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Published 20 February 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.06.2008.0200]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Reminder of important clinical lesson

An important clinical lesson from a patient infected with HIV with diabetic nephropathy and retinopathy

Pasquale Martinelli, Annalisa Agangi, Matilde Sansone, Raffaele Napolitano, Giuseppe Maria Maruotti

University of Naples Federico II, Obstetrics and Gynecology, via Pansini, 5, Naples, 80131, Italy

Correspondence to:
martinel{at}unina.it

SUMMARY

In resource-rich settings, advances in antiretroviral therapy have reduced the morbidity and increased the life expectancy of patients infected with HIV and consequently increased the likelihood of observing other non-HIV-related diseases in this group of patients. We report a high-risk pregnancy in a 26-year-old woman infected with HIV with complicated insulin-dependent diabetes mellitus. Because of maternal concomitant disease and concerns regarding potential antiretroviral toxicity on maternal disease, an abbreviated regimen of zidovudine prophylaxis was offered to prevent neonatal infection. After the iatrogenic preterm delivery of a healthy and uninfected baby, the patient experienced vulvar oedema and she is now waiting for renal transplantation.

In conclusion, our case is one of a range of possible scenarios that may develop in pregnant women who are infected with HIV, reflecting the highly active antiretroviral therapy (HAART)-associated improvements in survival and health.


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