Fetal death as a result of placental immune reconstitution inflammatory syndrome - 07/08/11
, D. Lemercier c, A. Coulomb d, R. Grigorescu d, L. Paris e, F. Touafek e, G. Carcelain f, A. Canestri a, b, M. Pauchard a, b, C. Katlama a, b, M. Dommergues c, R. Tubiana a, b
Corresponding author at: Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, 47/83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. Tél.: +33 1 42 16 01 71; fax: +33 1 42 16 01 26.Summary |
A 26-year-old woman was HIV-1 diagnosed at 11 weeks of pregnancy (CD4 = 7/mm3, 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/mm3, 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.
Le texte complet de cet article est disponible en PDF.Keywords : Immune reconstitution inflammatory syndrome, Congenital toxoplasmosis, Opportunistic infection, Placentitis
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Vol 61 - N° 2
P. 185-188 - août 2010 Retour au numéro
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