Life-threatening maternal and fetal macrocytic anemia from antiretroviral therapy.
case_report · Level V
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Abstract
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. 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. Maternal-fetal macrocytic anemia may complicate antiretroviral therapy.
Medical subject headings
- Anemia, Macrocytic
- Anti-HIV Agents
- Fetal Diseases
- HIV Infections
- Pregnancy Complications, Hematologic
- Pregnancy Complications, Infectious