title: [Medullary aplasia during treatment for congenital toxoplasmosis in a twin pregnancy].
abstract: The authors report a case of a patient who in the 24th week of a twin pregnancy became sero-positive for toxoplasmosis. This was diagnosed by cordocentesis as being infected, and the treatment was therefore started with pyrimethamine and sulfadiazine and folic acid at the 28th week of pregnancy. At 35 weeks, the patient had an acute medullary aplasia due to the absence of the folates. The mother's state was improved rapidly by giving her folinic acid and the twins were normal haematologically. In this case, the authors point out how important the folates are in a pregnancy, especially in twin pregnancies, and point out the precautions that have to be taken when treatment with pyrimethamine and sulfadiazine is started for congenital toxoplasmosis.
authors.affiliation: Service de Gynécologie-Obstétrique, CHRU de Lille.
authors.forename: I
authors.initials: I
authors.lastname: Switala
authors.forename: P
authors.initials: P
authors.lastname: Dufour
authors.forename: A S
authors.initials: AS
authors.lastname: Ducloy
authors.forename: D
authors.initials: D
authors.lastname: Vinatier
authors.forename: C
authors.initials: C
authors.lastname: Bernardi
authors.forename: J C
authors.initials: JC
authors.lastname: Monnier
authors.forename: I
authors.initials: I
authors.lastname: Plantier
authors.forename: B
authors.initials: B
authors.lastname: Fortier
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000097:blood / Q000139:chemically induced*; D000756:Anemia, Sideroblastic; D017218:Cordocentesis; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005494:Folic Acid Deficiency / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D002955:Leucovorin / Q000494:pharmacology / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy*; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple; D011739:Pyrimethamine / Q000009:adverse effects* / Q000494:pharmacology; D015572:Spiramycin / Q000627:therapeutic use; D013411:Sulfadiazine / Q000009:adverse effects*; D014123:Toxoplasmosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D014427:Twins
chemical_list: D013411:Sulfadiazine; D015572:Spiramycin; D005492:Folic Acid; D002955:Leucovorin; D011739:Pyrimethamine
vernacular_title: Aplasie médullaire au cours du traitement d'une toxoplasmose congénitale lors d'une grossesse gémellaire.