Pediatrics/Interpretation of blood tests TORCH
Respected Sir or Madam,
Greetings from New Delhi, India.
We are planning to adopt a child. However, few of the blood tests (from TORCH Panel) conducted on the prospective child (at the age of 4 completed months) are a concern.
Cytomegalovirus, CMV Antibody, IgM – Negative (0.03)
Cytomegalovirus, CMV Antibody, IgG – Positive (16 UA/ml)
Herpes Simplex 1&2 IgM – Negative (0.17)
Herpes Simplex 1&2 IgG – Positive (1.14)
All other blood tests conducted now at four months of age are normal.
We have details of the abandoned child from day 3 of his birth. Since then to till now, we have not observed any of the usual clinical features / symptoms of CMV and HSV 1 &2. The child is physically healthy, alert & active, normal feed. Child never had fever, jaundice, or any symptoms of pneumonia. Child once had seasonal cold and cough. Never had seizures or observed any cold-sores.
Selected parameters on Day 3 of the birth:
• General condition, vitals: stable;
• Chest X-ray – Normal;
• CNS – AF/AL – Normal. USA and NNR - Positive
• Weight: 2.08 kilograms; (Current weight 5.5 kilograms – after four completed months of age)
• Head circumference: 31 cms (39 cms now after four completed months of age)
We sincerely request medical experts to advice on interpretation of CMV and Herpes blood report. You may wish to clarify whether or not IgG positive status indicates congenital infection (especially when IgM is negative and no past symptoms). Alternatively can we assume that the positive IgG indicates that the maternal antibodies have transferred to baby through placenta? If this is right, till now, child is never infected with either of the infections.
Please do let us if any tests need to be repeated, further advice any other genetic & metabolic tests that are appropriate for a child of five months. Your advice and guidance would be of immense help in deciding the adoption of a lovely and bubbly child. Thank you,
In a child this age, it is hard to think that these are acquired infections, especially in the first 4 months of life. I would assume they are congenital and the antibody response is due to that or, and I have no way of finding this out, are simply the passive transfer of maternal IgG antibodies. These tend to persist for the first 6 months or so of life and then go away. I know of no tests that can distinguish between the two possibilities.
If she is fine and healthy, adopt her!
Good luck, Dr. Olson