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Bader-Meunier B, Bulai Livideanu C, Larroche C, Durieu I, Artru L, Beucher A, Cormier G, Cornec D, Delarco M, Dubost JJ, Fontaine C, Gourin MP, Javier RM, de Jauréguiberry JP, Maisonneuve H, Toussirot E, Ugo V, Echaubard S, Mahlaoui N, Aouba A, Bodemer C, Briot K, Frenzel L, Lortholary O, Chandesris MO, Hermine O. Association of mastocytosis with inflammatory joint diseases: a series of 31 patients. Semin Arthritis Rheum 2014; 44:362-5. [PMID: 25037281 DOI: 10.1016/j.semarthrit.2014.05.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/10/2014] [Accepted: 05/12/2014] [Indexed: 01/29/2023]
Abstract
OBJECTIVES We studied the clinical phenotypes and tolerance to treatments in a series of patients affected by both inflammatory joint diseases and mastocytosis. METHODS This retrospective multicenter study was conducted on behalf of 3 networks focused on mastocytosis, pediatric, and adults' inflammatory joint diseases. Patients who displayed both mastocytosis and inflammatory joint diseases were included. RESULTS A total of 31 patients were included. They had spondyloarthritis (SpA) (16 patients), rheumatoid arthritis (6 patients), juvenile idiopathic arthritis (2 patients), and undifferentiated arthritis (7 patients). The median ages at diagnosis of arthritis and mastocytosis were 44 and 40.5 years, respectively. Disease-modifying anti-rheumatic drugs (DMARDs) were required in 22 patients, comprising mostly methotrexate (13 patients), salazopyrin (8 patients), anti-tumor-necrosis-factor agents (7 patients), and corticosteroids (9 patients). They were well tolerated. Adverse events occurred in 2/24 patients receiving non-steroidal anti-inflammatory drugs. The prevalence of SpA among the 600 patients included in the mastocytosis cohort was 2.33%, which is significantly higher than the prevalence of SpA in the French population (p < 0.001). CONCLUSIONS This study suggests that mastocytosis is associated with a higher prevalence of SpA than expected, and that DMARDs, notably anti-TNFα agents, are well tolerated in patients with mastocytosis. Mast cells might be involved in the development of SpA.
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Affiliation(s)
- Brigitte Bader-Meunier
- Department of Pediatric Immunology and Rheumatology, INSERM U768, Hôpital Necker Enfants Malades (AP-HP), Paris 75015, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France.
| | | | - Claire Larroche
- Department of Internal Medicine, CHU Avicenne, (AP-HP), Bobigny, France
| | - Isabelle Durieu
- Department of Internal Medicine, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Université de Lyon, Pierre Bénite, France
| | - Laure Artru
- Department of Rheumatology, Hôpital du Mans, Le Mans, France
| | - Anne Beucher
- Department of Internal Medicine, CHU Angers, Angers, France
| | - Grégoire Cormier
- Department of Rheumatology, CHD Vendée, La Roche sur Yon, France
| | - Divi Cornec
- Department of Rheumatology, CHRU Brest, Brest, France
| | - Michel Delarco
- Department of Rheumatology, Hôpital de Bigorre, Tarbes, France
| | - Jean-Jacques Dubost
- Department of Rheumatology, Hopital G. Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Christophe Fontaine
- Department of Internal Medicine, Clinique Mutualiste Beau Soleil, Montpellier, France
| | | | | | | | - Hervé Maisonneuve
- Department of Internal Medicine, CHD les Oudairies, La Roche sur Yon, France
| | - Eric Toussirot
- Clinical Investigation Center Biotherapy INSERM CBT-506, CHRU de Besançon, Besançon, France; Department of Rheumatology, CHRU de Besançon, Besançon, France
| | - Valérie Ugo
- Laboratory of Hematology, CHU de Brest, Brest, France
| | | | - Nizar Mahlaoui
- Department of Pediatric Immunology and Rheumatology, INSERM U768, Hôpital Necker Enfants Malades (AP-HP), Paris 75015, France
| | - Achille Aouba
- Department of Hematology, Hôpital Necker EnfantsMalades (AP-HP), Paris, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France
| | - Christine Bodemer
- Department of Dermatology and Pediatric Dermatology, Hôpital Necker Enfants Malades (AP-HP), Paris, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France
| | - Karine Briot
- Department of Rheumatology, Hôpital Cochin, Paris Descartes University, Paris, France
| | - Laurent Frenzel
- Department of Hematology, Hôpital Necker EnfantsMalades (AP-HP), Paris, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France
| | - Olivier Lortholary
- Department of Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants Malades (AP-HP), Paris, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France
| | - Marie-Olivia Chandesris
- Department of Hematology, Hôpital Necker EnfantsMalades (AP-HP), Paris, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France
| | - Olivier Hermine
- Department of Hematology, Hôpital Necker EnfantsMalades (AP-HP), Paris, France; Institut Imagine, Université Sorbonne Paris cité, Hôpital Necker-Enfants Malades (AP-HP), Paris, France
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Abstract
Oral manifestations of hematologic and nutritional deficiencies can affect the mucous membranes, teeth, periodontal tissues, salivary glands, and perioral skin. This article reviews common oral manifestations of hematologic conditions starting with disorders of the white blood cells including cyclic hematopoiesis (cyclic neutropenia), leukemias, lymphomas, plasma cell dyscrasias, and mast cell disorders; this is followed by a discussion of the impact of red blood cell disorders including anemias and less common red blood cell dyscrasias (sickle cell disease, hemochromatosis, and congenital erythropoietic porphyria) as well as thrombocytopenia. Several nutritional deficiencies exhibit oral manifestations. The authors specifically discuss the impact of water-soluble vitamins (B2, B3, B6, B9, B12, and C), fat-soluble vitamins (A, D, and K) and the eating disorders anorexia nervosa and bulimia nervosa on the oral mucosa.
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