Lyell Syndrome with Fatal Outcome in Two Pregnant Women Receiving Antiretroviral Therapy in Guinea ConakryReport as inadecuate




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An old woman, 28 years old, weighing74 kg was referred for skin detachment associated with bubbles and mucosal erosions.This clinical picture had occurred 15 days after the institution of a triplecombination: AZT 300 mg+ 3TC 150 mg and nevirapine200 mg, during apregnancy of 20-weekgestation. The woman was in her third gestation. The second case is aged 26,weighing 65 kg. This clinical picture had occurred 20 days after the administration of a tripletherapy combination: AZT 300 mg + 3TC 150 mg and nevirapine 200 mg,during a pregnancy of 32-week gestation. It was the fourth gestation. The birth of a stillborn hadoccurred the day before his admission into our service. The diagnosis of ToxicEpidermal Necrolysis with nevirapine was selected on the basis of the clinicaland anamnestic arguments. The biological tests showed the following results:transaminases ALT and AST were within normal limits, blood glucose, and urea > 10 mmol-l. The evolution was marked by thepatient death to Day 9 D9 and at D2 of hospitalization. Discussion: NET and the SJS have been reported in pregnant women aspotentially dangerous complications that are often associated with suspecteddrugs. Among these drugs, antiretroviral drugs, prescribed to pregnant women toprevent mother to child transmission of HIV are often reported. Our case is anillustration of the problem of HIV management in pregnant women. It alsofocuses on the association between pregnancy and Toxic Epidermal Necrolysis.Nevirapine is an effective drug in the regimens proposed in the management ofHIV patients in limited resources countries. But the high frequency oftoxidermia with this drug should lead to its replacement by otherantiretrovirals least providers of toxidermia as anti proteases in the contextof PMTCT programs.

KEYWORDS

Lyell; Pregnant Women; Nevirapine; Fatal Outcome

Cite this paper

M. Cissé, M. Soumah, T. Tounkara, B. Diané, F. Sack, H. Baldé, A. Camara, A. Camara and A. Doumbouya -Lyell Syndrome with Fatal Outcome in Two Pregnant Women Receiving Antiretroviral Therapy in Guinea Conakry,- Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 3 No. 2, 2013, pp. 135-138. doi: 10.4236-jcdsa.2013.32021.





Author: Mohamed Cissé, Mohamed Maciré Soumah, Thierno Mamadou Tounkara, Boh Fanta Diané, Fodé Bangaly Sack, Houleymatou Baldé, Amara

Source: http://www.scirp.org/



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