Acute onset lactic acidosis and pancreatitis in the third trimester of pregnancy in HIV-1 positive women taking antiretroviral medication.
We report the case histories of two HIV-1 positive women in the third trimester of pregnancy who presented with acute lactic acidosis and acute pancreatitis, respectively. One case was fatal for mother and baby. Both women had been stable on regimens containing stavudine and didanosine for at least 2 years before their acute presentations. We speculate on the differential diagnosis, discuss possible reasons for an increased risk of these presentations in pregnant women taking antiretrovirals, and advocate increased vigilance of these women, particularly in the last trimester.
Sarner
L
L
The Greenway Centre, Newham General Hospital, London E13 8SL, UK. liatsarner@hotmail.com
Fakoya
A
A
D000140:Acidosis, Lactic / Q000139:chemically induced*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000208:Acute Disease; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D016049:Didanosine / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010195:Pancreatitis / Q000139:chemically induced*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D018119:Stavudine / Q000009:adverse effects
D019380:Anti-HIV Agents; D018119:Stavudine; D016049:Didanosine