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Background: Despite the efficacy of raltegravir in reducing viral load in HIV-infected patients, evidence for its safety in late pregnancy is lacking. A high rate of placental transfer was recently demonstrated., Case: A treatment-naïve 34-year-old HIV-1-positive woman of African origin began treatment with zidovudine/lamivudine, lopinavir/ritonavir, and raltegravir at 35 weeks of pregnancy. After 11 days of treatment with raltegravir, a substantial reduction in viral load was achieved. Concurrently, she had a 23-fold increase in serum alanine aminotransferase and a 10-fold increase in serum aspartate aminotransferase, both of which returned to normal when raltegravir treatment was discontinued. A healthy boy was delivered at term. The infant's tests for HIV were negative at five months, and he had no health problems at eight months., Conclusion: This is the first case report, to our knowledge, of increased maternal serum transaminase levels following the use of raltegravir in a woman at a late stage of pregnancy.

Objective: The main objective is to describe the incidence of adverse drug reactions (ADR) coded by medical archivists from patient medical records. The secondary objective is to determine the drug classes causing ADRs according to age and to compare the incidence according to the revision of the International Classification of Diseases (ICD) used., Methods: This is a non experimental and descriptive study of ADR in a teaching hospital. All ADR codes (i.e. codes E930 to E949 in ICD-9 version and codes Y40 to Y59 in ICD-10 version) in medical records of patients aged 18 and under have been included. The research protocol has been accepted by the institutional review board committee of CHU Sainte-Justine., Results: We calculated on average 225.7±65.1 ADRs coded per year for an annual average incidence of pediatric ADRs of 1.64%±0.41% (n=4740 ADRs, average 1.3 ADR per patient) for a total of 294,480 admissions between April 1st, 1989 and March 31st, 2010. ADRs coded occurred amongst 0 to 2 years old and 12 to18 years old in a proportion of 30.5% and amongst 3 to 11 years old in a proportion of 39%. ADRs are caused by antibiotics (28%), anticancer drugs (18%), opiates (6%) and steroids (6%) which represent around 50% of all ADRs., Conclusion: The incidence of pediatric ADRs is increasing throughout the studied period, mainly because a more complete codification of episodes of care by medical archivists has been prioritized by the hospital administration., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Objective: To report a case of Guillain-Barré syndrome (GBS) following a dose of influenza A (H1N1) vaccine (Arepanrix)., Case Summary: An 11-year-old boy was admitted to the hospital after presenting with facial diplegia; abdominal, forehead, and thigh pain; and acute cervical pain. He had received the Arepanrix H1N1 subcutaneous vaccine 13 days before symptom onset. The neurologic examination also revealed a symmetric bilateral paralysis of the VIIth cranial nerve and intense pain, proximal weakness of the shoulder girdles and pelvis, and preserved deep tendon reflexes. Cerebrospinal fluid analysis revealed an albuminocytologic dissociation. Therefore, a diagnosis of atypical GBS following vaccination against HINI influenza was made., Discussion: Based on the clinical evaluation, laboratory test results, neurologic features, and the exclusion of alternative diagnoses, the Naranjo probability scale revealed a probable relationship between the clinical manifestations of GBS and the vaccine against influenza A (H1N1) received by the patient. This is the first published case for the 2009 influenza pandemic in children., Conclusions: While recent studies have found inconclusive results on the association between influenza vaccine and GBS, all suspected cases should be published for further evaluation.