Résumé
OBJECTIVE: To examine the first-trimester maternal serum placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels in pregnancies associated with pre-eclampsia (PE) or small-for-gestational-age (SGA) infants, and determine the predictive accuracy of PlGF and of PAPP-A for either PE or SGA infants. METHODS: This prospective, observational study included 175 pregnant women, and of these women, due to participant withdrawal or loss to follow-up, delivery data were collected from the medical records of 155 women, including 4 who had twin pregnancies. The women's maternal history was recorded, and the PlGF and PAPP-A levels at 11 to 13 gestational weeks were measured. During the second trimester, the maternal uterine artery's systolic/diastolic ratio was measured. Multiples of the median (MoM) of PlGF and PAPP-A were determined, and the associations of these values with the risk factors of SGA and PE were evaluated. Logistic regression analysis was used to determine whether PlGF and PAPP-A are useful markers for predicting SGA infants. RESULTS: The PAPP-A MoM level was significantly lower in women with advanced maternal age, multipara women, and women with gestational diabetes than in their counterparts. The PlGF and PAPP-A MoM levels were higher in women with a twin pregnancy than in those with a singleton pregnancy. There was a significant relationship between the maternal serum PAPP-A MoM level in the first trimester and the uterine artery systolic/diastolic ratio in the second trimester. Results of logistic regression analysis showed that low PlGF and PAPP-A MoM levels were predictors of SGA infants (odds ratio, 0.143; 95% confidence interval, 0.025 to 0.806; odds ratio, 0.191; 95% confidence interval, 0.051 to 0.718, respectively). CONCLUSION: PlGF and PAPP-A are potentially useful as first-trimester markers for SGA infants and some hypertensive disorders of pregnancy.
Sujets)
Femelle , Humains , Nourrisson , Grossesse , Diabète gestationnel , Études de suivi , Modèles logistiques , Âge maternel , Dossiers médicaux , Étude d'observation , Odds ratio , Plasma sanguin , Pré-éclampsie , Premier trimestre de grossesse , Deuxième trimestre de grossesse , Grossesse gémellaire , Protéine A plasmatique associée à la grossesse , Femmes enceintes , Études prospectives , Facteurs de risque , Protéine A staphylococcique , Artère utérineRésumé
Highly active antiretroviral therapy (HAART), which restores specific immune responses, may paradoxically cause an inflammatory reaction known as immune reconstitution inflammatory syndrome (IRIS). We report a patient with acquired immune deficiency syndrome, who presented Molluscum contagiosum as IRIS after HAART, the first case in Korea.
Sujets)
Humains , Syndrome d'immunodéficience acquise , Thérapie antirétrovirale hautement active , VIH (Virus de l'Immunodéficience Humaine) , Syndrome inflammatoire de restauration immunitaire , Iris , Corée , Molluscum contagiosum , Peau , Manifestations cutanéesRésumé
According to current evidence, human immunodeficiency virus (HIV)-infected patients who have undergone treatment with antiretroviral therapy are at greater risk of developing herpes zoster, not when they are severely immunocompromised, but, paradoxically, when their immune system is recovering. This is a manifestation of the immune reconstitution inflammatory syndrome (IRIS). Here we report on a case of IRIS, presented as herpes zoster in a HIV-infected patient after undergoing highly active antiretroviral therapy (HAART).