抗逆转录病毒疗法导致的危及生命的母婴巨细胞贫血。

Life-threatening maternal and fetal macrocytic anemia from antiretroviral therapy.

作者信息

Myers Stephen A, Torrente Sandra, Hinthorn Daniel, Clark Perry L

机构信息

Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, Kansas 66160-7316, USA.

出版信息

Obstet Gynecol. 2005 Nov;106(5 Pt 2):1189-91. doi: 10.1097/01.AOG.0000164069.51304.e7.

DOI:10.1097/01.AOG.0000164069.51304.e7

PMID:16260567

Abstract

BACKGROUND

Antiretroviral therapy is recommended for human immunodeficiency virus (HIV)-infected patients during pregnancy to reduce the vertical transmission to the newborn. Complications from this therapy are uncommon.

CASE

A 38-year-old HIV-positive pregnant woman was treated with lamivudine and zidovudine. At 28 weeks of gestation, her hemoglobin had fallen to 4.6 g/dL with an mean corpuscular volume (MCV) of 126 microm. At 36 weeks the fetal biophysical profile was abnormal. A pale hydropic infant was delivered via emergency cesarean, with a hemoglobin of 2.1 gm and MCV of 131 microm. The newborn hemoglobin normalized after withdrawal of the neonatal retroviral therapy.

CONCLUSION

Maternal-fetal macrocytic anemia may complicate antiretroviral therapy.

摘要

背景

建议对感染人类免疫缺陷病毒（HIV）的孕妇进行抗逆转录病毒治疗，以减少垂直传播给新生儿。这种治疗的并发症并不常见。

病例

一名38岁的HIV阳性孕妇接受了拉米夫定和齐多夫定治疗。妊娠28周时，她的血红蛋白降至4.6 g/dL，平均红细胞体积（MCV）为126微米。妊娠36周时，胎儿生物物理评分异常。通过紧急剖宫产分娩出一个面色苍白的水肿婴儿，血红蛋白为2.1克，MCV为131微米。新生儿停用抗逆转录病毒治疗后血红蛋白恢复正常。