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What Is TORCH PANEL, IgG & IgM?

The word TORCH represents four infectious diseases, toxoplasmosis, rubella, cytomegalovirus infection and herpes simplex virus. TORCH panel test checks for the presence of these infections in a pregnant woman and infants. IgG and IgM are two antibodies present in our body that fight these infections, with specific IgG and IgM being generated against each pathogen.

Thus, the TORCH panel, IgG & IgM test is a serological test that establishes the presence of TORCH infections by checking for the presence of antibodies IgG or IgM or both in the blood of the individual against TORCH diseases.

Infections caused by TORCH pathogens usually do not affect adults in general, but pregnant women and infants are highly susceptible. These infections are prevalent in India and are difficult to diagnose in early stages. Infections can be transmitted from a pregnant mother to growing foetus and can lead to miscarriage, stillbirths and birth defects. Therefore, it becomes important to check for signs of these infections.

  1. Why Is TORCH PANEL, IgG & IgM Performed?
  2. How do you prepare for TORCH PANEL, IgG & IgM?
  3. How is TORCH PANEL, IgG & IgM performed?
  4. What do TORCH PANEL, IgG & IgM results mean?

A doctor may order a TORCH panel test in the following cases:

  • In pregnant women with:
    • History of a previous infection
    • Previous spontaneous miscarriage or stillbirth
    • Early neonatal death in a previous case
    • Previous intrauterine foetal death
    • Intrauterine growth retardation
    • Lower socioeconomic strata
  • In infants with:
    • Slow growth and development
    • Congenital disabilities
    • Problems with the nervous system

Since the TORCH panel is a blood test, it does not require much preparation. It is crucial to keep the doctor informed of any medical conditions one might have or any medicines or herbs prescribed to pregnant women or infants.

In case of a pregnant woman, a blood sample is taken from a vein in their arm or hand. A technician may tie a tourniquet around the arm and withdraw blood using a sterile needle. Some women may experience slight pain and bruising at the needle insertion site; this will subside soon. The blood sample is then deposited into a vial and a bandage is applied at the sight of vein puncture.

In case the sample is taken from an infant, a prick may be made on the heel or finger of the baby with a sterile needle. Only a small amount of blood is taken on a glass slide or in a small container, and the needle prick is covered with cotton gauze and pressed slightly to stop the flow of blood. There may be mild bruising at the site of puncture that will fade away soon.

Normal results:

TORCH PANEL, IgG & IgM test has a simple yes or no result. Normal results would be reported as negative, which means that there are no IgG or IgM antibodies in the blood of the individual, and he/she is free from TORCH infections.

False negative results may also be reported with this test. It could happen when the individual is immunodeficient or due to cross-reactivity of antibodies in the sample with testing solutions. To confirm the findings, the doctor may order further tests.

Abnormal results:

An abnormal result is reported as positive, which means that IgG and IgM antibodies to any of the TORCH infections are present in blood. This is an indication of the presence of infection in body. The results may also mention which out of the four infections is mainly present in the body. 

False positive results are also possible with this test if the individual has autoimmune or rheumatoid antibodies in blood. In the case of infants, a false positive result may occur due to prior infections or maternal infection. In such a case, the doctor may order for more tests to confirm results and decide the treatment accordingly.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. National Health Service [internet]. UK; TORCH screen
  2. Abeer A. abdelmonem, Hany A. Abdel-Hafeez. Prevalence of Antenatal TORCH’ Infections by Serological detection in Cases of Poor Obstetric Outcome . Journal of American Science. 2014;10(12): page 311—314.
  3. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier, 2018. Chapter 37, Viral infections of the fetus and newborn.
  4. Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier, 2019. Chap 66, Approach to infections in the fetus and newborn.
  5. Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO. Remington and Klein's Infectious Diseases of the Fetus and Newborn. 8th ed. Philadelphia, PA: Elsevier Saunders, 2016. Chap 1, Current concepts of infections of the fetus and newborn infant.