Document Detail


Fetal death as a result of placental immune reconstitution inflammatory syndrome.
MedLine Citation:
PMID:  20361998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 26-year-old woman was HIV-1 diagnosed at 11 weeks of pregnancy (CD4 = 7/mm(3), HIV-1 RNA = 108,000 copies/mL) with immunity against toxoplasmosis (Toxoplasma IgG = 1800 UI/mL). A fetal death was diagnosed 7 weeks after starting HAART (CD4 = 185/mm(3), HIV-1 RNA = 391 copies/mL) with a positive Toxoplasma PCR on fetal tissues and amniotic fluid. The absence of severe toxoplasmic foetopathy, the very exaggerated and atypical placental inflammation and the immune restoration context led to the diagnosis of placental IRIS associated with Toxoplasma gondii reactivation. This outcome remains undescribed and could represent an issue in resource-limited settings where HIV-pregnant patients are often severely immunodeficient and infected with opportunistic pathogens.
Authors:
F Caby; D Lemercier; A Coulomb; R Grigorescu; L Paris; F Touafek; G Carcelain; A Canestri; M Pauchard; C Katlama; M Dommergues; R Tubiana
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-03-31
Journal Detail:
Title:  The Journal of infection     Volume:  61     ISSN:  1532-2742     ISO Abbreviation:  J. Infect.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-26     Completed Date:  2010-11-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  185-8     Citation Subset:  IM    
Affiliation:
Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, Assistance publique des hôpitaux de Paris (AP-HP), Paris, France. fabienne.caby@psl.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid / parasitology
Anti-HIV Agents / adverse effects,  therapeutic use*
Antiretroviral Therapy, Highly Active / adverse effects
CD4 Lymphocyte Count
DNA, Protozoan / isolation & purification
Female
Fetal Death*
HIV Infections / complications*,  drug therapy,  virology
HIV-1 / isolation & purification
Humans
Immune Reconstitution Inflammatory Syndrome / complications,  diagnosis*
Placenta / pathology
Pregnancy
Pregnancy Complications, Infectious / drug therapy*
RNA, Viral / blood
Toxoplasma / isolation & purification
Toxoplasmosis / complications*,  diagnosis*,  parasitology
Viral Load
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/DNA, Protozoan; 0/RNA, Viral

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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