (11.5%). When considering patients with two Nonsense / Frameshift variants as a group and those with two Missense variants, we found significantly lower ceruloplasmin for the former: 2.8 ± 0.7 mg/dl vs 8.4 ± 5mg/dl (p<0.05)., Conclusion: p.His1069Gln is the most frequent variant (14,2%) and exons 14, 8, and 2 of the ATP7B gene account for 41.7% of total variants. However, there is significant heterogeneity in the French population concerning the other ATP7B variants. Nonsense / Frameshift variants were associated with lower ceruloplasmin levels., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Wilson disease is an autosomal recessive disease that produces a copper accumulation in many organs, initially in the liver, progressing to liver cirrhosis, and in the brain, with different neurologic symptoms. Diagnosis is based on clinical, biochemical, and genetic tests. Different treatments based on chelating agents may help reduce the disease's spontaneous morbidity and mortality. We describe three patients who presented Wilson disease before 18 years of age, with initial neurologic symptoms between 1998 and 2010. After comparison with literature reports, their clinical symptoms, progression, and care allowed us to propose a treatment algorithm. Neurologic symptoms are present in 35% of the patients with Wilson disease such as dystonia, extrapyramidal syndrome, dysarthria, dysphagia, and psychiatric symptoms. The time to diagnosis remains too long and may account for the increased severity of the illness encountered and problems treating these patients. The first treatment choice must be triethylenetetramine, which causes fewer side effects of initial worsening of symptoms compared to D-penicillamine. Zinc therapy is the first treatment for asymptomatic patients or those on maintenance treatment. Finally, liver transplantation is a potential treatment even if the patient presents severe neurological disability because it may improve clinical symptoms. However, further research is warranted on this matter., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background and Objective: Metabolic bone disease is frequent in chronic intestinal failure. Because fluoride has a major effect on bones, the status of both fluoride and bone was studied in long-term home parenteral nutrition (HPN) patients., Design: We studied 31 adults aged (x +/- SD) 56.3 +/- 15.1 y, mainly patients with short-bowel syndrome, who had been receiving HPN for >1 y. Bone mineral density (BMD) was measured by absorptiometry, and serum fluoride was measured by using a fluoride-sensitive electrode. All patients ate and drank ad libitum. HPN (3.4 +/- 1.2 times/wk) complemented oral nutrition. Potential explicative factors were estimated by using a linear regression model (mixed-effects model)., Results: Of 120 fluoride dosages (2-6/patient), 102 were above the upper normal limit (1.58 micromol/L) at the laboratory. Mean (+/- SD) daily fluoride supply was 8.03 +/- 7.71 mg (US adequate intake: 3.1 mg/d for women and 3.8 for men; tolerable upper normal limit: 10 mg/d); intravenous fluoride varied from 0.06 to 1.45 mg, and oral fluoride varied from 0.09 to 27.8 mg. Serum fluoride concentrations were correlated with creatinine clearance and fluoride supply. BMD was significantly lower in the femoral neck than in the spinal area. After adjustment for sex and the duration of HPN, only the effect of serum fluoride on spinal BMD was significant. Two patients had symptoms of fluorosis, eg, calcaneum fissures, interosseous calcifications, or femoral neck osteoporosis., Conclusions: In chronic intestinal failure, high intakes of fluoride are frequent because of the beverages ingested to compensate for stool losses. Hyperfluoremia has an effect on bone metabolism and may increase skeletal fragility. The consumption of fluoride-rich beverages for extended periods is therefore not advisable.

Objectives: To evaluate the additional information provided by pulse transit time (PTT), a noninvasive tool, when using during polysomnography for the diagnosis of sleep breathing disorders in a pediatric population., Main Findings: Respiratory and microarousals events were scored twice. The first scoring was performed using nasal pressure, thermistors, thoracic and abdominal movements, and oxygen saturation. The second scoring, blinded to the first scoring, was performed using PTT in combination with all the other signals. Microarousals were scored once visually on the EEG trace (cortical arousals [CAs]) and once using the PTT signal (autonomic arousals [AAs]) blinded to EEG. For the whole group of 16 children studied (mean age, 9.5 years), there was no significant difference between the respiratory disturbance index (RDI) with or without PTT analysis (22.4 +/- 13.5/h vs 20.4 +/- 14.3/h; not significant [mean +/- SD]). Among the children exhibiting a "without PTT" RDI < 30/h, 5 of 12 children (41.66%) showed a clinically significant >/= 5/h increase in RDI when using PTT. AAs detected by PTT were significantly more frequent than CAs during rapid eye movement (REM) sleep (7.4 +/- 3.9/h vs 3.2 +/- 2.3/h; p < 0.001) and slow wave sleep (SWS) [6.0 +/- 4.3/h vs 0.6 +/- 0.5/h; p < 0.0001]., Conclusions: The quantification of respiratory effort using PTT improves the detection of respiratory events in children. The detection of microarousals is improved particularly in REM and SWS.

The increase in asthma prevalence over the past 20 years could be due to modification of exposure to environmental factors (environmental theory) or to the lost of protective factors (hygienist theory). Among environmental factors this paper reviewed the controversial role of exposure to house dust mite (HDM). If exposure to HDM is deleterious in asthmatics known to be sensitised to this allergen, the effect of HDM exposure on asthma incidence has been challenged recently, based on longitudinal studies showing no correlation between level of exposure to HDM and asthma incidence. Exposure to animal dander may have protective effects. This review has shown that, even if some studies have shown potential protective effect of early exposure, the protection seems to be better in families with a low risk of atopy; almost all studies tend to show a deleterious effect of current exposure; exposure to dog dander may be more protective than cat. These studies cannot give definite conclusions to change current advices of early eviction of HDM and animal dander, especially in families with a high risk of atopy. The deleterious effect of passive smoking on asthma prevalence and severity is undisputable and our efforts should concentrate on obtaining effective eviction of passive smoking.

In our hospital, in accordance with recommendations for personnel protection, hazardous drugs are prepared in a class II biological safety cabinet (BSC) located in a specific area of the pharmacy. The aim of this study was to validate the efficiency of this unit in personnel protection by measuring levels of platinum in the working environment (platinum being the most common antineoplastic agent used in this hospital). Two series of surface sampling were conducted, preparation guidelines were changed for parts after first results have been completed. Performance of the sampling method is about 35%. Platinum was measured by atomic absorption spectrophotometry technique. The analytical detection limit was 10 mug/L of platinum and was sufficient to detect less than one micro-drop of cisplatinum solution (1 mg/mL). Platinum was found inside the BSC at the end of the working day: 2 to 998 pg/cm2 or 2 to 20 ppm of the total cisplatinum handled. All samples outside the BSC showed little (less than the detection limit) or no contamination. Gloves were often contaminated, either by contaminated commercial drug vials or through handling errors. Working guidelines changes did not lead to the absence contamination on surfaces. Gloves should therefore be changed frequently (every 15 min), personnel training should be regularly re-evaluated, BSC and rooms should be thoroughly cleaned every day. In this way, a centralized unit provides total protection from exposure to hazardous drugs.

Case Report: Two children were admitted for poisoning by organophosphate pesticides applied as hair rinses against lice. These chemical agents inhibit the acetylcholinesterase enzyme at various sites. The resultant accumulation of the transmitter acetylcholine causes abnormal signs and symptoms. The diagnosis is based on a reduction in the blood cholinesterase activity. The specific treatment comprises the administration of atropine and pralidoxime., Conclusion: Accidental poisoning by organophosphate insecticides may occur, due to the misuse of such substances as shampoo against lice. An accurate information for users is necessary.

Although when an infant or a young child presents with persistent or recurrent wheezing, the probability of asthma is high, one must remain very careful in order not to miss an other etiology. Except for the chest X ray with inspiratory and expiratory studies that is mandatory, the other evaluations should be based on a careful interview and clinical examination. Fiberoptic bronchoscopy may be indicated each time there is a doubt on foreign body aspiration or tracheobronchomalacia.

Unlabelled: Chronic recurrent multifocal osteitis (OCRM) is a rare condition in children, of unknown aetiology, which may be misdiagnosed as osteomyelitis, arthritis or tumour., Patients and Methods: We present a retrospective multicentric study of 17 patients (five boys and 12 girls) with an average follow-up of 7.5 years (six months-25 years)., Results: A spectrum of presenting features is possible, ranging from bone lesions alone to lesions combined with arthritis, palmoplantar pustulosis or psoriasis. The diagnosis was delayed from two weeks to five years. Roentgenographic evaluation was often normal at the beginning of the disease or showed nonspecific bone reactions. Radioisotope bone scans assisted in establishing the diagnosis and in identifying lesions that were initially clinically silent. Bone biopsies were performed in seven cases. Histopathological examination showed only mild inflammatory nonspecific changes. Microbiological cultures were always negative. Treatments were different according to the evolution of the disease and the hospital. There was no response to antibiotics in seven patients. The response to nonsteroidal anti-inflammatory agents and steroids was moderate and often transient. Salazopyrine and pamidronate treatment used in two patients allowed a durable remission. We lost sight of four patients, pain persisted in three in spite of treatment, it disappeared in two with treatment, mild pain persisted in five without treatment and remission occurred in three without treatment., Conclusion: This study clarifies the clinical and radiologic features of chronic recurrent multifocal osteomyelitis. The recognition of this rare entity is often delayed and difficulties in patient management sometimes emerge from its usual protracted course.

Dehydrated hereditary stomatocytosis (DHS) is a rare genetic disorder of red cell permeability to cations, leading to a well-compensated hemolytic anemia. DHS was shown previously to be associated in some families with a particular form of perinatal edema, which resolves in the weeks following birth and, in addition, with pseudohyperkalemia in one kindred. The latter condition was hitherto regarded as the separate entity, "familial pseudohyperkalemia." DHS and familial pseudohyperkalemia are thought to stem from the same gene, mapping to 16q23-q24. This study screened 8 French and 2 American families with DHS. DHS appeared to be part of a pleiotropic syndrome in some families: DHS + perinatal edema, DHS + pseudohyperkalemia, or DHS + perinatal edema + pseudohyperkalemia. If adequately attended to, the perinatal edema resolved spontaneously after birth. Logistic regression showed that increased mean corpuscular volume and mean corpuscular hemoglobin concentration were the parameters best related to DHS. In patients in whom cation fluxes were investigated, the temperature dependence of the monovalent cation leak exhibited comparable curves. Specific recombination events consistently suggested that the responsible gene lies between markers D16S402 and D16S3037 (16q23-q24). The 95% confidence limits (Z(max) >/= 3.02) spanned almost the complete 9-cM interval between these 2 markers.

Hemoptysis in children are infrequent and often self-limiting. They are a manifestation of the broader spectrum of pulmonary haemorrhage. Diffuse pulmonary haemorrhages are often associated with diseases of other organs (cardiopathies, systemic diseases). Focal haemorrhages have multiple aetiologies, dominated by bronchopulmonary infections and cystic fibrosis. Fiberoptic bronchoscopy allows one to localise the bleeding, look for local causes and diagnose pulmonary hemosiderosis by BAL. For local lesions and if the medical management fails, bronchial arteriography is indicated to perform the embolisation of the bleeding vessels.

We report clinical, genetical and genealogical findings in 149 French families from the Rhône-Alpes area studied over a 5-year period. There was a significant excess of DM females compared to DM males with (CTG) repeat sizes between 1-2 kb. The mean maternal (CTG) repeat size was higher than paternal repeat size. Anticipation phenomenom was significantly higher after maternal than after paternal transmission. A significant correlation between parental (CTG) repeat size and intergenerational variation both in paternal and maternal transmissions was observed. The anticipation phenomenom was more important for sons than daughters particularly after maternal transmission. The mean (CTG) repeat size in mothers of CDM cases was about twice that of mothers of NCDM children. The risk of giving birth to a CDM child increased considerably when the number of maternal (CTG) repeats was over 300 (CTG). A significant excess of DM females was observed. They had on average 24% fewer children than male patients. Paternal transmission (63.6%) of DM occurred more frequently than maternal transmission (52.7%).

Purpose: The social, medical, and psychological outcomes of 552 adolescents hospitalized subsequent to an attempted suicide were assessed after an average 5-year follow-up period., Methods: Evaluation took place by means of mailed questionnaires completed by the adolescents, their parents, and the general practitioner. Using regression analysis, responses were compared with those of a comparison group (n = 273)., Results: In the suicidal group, the mean annual mortality rate was seven-fold greater than in the general population of the same age. Education level was lower, and the consumption of alcohol, psychiatric hospitalizations, and contacts with the criminal justice system were more frequent than in the control group. No other variables explored were significantly different between the two groups., Conclusions: The results of this study carried out on a large sample of French suicidal adolescents tend to confirm results of previous studies performed in other countries. They show that the prognosis for the suicidal adolescent group is less favorable than that of the comparison group.

A study on the psychological consequences of parental separation on children was performed among 3,098 pupils of first year secondary school during the 1995-1996 academic year in the department of Isère. The children family situation was compared with the results of personality test of Coopersmith (SEI). The main characteristics of the children, in particular family condition such as parental death or parental separation are in agreement with the French national data. Among the children with separated parents, 29% were less than 3 years old when their parents broke up. In 85% of the cases the child lived mainly with his/her mother, in 9% of the cases with his/her father, in 4% of cases in a joint-custody arrangement, in 1% of the cases in an other person's home. The overall SEI scores were good. There was a significant overrepresentation of girls with extreme scores. Compared with the scores of the children of unseparated parents, the average SEI scores were low for children with separated parents and for children with one dead parent, but differences were observed between girls end boys. The age of children at the time of the separation did not influence the SEI score and there was little influence of the father-child regular contacts.

The authors describe an experience of early intervention by child psychiatrists in adolescents attending an emergency care pediatrics unit for suicide attempts. The two main aspects of this intervention are: 1) a former interview between the child psychiatrist and the suicidal adolescent taking place within the emergency care pediatrics unit; 2) a systematic few days hospitalization of the suicidal adolescent in a child-adolescent psychiatric unit allowing early therapy for both the adolescent and his/her parents. Based on preliminary results the authors believe that early child psychiatrist intervention provides an improvement in the care of suicidal adolescents, especially to prevent recurrent suicide attempts, as compared with conventional care with delayed child psychiatrist participation.

The authors present a synthesis of the studies published in the literature since 1980 concerning the psychological consequences of parental separation on children. The risk of psychological disturbances varies according to the age and the sex of the child, and to the different parental attitudes. Pediatricians have an important role in preventing psychological consequences of parental separation on children by giving information to the parents and helping the children to understand and accept the event. In addition early recognition of psychological disturbances is important in order to offer a specialized support to the child.

Intrafamilial violence represents a vast topic, even if one limits the subject to the nuclear family. Indeed it includes violence from parents to the child, violence between brothers and sisters, conjugal violence and violence exercised by the child to his parents. Although one can differentiate the types of violence (physical, sexual, and psychological), they often coexist within the same family. Adolescence favors the onset or the reactivation of familial violence; this violence often has repercussion on the psychological equilibrium of the adolescent. Very little is written about parents abused by one of their children (usually an adolescent). This phenomenon is relatively unrecognized and its frequency probably under-estimated. It points to a distortion in parent to child relationship. Therapeutic and/or socio-educational approach must be directed toward both the victim and the aggressor.

A case of parameningeal cervical rhabdomyosarcoma with severe bone destruction is reported in a 3 month-old infant; symptoms were present at birth. The treatment consisted of exclusive intensive chemotherapy. The outcome was favourable with complete tumor regression and vertebral bone reconstruction. The child was on complete remission without sequellae two years later.

The antecedents of pediatric hospitalization and previous history of somatic disturbance in 101 adolescents aged 12-16 yr hospitalized in a pedopsychiatric unit were compared to those of a representative population of 101 high school adolescents without psychiatric problems. Patients and controls were matched according to age, sex and parents nationality. The result showed that adolescents with psychiatric disorders were significantly more frequently hospitalized during infancy and childhood, particularly for medical reasons. They also presented many more algic syndromes, recurrent headaches, recurrent vomiting and epilepsy. Thus, recurrent pediatric hospitalization and chronic somatic disturbance appear to be warning signals of a possible psychiatric risk and should lead to a psychological investigation of the child and his relations with the family.

Gliomas involving the brain stem represent 10% of pediatric central nervous system neoplasms. They result in multiple cranial nerve involvement, long tracts signs, cerebellar signs, usually with no evidence of raising in intracranial pressure. The diagnosis is established by computed tomographic scan and magnetic resonance imaging. Classic management consists in conventional radiation therapy but the prognosis is very dismal with a five year survival rate about 30%.

Primary intra-cranial germ-cell tumors are a rare and heterogeneous group of neoplasms, identical to germ-cell tumors of gonads and other organs. These tumors arise along the midline, from the supra-sellar cistern to the pineal gland, and have neurological, ophthalmological, and endocrinological expression. The diagnosis is established by detection of increased levels of tumoral markers and/or by histological examination. The treatment includes chemotherapy, radiotherapy and surgery.

In 19 children with familial hypercholesterolemia type IIa measures to reduce the amount of saturated fat and cholesterol in the diet lead to a mean decrease of cholesterolemia of 15%, thus confirming the favorable effect of the diet previously reported in the literature. However, there were large variations in the efficacy of the diet from no effect up to a 30% decrease. "Non-responders", in whom the diet was not effective, require treatment with drugs. The diet must be individualised and should involve the whole family. Children must be followed in order to encourage compliance to the dietetic measures and to detect eventual side effects. Furthermore, the dietetic measures must be associated with steps to control the other risk factors of arteriosclerosis.

Dilated cardiomyopathies occur mostly in infants and affect their vital and functional prognosis. They may be primary or secondary to various pathologies such as congenital cardiac malformation, toxic myocardial drugs or mucoviscidosis. Medical treatment may only be transiently effective and brutal or progressive aggravation may lead to cardiac transplantation being considered in those cardiomyopathies which are primary (without metabolic causes) or chronic secondary. Echocardiographic survey is the most efficient way to follow the evolution and to detect complications (cardiac thrombosis).

In 2 boys, aged 3 and 13 years, suffering from severe growth failure, endocrine evaluation showed growth hormone deficiency and central hypothyroidism without diabetes insipidus. Magnetic resonance imaging demonstrated a transection of the pituitary stalk, and the presence of an ectopic neurohypophyseal nodule.

In France the epidemiology of child abuse is badly known, because of the lack of connexion between different institutions. We present a child abuse observatory set up in Grenoble in May 1987. The social, educational, judicial and medical department's services are working together. In the first 20 months, 87 cases were recorded: 57 physical abuse, 26 sexual abuse and 5 cases of abuses due to negligence. Precise information was collected concerning the victims, their siblings, the family's risk factor and the offenders, the method by which the information was obtained and the prosecution undertaken. A 10 July 1989 law enforced each Department's governor to set up a service for collecting information about child abuse. Our observatory will serve as a model for this law application.

Pharmacokinetic studies of 13 children treated with cyclosporine A (CyA) were retrospectively analysed (9 renal transplants, 1 combined liver-kidney transplant, 1 heart transplant; 2 were treated for a nephrotic syndrome). The patients were separated into 2 groups: patients 0-15 years (group 1), patients 15-18 years (group 2). In comparison with adults (group 3), children of the 2 groups required higher CyA doses, related either to body weight or to body surface area. CyA dosage was performed by high performance liquid chromatography on whole blood samples. Despite higher doses, trough CyA levels were lower in groups 1 and 2 compared with group 3. Nephrotoxicity occurred in the only 2 children treated with CyA doses higher than 10 mg/kg/d.

Using clinical, morphological, genetic, and biochemical criteria, we studied ten white and North African families with hereditary elliptocytosis (HE). In four families, elliptocytic individuals displayed a highly significant reduction of band 4.1, which was recorded using two electrophoretic procedures. The 4.1a/4.1b ratio was also significantly reduced, as is usually observed in suspensions enriched in young red cells. This form of HE was invariably associated with the following characteristics: absence of clinical signs; numerous, smooth and well-elongated elliptocytes; dominant transmission; and, when investigated, normal osmotic fragility. Its frequency, among all forms of HE, is about one third as a first estimate, at least in whites and North Africans. In the other six families studied, elliptocytic subjects presented normal 4.1 bands. Again, the 4.1a/4.1b ratio was decreased, reflecting the red cell age-dependent changes in these two components. In three of these families, elliptocytosis was accompanied by clinical signs of variable intensity, and the mode of inheritance could not be unequivocally determined. Therefore, HE with a partially reduced band 4.1 defines a homogeneous variety of HE that can be isolated from other forms of HE. We suggest that it be termed the 4.1 (-) trait, so as to correspond with a previously proposed terminology.

Nailfold capillaries may be visualized in vivo using a simple non invasive microscopic technic. The assessment of capillary flow disturbances and organic microangiopathies is therefore rendered possible through capillary microscopy. Three kinds of clinically significant morphological abnormalities can be easily recognized: megacapillaries are huge capillaries with a diameter greater than 50 microns. They are mainly found in progressive systemic sclerosis and dermatomyositis, together with avascular areas and pericapillary edema; ramified capillaries are neovessels, most frequently related to subclinical cutaneous vasculitis; capillary hemorrhages may be induced either by active microangiopathies, or by deep vasomotor changes. The semiological consistency of these abnormalities makes capillary microscopy a valuable procedure for the early recognition of connective tissue diseases and the evaluation of vasomotor disturbancies in children as well as in adults. Further investigation of other microangiopathies like purpura rheumatica and diabetes are needed.

An IgM immunosorbent agglutination assay (ISAGA) test was evaluated for detection of IgM antibodies in diagnosis of congenital toxoplasma infection, and compared with IgM IFI test. Of 36 sera from infants with congenital infection, the IgM ISAGA test was positive in 19 cases (52%), whereas the IgM IFI test was positive in only 4 cases (11%). Of those sera obtained during the first 90 days of life from the infected infants, 70% were positive in the IgM ISAGA test whereas only 23% in the IgM IFI test. Neonatal sera from 10 infants suspected, but in whom this diagnosis was ruled out, were also evaluated: one false positive was found with the ISAGA test, but without control 15 days later. The ISAGA test is a simple, sensitive and probably highly specific test for diagnosis of congenital toxoplasma infection.