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Knapp S, Bolko L, Servettaz A, Didier K. [[Eosinophilic fasciitis: From pathophysiology to therapeutics]]. Rev Med Interne 2024:S0248-8663(24)00086-9. [PMID: 38519306 DOI: 10.1016/j.revmed.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/24/2024]
Abstract
Eosinophilic fasciitis (EF) is a rare connective tissue disorder characterized by painful edema and induration of the limbs and trunk, likely associated with hypereosinophilia and hypergammaglobulinemia. EF causes arthralgia and range of motion limitation, leading to significant functional impairment and poor quality of life. Since its description by Shulman in 1974, over 300 cases have been reported. We present here a review of the latest diagnostic, pathophysiological and therapeutic developments in this disease. Magnetic resonance imaging appears useful to guide diagnosis and biopsy. Diagnosis is based on a deep skin biopsy involving the fascia, which will reveal edema, sclerofibrosis of the muscular fascia and subcutaneous tissue, and an inflammatory infiltrate sometimes composed of eosinophilic polynuclear cells. EF may occur in patients treated with immune checkpoint inhibitors and the diagnosis should be raised in case of cutaneous sclerosis in these patients. The pathophysiology of the disease remains poorly understood, and its management lacks randomized, controlled, blinded trials. First-line treatment consists in oral corticosteroid therapy, sometimes combined with an immunosuppressant, mainly methotrexate. A better understanding of the pathophysiology has opened new therapeutic perspectives and clarified the role of targeted therapies in the management of EF, such as interleukin-6 inhibitors, whose efficacy has been reported in several cases.
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Affiliation(s)
- S Knapp
- Service de médecine interne, maladie infectieuse et immunologie clinique, hôpital Robert-Debré, CHU de Reims, rue du Général-Kœnig, 51092 Reims cedex, France
| | - L Bolko
- Service de rhumatologie, hôpital Maison Blanche, CHU de Reims, Reims, France
| | - A Servettaz
- Service de médecine interne, maladie infectieuse et immunologie clinique, hôpital Robert-Debré, CHU de Reims, rue du Général-Kœnig, 51092 Reims cedex, France; EA 7509 IRMAIC, université de Reims Champagne-Ardenne, Reims, France
| | - K Didier
- Service de médecine interne, maladie infectieuse et immunologie clinique, hôpital Robert-Debré, CHU de Reims, rue du Général-Kœnig, 51092 Reims cedex, France; EA 7509 IRMAIC, université de Reims Champagne-Ardenne, Reims, France.
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Culerrier J, Nguyen Y, Karadag O, Yasar Bilge S, Kronbichler A, Jayne D, Régent A, Teixeira V, Marchand-Adam S, Duffau P, Oro S, Droumaguet C, Andre B, Luca L, Lechtman S, Aouba A, Lebas C, Servettaz A, Puéchal X, Terrier B. Caractéristiques et évolution des vascularites associées aux ANCA induites par les antithyroïdiens de synthèse comparativement aux formes primitives : étude rétrospective multicentrique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Stavris C, Chiche L, Charpin C, Dukan P, Doncarli C, Drouet H, Delord M, Renard L, Allemand J, Caillères S, Talbi N, Halfon P, Retornaz F, Servettaz A. [Asthenia, weight loss in a 55 year-old woman]. Rev Med Interne 2022; 43:626-629. [PMID: 35908996 DOI: 10.1016/j.revmed.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 10/16/2022]
Affiliation(s)
- C Stavris
- Médecine interne, Hôpital européen Marseille, Marseille, France.
| | - L Chiche
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - C Charpin
- Rhumatologie, Hôpital européen Marseille, Marseille, France
| | - P Dukan
- Hépato-Gastro-Entérologie, Hôpital européen Marseille, Marseille, France
| | - C Doncarli
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - H Drouet
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - M Delord
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - L Renard
- Dermatologie, boulevard Chave, Marseille, France
| | - J Allemand
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - S Caillères
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - N Talbi
- Centre français des Porphyries, Hôpital Louis Mourier, Colombes, France
| | - P Halfon
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - F Retornaz
- Médecine interne, Hôpital européen Marseille, Marseille, France
| | - A Servettaz
- Service de médecine interne, maladies infectieuses, immunologie clinique, CHU de Reims, 45 rue Cognacq-Jay, 51092 Reims cedex, France
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Chevalier K, Genin M, Petit Jean T, Avouac J, Flipo RM, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Servettaz A, Marotte H, Domont F, Chazerain P, Devaux M, Mekinian A, Sellam J, Fautrel B, Rouzaud D, Ebstein E, Costedoat-Chalumeau N, Richez C, Hachulla E, Mariette X, Seror R. AB1131 IDENTIFICATION OF FACTORS ASSOCIATED WITH THE OCCURRENCE OF SEVERE FORMS OF COVID-19 INFECTION IN PATIENTS WITH AUTOIMMUNE/INFLAMMATORY RHEUMATIC DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPatients with autoimmune/inflammatory rheumatic diseases (AIRD) were suspected to be an at-risk population of severe COVID-19. However, whether this higher risk is linked to the disease or to its treatment is difficult to determine.ObjectivesTo identify, among AIRD patients, factors associated with occurrence of moderate-to-severe COVID19 infection and to evaluate if having an AIRD was associated with an increased risk of severe form of COVID19 infection (defined by hospitalization in ICU or death), compared to general population.MethodsData source: The “Entrepôt des Données de Santé (EDS)” collect data from electronic health records of all patients hospitalized or followed in the AP-HP (39 hospitals in Paris area, France). The French RMD COVID19 cohort is a national multi-center cohort that included patients with confirmed AIRD and diagnosed with COVID-19. All AIRD patients diagnosed with COVID-19 before September 2020 from both cohorts were included.-We Identified factors associated with severe COVID-19 was made in a combined analysis of the 2 cohorts.-Then, we compared COVID-19 infection severity in the EDS-COVID database in AIRD patients and controls, by a propensity score (PS)-matched case-control (1:4) studyResultsAmong 1213 patients (334 in EDS and 879 in RMD cohort), 195 (16.1%) experienced a severe COVID19. In multivariate analysis, greater age, history of interstitial lung disease, arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory disease and treatment with corticosteroids or rituximab were associated with severe COVID-19 (Table 1).Table 1.AIRD patient’s characteristics associated with severity of COVID-19Patients with mild or moderate infectionPatients with severe infectionOR ajustés 95%CIp-value(N = 1018)(N = 195)Patients characteristics Age55.9 (16.7%)70.3 (14.3%)1.05 [1.03;1.07]<0.001 Gender: Female695 (68.3%)105 (54.1%)0.59 [0.38;0.94]0.025 Interstitial pneumonia38 (3.7%)20 (10.3%)2.94 [1.34;6.34]0.008 Obesity143 (17.8%)38 (27.7%)2.09 [1.26;3.43]0.004 Hypertension268 (26.3%)114 (58.5%)1.81 [1.13;2.89]0.013Underlying Disease: Chronic inflammatory arthritis618 (60.8%)72 (36.9%)Ref. Auto-inflammatory disease29 (2.9%)5 (2.6%)3.91 [1.2;11.32]0.025 Other29 (2.9%)4 (2.1%)0.35 [0.06;1.41]0.15 Connectivitis190 (18.7%)34 (17.4%)1.13 [0.62;2.01]0.69 Sarcoidosis40 (3.9%)24 (12.3%)5.19 [2.15;12.3]<0.001 Vasculitis111 (10.9%)56 (28.7%)1.8 [1.02;3.16]0.044Treatments Corticosteroid318 (31.2%)117 (60.0%)2.47 [1.58;3.87]<0.001 Leflunomide44 (4.3%)2 (1.0%)0.13 [0;0.97]0.045 Rituximab37 (3.7%)22 (11.5%)4.05 [1.96;8.27]<0.001Not significant in multivariate analysisCOPD, Asthma, Coronary heart diseases, stroke, diabetes, smoking, cancer, non-steroidal anti-inflammatory drugs, colchicine, hydroxychloroquine, methotrexate, salazopyrine, mycophenolate mofetil, azathioprine, intravenous immunoglobulins, anti-TNFα, anti-IL1, -IL6, -IL17, Abatacept, JAK inhibitorAmong 35741 COVID-19 patients in EDS, 316 with AIRD were compared to 1264 PS-matched controls. Severe form occurred in 118 (37,3%) AIRD cases and 384 (30.4%) controls (Adjusted OR (aOR) for severe form= 1.43 [1.1;1.9], p=0,01). In analysis restricted to rheumatoid arthritis (RA) and spondylarthritis (SpA), no increased risk of severe form (aOR=1.11 [0.68;1.81]) form or death (aOR=1.00 [0.55;1.81]) was observed.ConclusionIn this multicenter study we confirmed that AIRD patients treated with rituximab or corticosteroids were at increased risk of severe COVID-19, as were those with vasculitis, auto-inflammatory disease, and sarcoidosis. Also, when compared to controls from the same cohort of hospitalized patients, AIRD patients had, overall, an increased risk of severe COVID-19, increased risk not observed in an analysis restricted to patients with RA or SpA.AcknowledgementsFAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributorsPatricia MartelAll clinicians/physicians implicated in COVID-19 patient care in APHP hospital and generated EDS patient dataDisclosure of InterestsNone declared
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Eshagh D, Quéméneur T, Karras A, Queyrel V, Augusto J, Agard C, Audard V, Couderc M, Duffau P, Durel C, Faguer S, Jourde-Chiche N, Lavergne A, Christian L, Limal N, Servettaz A, Smets P, Régent A, Mouthon L, Terrier B. Particularités phénotypiques et thérapeutiques des vascularites à ANCA au cours de la sclérodermie systémique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mettler C, Durel CA, Guilpain P, Bonnotte B, Cohen-Aubart F, Hamidou M, Lega JC, Guern VL, Lifermann F, Poindron V, Pugnet G, Servettaz A, Puéchal X, Guillevin L, Terrier B. Off-label use of biologics for the treatment of refractory and/or relapsing granulomatosis with polyangiitis. Eur J Intern Med 2022; 96:97-101. [PMID: 34716074 DOI: 10.1016/j.ejim.2021.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To describe the efficacy and safety of off-label use of biologics for refractory and/or relapsing granulomatosis with polyangiitis (GPA). METHODS We conducted a French retrospective study including GPA patients who received off-label biologics for refractory and/or relapsing disease after failure of conventional immunosuppressive regimens. RESULTS Among 26 patients included, 18 received infliximab (IFX), 2 adalimumab (ADA) and 6 abatacept (ABA). Biologics were initiated in median as 4th-line therapy (IQR 3-6) for relapsing and/or refractory disease in 23 (88%) and/or significant glucocorticoid-dependency in 8 cases (31%). At biologics initiation, median (IQR) BVAS and prednisone dose in anti- TNF-α and ABA recipients were 7 (3-8) and 2 (1-6), and 20 (13-30) mg/day and 20 (15-25) mg/day, respectively. Clinical manifestations requiring biologics were mainly pulmonary and ENT manifestations in 58% each. Anti-TNF-α and ABA were continued for a median duration of 8 months (IQR 6-13) and 11 months (IQR 6-18) respectively. Anti-TNF-α recipients showed remission, partial response and treatment failure in 10%, 30% and 60% at 6 months, and 25%, 20% and 55% at 12 months, respectively. ABA recipients showed remission, partial response and treatment failure in 17%, 33% and 50% at 6 months and 17%, 33% and 50% at 12 months. One patient treated with IFX experienced life-threatening reaction while one patient treated with ABA experienced a severe infection. CONCLUSION This real-life study suggests that off-label use of anti-TNF-α and abatacept shows efficacy in less than 50% of refractory and/or relapsing GPA.
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Affiliation(s)
- C Mettler
- Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Cochin Hospital, AP-HP, Paris, France
| | - C A Durel
- Department of Internal Medicine, CHU Lyon, Lyon, France
| | - P Guilpain
- Department of Internal Medicine-Multiorganic Diseases, Local Referral Center for Auto-immune Diseases, Saint-Eloi Hospital, Montpellier University, Montpellier, France
| | - B Bonnotte
- Department of Internal Medicine, Competence Center for Autoimmune Cytopenia, François Mitterrand University Hospital, Dijon, France
| | - F Cohen-Aubart
- Department of Internal Medicine 2, French National Centre for Rare Systemic Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - M Hamidou
- Department of Internal Medicine, Nantes University Hospital, 44093 Nantes, France
| | - J C Lega
- Department of Internal and Vascular Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Université Lyon 1, Equipe Evaluation et Modélisation des Effets Thérapeutiques, LBBE, UMR CNRS 5558, France
| | - V Le Guern
- Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Cochin Hospital, AP-HP, Paris, France
| | - F Lifermann
- Department of Internal Medecine, Dax - Côte d'Argent Hospital, Dax, France
| | - V Poindron
- Clinical Immunology Department, National Referral Center for Systemic Autoimmune Diseases, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - G Pugnet
- Department of Internal Medicine and Clinical Immunology, CHU Toulouse Rangueil, Toulouse, France
| | - A Servettaz
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, Reims, France
| | - X Puéchal
- Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Cochin Hospital, AP-HP, Paris, France
| | - L Guillevin
- Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Cochin Hospital, AP-HP, Paris, France
| | - B Terrier
- Department of Internal Medicine, National Referral Center for Rare Systemic and Autoimmune Diseases, Cochin Hospital, AP-HP, Paris, France.
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Glatre A, Pascard M, Salmon J, Servettaz A, Robbins A. L’éosinopénie: un marqueur simple et utile pour le diagnostic d’infection chez les patients sous tocilizumab? Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Georgin-Lavialle S, Terrier B, Guedon AF, Heiblig M, Comont T, Lazaro E, Lacombe V, Terriou L, Ardois S, Bouaziz JD, Mathian A, Le Guenno G, Aouba A, Outh R, Meyer A, Roux-Sauvat M, Ebbo M, Zhao LP, Bigot A, Jamilloux Y, Guillotin V, Flamarion E, Henneton P, Vial G, Jachiet V, Rossignol J, Vinzio S, Weitten T, Vinit J, Deligny C, Humbert S, Samson M, Magy-Bertrand N, Moulinet T, Bourguiba R, Hanslik T, Bachmeyer C, Sebert M, Kostine M, Bienvenu B, Biscay P, Liozon E, Sailler L, Chasset F, Audemard-Verger A, Duroyon E, Sarrabay G, Borlot F, Dieval C, Cluzeau T, Marianetti P, Lobbes H, Boursier G, Gerfaud-Valentin M, Jeannel J, Servettaz A, Audia S, Larue M, Henriot B, Faucher B, Graveleau J, de Sainte Marie B, Galland J, Bouillet L, Arnaud C, Ades L, Carrat F, Hirsch P, Fenaux P, Fain O, Sujobert P, Kosmider O, Mekinian A. Further characterization of clinical and laboratory features occurring in VEXAS syndrome in a large-scale analysis of multicenter case-series of 116 French patients. Br J Dermatol 2021; 186:564-574. [PMID: 34632574 DOI: 10.1111/bjd.20805] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND A new autoinflammatory syndrome related to somatic mutations of UBA1 was recently described and called VEXAS syndrome. OBJECTIVE To describe clinical characteristics, laboratory findings and outcomes of VEXAS syndrome. DESIGN Case-series. SETTING Patients referred to a French multicenter registry between November 2020 and May 2021. PATIENTS 116 patients with VEXAS syndrome. MEASUREMENTS Frequency and median of parameters and vital status, from diagnosis to the end of the follow-up. RESULTS Main clinical features were skin lesions (83.5%), non-infectious fever (63.6%), weight loss (62%), lung involvement (49.6%), ocular symptoms (38.8%), relapsing chondritis (36.4%), venous thrombosis (34.7%), lymph nodes (33.9%), and arthralgia (27.3%). Hematological disease was present in 58 cases (50%), considered as myelodysplastic syndrome (MDS, n= 58) and monoclonal gammapathy of unknown significance (n=12).UBA1 mutations included p.M41T (44.8%), p.M41V (30.2%), p.M41L (18.1%), and splice mutations (6.9%). After a median follow-up of 3.0 years, 18 patients died (15.5%), from infectious origin (n=9) and MDS progression (n=3). Unsupervised analysis identified 3 clusters: cluster 1 (47%) with mild-to-moderate disease; cluster 2 (16%) with underlying MDS and higher mortality rates; cluster 3 (37%) with constitutional manifestations, higher C-reactive protein levels and less frequent chondritis. Five-year probability of survival was 84.2% in cluster 1, 50.5 % in cluster 2, and 89.6% in cluster 3. UBA1 p.Met41Leu mutation was associated with a better prognosis. CONCLUSION VEXAS syndrome displays a large spectrum of organ manifestations and shows different clinical and prognostic profiles. It also raises a potential impact of the identified UBA1 mutation.
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Affiliation(s)
- S Georgin-Lavialle
- Sorbonne Université, AP-HP, Hôpital Tenon, service de médecine interne, CEREMAIA, F-75020, Paris, France
| | - B Terrier
- University of Paris, AP-HP, Cochin Hospital, Department of Internal Medicine, F-75014, Paris, France
| | - A F Guedon
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Hôpital Saint-Antoine, APHP, Paris
| | | | - T Comont
- University Hospital of Toulouse, Department of Internal Medicine and Clinical Immunology, Toulouse, France
| | - E Lazaro
- Department of Internal Medicine and Infectious Diseases, Hôpital Haut-Lévêque, Bordeaux, France
| | - V Lacombe
- Department of Internal Medicine, Angers University Hospital, Angers, France
| | - L Terriou
- Department of Internal Medicine, Lille University Hospital, Lille, France
| | - S Ardois
- Service de médecine interne, CHU de Rennes, Rennes, France
| | - J-D Bouaziz
- Université de Paris, Service de dermatologie, Hôpital Saint Louis, APHP, INSERM U944, Paris, France
| | - A Mathian
- Assistance Publique-Hôpitaux de Paris, Groupement Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - G Le Guenno
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - A Aouba
- Caen Université, Hôpital de Caen, Department of Internal Medicine, Caen, France
| | - R Outh
- Service de médecine interne et générale, Centre Hospitalier de Perpignan, Perpignan, France
| | - A Meyer
- Service d'immunologie clinique et médecine interne, Nouvel Hôpital Civil, CHU Strasbourg
| | - M Roux-Sauvat
- GHND, Centre Hospitalier Pierre Oudot, 30 avenue du Médipôle, BP 40348, 38302 Bourgoin-Jallieu Cedex
| | - M Ebbo
- Aix Marseille Université, AP-HM, Hôpital de la Timone, Department of Internal Medicine, Marseille, France
| | - L P Zhao
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - A Bigot
- 19University of Tours, Tours, France, Department of Internal Medicine and Clinical
| | - Y Jamilloux
- University Hospital of Lyon, Hospices Civils de Lyon, Department of Internal Medicine and Clinical Immunology, Lyon, France
| | - V Guillotin
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - E Flamarion
- Université de Paris, Service de médecine interne, HEGP Paris, France
| | - P Henneton
- Service de Médecine Vasculaire, CHU Montpellier, 80 Av Augustin Fliche, Montpellier, 34090
| | - G Vial
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - V Jachiet
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France
| | - J Rossignol
- Université de Paris, Service d'hématologie, Necker Enfants Malades, Paris, France
| | - S Vinzio
- Univ. Grenoble Alpes, Inserm, U1036, CHU Grenoble Alpes, CEA, IRIG-BCI, 38000, Grenoble, France
| | - T Weitten
- Service de médecine interne, Centre Hospitalier (CHICAS), GAP, France
| | - J Vinit
- Service de médecine interne, Centre Hospitalier, Chalons, France
| | - C Deligny
- Service de Rhumatologie - Médecine Interne 5D · CHU de Martinique - Hôpital P. Zobda-Quitman, France
| | - S Humbert
- CHU de Besançon, Service de Médecine Interne, Besançon, France
| | - M Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - N Magy-Bertrand
- CHU de Besançon, Service de Médecine Interne, Besançon, France
| | - T Moulinet
- Department of Internal Medicine and Clinical Immunology, Regional Competence Center for Systemic and Autoimmune Rare Diseases, Nancy University Hospital, UMR 7365, IMoPA, Lorraine University, CNRS, Vandoeuvre-lès-Nancy, France
| | - R Bourguiba
- Sorbonne Université, AP-HP, Hôpital Tenon, service de médecine interne, CEREMAIA, F-75020, Paris, France
| | - T Hanslik
- AP-HP, Hôpital Ambroise Paris, service de médecine interne, Paris, France
| | - C Bachmeyer
- Sorbonne Université, AP-HP, Hôpital Tenon, service de médecine interne, CEREMAIA, F-75020, Paris, France
| | - M Sebert
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - M Kostine
- Department of Rheumatology, Hôpital Haut-Lévesque, Bordeaux, France
| | - B Bienvenu
- Hôpital Saint Joseph, service de médecine interne, Marseille, France
| | - P Biscay
- Clinique Mutualiste Pessac Médecine Interne, Pessac, France
| | - E Liozon
- Service de Médecine Interne, CHU Dupuytren, Limoges, France
| | - L Sailler
- University Hospital of Toulouse, Department of Internal Medicine, Toulouse, France
| | - F Chasset
- Sorbonne Université, Hôpital Tenon, service de dermatologie et allergologie et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75020, Paris, France
| | - A Audemard-Verger
- 19University of Tours, Tours, France, Department of Internal Medicine and Clinical
| | - E Duroyon
- Service d'Hématologie Biologique, DMU BioPhyGen GH AP-HP. Centre-University de Paris
| | - G Sarrabay
- Laboratory of Rare and Autoinflammatory Genetic Diseases and Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), CHU Montpellier, University of Montpellier, Montpellier, France
| | - F Borlot
- Service de médecine Interne, CH Béziers, France
| | - C Dieval
- Service de médecine interne et hématologie, CH régional, Rochefort, France
| | - T Cluzeau
- Hematology department, CHU of Nice, Cote d'Azur University, Nice, France
| | - P Marianetti
- CHU de REIMS, Service de médecine interne, maladies infectieuses, immunologie clinique
| | - H Lobbes
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - G Boursier
- Laboratory of Rare and Autoinflammatory Genetic Diseases and Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), CHU Montpellier, University of Montpellier, Montpellier, France
| | - M Gerfaud-Valentin
- University Hospital of Lyon, Hospices Civils de Lyon, Department of Haematology, Lyon, France
| | - J Jeannel
- Université de Paris, Service de médecine interne, HEGP Paris, France
| | - A Servettaz
- CHU de REIMS, Service de médecine interne, maladies infectieuses, immunologie clinique
| | - S Audia
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - M Larue
- APHP, Service de rhumatologie, Hôpital Henri Mondor, Créteil, France
| | - B Henriot
- Service de médecine interne, Centre Hospitalier René Pleven, Dinan, France
| | - B Faucher
- Aix Marseille Université, AP-HM, Hôpital de la Timone, Department of Internal Medicine, Marseille, France
| | - J Graveleau
- CHU de Nantes Hôtel Dieu, Service de Médecine Interne, Nantes, France
| | - B de Sainte Marie
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - J Galland
- Service de médecine interne, hôpital Fleyriat, Centre hospitalier Bourg-en-Bresse, France
| | - L Bouillet
- Univ. Grenoble Alpes, Inserm, U1036, CHU Grenoble Alpes, CEA, IRIG-BCI, 38000, Grenoble, France
| | - C Arnaud
- University Hospital of Toulouse, Department of Internal Medicine, Toulouse, France
| | - L Ades
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - F Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Hôpital Saint-Antoine, APHP, Paris
| | - P Hirsch
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service d'hématologie biologique, F-75012, Paris, France
| | - P Fenaux
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - O Fain
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France
| | - P Sujobert
- CHU de Besançon, Service de Médecine Interne, Besançon, France
| | - O Kosmider
- Service d'Hématologie Biologique, DMU BioPhyGen GH AP-HP. Centre-University de Paris
| | - A Mekinian
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France
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Avouac J, Drumez E, Hachulla E, Seror R, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Marotte H, Servettaz A, Domont F, Chazerain P, Devaux M, Claudepierre P, Langlois V, Mekinian A, Maria A, Banneville B, Fautrel B, Pouchot J, Thomas T, Flipo RM, Richez C. OP0284 OUTCOME OF COVID-19 IN PATIENTS WITH RHEUMATIC AND INFLAMMATORY DISEASES TREATED WITH RITUXIMAB: DATA FROM DE FRENCH RMD COVID-19 COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Various observations have suggested that the course of the COVID-19 infection may be less favorable in patients with inflammatory rheumatic and musculoskeletal diseases (iRMD) receiving rituximab (RTX).Objectives:To investigate whether treatment with RTX is associated with severe infection and death.Methods:We performed an observational, multicenter, French national cohort study querying the French RMD COVID-19 cohort, including highly suspected/confirmed iRMD-COVID-19 patients. The primary endpoint was to assess the severity rate of COVID-19. Severe disease was defined by hospitalization in intensive care unit or death. The secondary objectives were to analyze death rate and length of hospital stay. Two control groups were considered for comparison with RTX treated patients: a first group including all non-RTX treated iRMD patients and a second consisting on RTX untreated iRMD patients with diseases for which RTX is a recognized therapeutic option. Adjusting on potential confounding factors was performed by using inverse probability of treatment weighting (IPTW) propensity score method.Results:We collected a total of 1090 records. Patients were mainly females (67.3%, 734/1090) with a mean age of 55.2±16.4 years, and 51.1% (557/1090) were over the age of 55. Almost 70% of the population had at least one comorbidity (756/1090). A total of 63 patients were treated with RTX, mainly for rheumatoid arthritis (RA) (31/63, 49.2%). RTX treated patients were more likely to be males, with older age, higher prevalence of comorbidities and corticosteroid use. The control population consisted on 1027 non-RTX treated iRMD patients, and 495 RTX untreated iRMD patients with diseases for which RTX is a recognized therapeutic option.Of the 1,090 patients, 137 developed severe disease (12.6%). After adjusting on potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure and the underlying disease), severe disease was confirmed to be observed more frequently in patients receiving RTX compared to all RTX untreated iRMD patients (effect size, ES 3.26, 95% confidence interval, CI 1.66 to 6.40, p<0.001) and the subgroup of untreated RTX patients with diseases eligible for RTX therapy (ES 2.62, 95% CI 1.34 to 5.09, p=0.005). Patients who developed a severe disease had a more recent rituximab infusion compared to patients with mild or moderate disease. Indeed, the time between the last infusion of rituximab and the first symptoms of COVID-19 was significantly shorter in patients who developed a severe form of COVID-19 (Figure 1).Figure 1.Distribution (Tukey’s box plot) of Lag time between last infusion of Rituximab according to disease severity. P-Values for comparison between disease severity with Kruskal Wallis test are reported; P-Value<0.001 for either post-hoc comparison of severe disease group with moderate or mild disease group (calculated using Dunn’s test).Eighty-nine patients in our cohort died, resulting in an overall death rate of 8.2%. Death rate was numerically higher in RTX treated patients (13/63, 20.6%) compared to all RTX untreated iRMDs patients (76/1027, 7.4%) and the subgroup of untreated RTX patients with diseases eligible for RTX therapy (49/495, 9.9%). After considering the previously described confounding factors, the risk of death was not significantly increased in patients treated with RTX compared to all RTX untreated iRMDs patients (ES 1.32, 95% CI 0.55 to 3.19, p=0.53) (Table 2) and the subgroup of untreated RTX patients with diseases eligible for RTX therapy (ES 1.48, 95% CI 0.68 to 3.20, p=0.32). In line with a more severe COVID-19 disease, the length of hospital stay was markedly longer in patients treated with RTX compared to both untreated RTX patient groups.Conclusion:RTX therapy is associated with a more severe COVID-19 infection. RTX will have to be applied with particular caution in patients with iRMDs.Acknowledgements:Muriel Herasse played a major role in collecting the missing data of the cohort.We thank Julien Labreuche (biostatistician, CHU-Lille) for the help in the statistical analysis.Disclosure of Interests:None declared
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Bourse Chalvon N, Pennaforte J, Servettaz A, Boulagnon C, Gavand P, Lekieffre M, Cohen Aubart F, Haroche J, Mathian A, Amoura Z, Costedoat-Chalumeau N, Orquevaux P, Piette J. Les valvulopathies sévères associées au LES et/ou au SAPL (dont l’endocardite de Libman-Sachs) sont une complication du syndrome des anti-phospholipides : analyse rétrospective de 23 patients opérés. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Canard C, Molitor A, Gusdorf L, Vanhaecke C, Servettaz A, Georgin-Lavialle S, Durlach A, Touitou I, Sarrabay G, Carapito R, Barham S, Viguier M. Péri-artérite noueuse familiale non liée à un déficit en adénosine déaminase-2. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mettler C, Durel C, Cohen-Aubart F, Guilpain P, Hamidou M, Lega J, Le Guern V, Lifermann F, Poindron V, Pugnet G, Samson M, Servettaz A, Puéchal X, Guillevin L, Terrier B. Utilisation hors-AMM des biothérapies au cours des granulomatoses avec polyangéite réfractaires ou en rechute. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lejeune G, Hoeffel C, Armengol G, Servettaz A. Atteintes hépato-biliaires dans l’artérite à cellules géantes : description de deux cas et revue de la littérature. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Didier K, Sobanski V, Barbe C, Robbins A, Truchetet M, Barnetche T, Hot A, Fort R, Guilpain P, Maria A, Agard C, Pennaforte J, Viguier M, Martin T, Pham B, Launay D, Servettaz A. Auto-anticorps dans la sclérodermie systémique : méta-analyse de la prévalence de 9 auto-anticorps spécifiques dans différentes régions du monde. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Didier K, Giusti D, Le Jan S, Terryn C, Muller C, Pham B, Le Naour R, Antonicelli F, Servettaz A. La NETose est associée aux complications vasculaires dans la sclérodermie systémique. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Legrain P, Robbins A, Guillon M, Quinquenel A, Servettaz A. Une surdité bilatérale révélatrice d’un syndrome de Bing-Neel. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Husson B, Visseaux L, Noel V, Dubard de Gaillarbois T, Durlach A, Alame A, Bernard P, Servettaz A, Viguier M. Maladie de Takayasu révélée par un érythème suspendu en caleçon. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Toquet S, Uzunhan Y, Leroux G, Bonnotte B, Gallay L, Limal N, Deligny C, Servettaz A, Paule R, Humbert S, Benveniste O, Allenbach Y. Facteurs pronostiques de la dermatomyosite à anticorps anti-MDA5 : sexe féminin et atteinte articulaire de bon pronostic. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hentzien M, Mestrallet S, Halin P, Pannet L, Lebrun D, Drame M, Bani-Sadr F, Galempoix J, Strady C, Reynes J, Penalba C, Servettaz A. Construction et validation interne d’un score clinicobiologique prédictif de formes graves d’infection à Puumala virus (Nephropathia Epidemica) parmi les cas survenus dans les Ardennes entre 2000 et 2014. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lebrun D, Hentzien M, Cuzin L, Rey D, Joly V, Cotte L, Allavena C, Dellamonica P, Servettaz A, Bani-Sadr F. Épidémiologie des maladies auto-immunes et systémiques chez les patients vivant avec le VIH suivi dans la cohorte française nationale Dat’AIDS. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lebrun D, Hentzien M, Rey D, Joly V, Ferry T, Cuzin L, Allavena C, Dellamonica P, Servettaz A, Bani-Sadr F. Épidémiologie des maladies auto-immunes et des maladies de système chez les patients VIH+ suivis dans la cohorte DAT’AIDS. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hentzien M, Strady C, Vernet-Garnier V, Servettaz A, De Champs C, Delmer A, Bani-Sadr F, N’Guyen Y. Facteurs pronostiques associés à la mortalité intra-hospitalière sur 30 jours lors des bactériémies à staphylocoques à coagulase négative : absence d’impact de la concentration minimale inhibitrice à la vancomycine. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ammar Y, Launois C, Perotin JM, Dury S, Servettaz A, Perdu D, Vallerand H, Nardi J, Boulagnon-Rombi C, Pluot M, Lebargy F, Deslee G. Hypoventilation alvéolaire sévère révélant un shrinking lung syndrome lupique. Rev Mal Respir 2017; 34:571-575. [DOI: 10.1016/j.rmr.2016.10.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 10/17/2016] [Indexed: 12/01/2022]
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Garval E, Pennaforte JL, Jaussaud R, Servettaz A, Bernard P, Reguiai Z. Traitement du lupus érythémateux par bélimumab en pratique courante : étude rétrospective de 15 malades. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Robbins A, Lacoste M, Boulagnon C, Jaussaud R, Servettaz A. Thrombose artérielle poplitée bilatérale révélant une cryofibrinogénémie primitive. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Toquet S, Servettaz A, Noel V, Jaussaud R. Un cas de dermatomyosite à anticorps anti-MDA5. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Maestraggi Q, Chillet P, Poiron L, Ouldzein S, Petitpas D, Aumersier M, Orquevaux P, Servettaz A, Berger P. Une encéphalite rare : l’encéphalite limbique à anticorps anti-récepteur du N-méthyl-d-aspartate. À propos d’un cas pris en charge en réanimation. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Daelman L, Garcia T, Servettaz A, Tourbah A. Méningo-encéphalite chronique révélée par un syndrome démentiel. Rev Neurol (Paris) 2014; 170:465-7. [DOI: 10.1016/j.neurol.2014.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 02/20/2014] [Accepted: 02/21/2014] [Indexed: 10/25/2022]
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Maestraggi Q, Servettaz A, Laurant-Noël V, Kianmanesh R, Sommacale D, Jaussaud R. Cholangite sclérosante ischémique au cours de la maladie de Rendu-Osler. À propos d’un cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Perney A, Laurant-Noël V, Servettaz A, Bani-Sadr F, Lambert D, de Champs C, Protin JM, Jaussaud R. Diagnostic et prise en charge de la maladie de Lyme en phase précoce : difficultés rencontrées par le médecin généraliste. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gauche V, Servettaz A, Laurant-Noël V, Jaussaud R. Les thérapeutiques alternatives et complémentaires dans la prise en charge des déficits immunitaires primitifs : plébiscitées par les patients mais souvent ignorées des médecins. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Leroy C, Servettaz A, Beaumont C, Derancourt C, Jaussaud R, Gaillard D. À propos d’une forme familiale autosomique dominante d’hyperferritinémie : le syndrome cataracte-hyperferritinémie. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Batalla A, Penalba C, Ainine K, Line D, Servettaz A, Strady C, Jaussaud R. Comparaison épidémiologique et clinico-biologique de 377 cas de fièvre hémorragique avec syndrome rénal (FHSR) issus de la zone épidémique et de la zone endémique. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Guilpain P, Chéreau C, Goulvestre C, Servettaz A, Montani D, Tamas N, Pagnoux C, Hachulla E, Weill B, Guillevin L, Mouthon L, Batteux F. The oxidation induced by antimyeloperoxidase antibodies triggers fibrosis in microscopic polyangiitis. Eur Respir J 2010; 37:1503-13. [PMID: 21071471 DOI: 10.1183/09031936.00148409] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Lung fibrosis is considered a severe manifestation of microscopic polyangiitis (MPA). Antimyeloperoxidase (anti-MPO) antibodies in MPA patients' sera can activate MPO and lead to the production of reactive oxygen species (ROS). While high levels of ROS are cytotoxic, low levels can induce fibroblast proliferation. Therefore, we hypothesised that the oxidative stress induced by anti-MPO antibodies could contribute to lung fibrosis. 24 MPA patients (45 sera) were enrolled in the study, including nine patients (22 sera) with lung fibrosis. Serum advanced oxidation protein products (AOPP), MPO-induced hypochlorous acid (HOCl) and serum-induced fibroblast proliferation were assayed. AOPP levels, MPO-induced HOCl production and serum-induced fibroblast proliferation were higher in patients than in healthy controls (p<0.0001, p=0.0001 and p=0.0005, respectively). Increased HOCl production was associated with active disease (p=0.002). Serum AOPP levels and serum-induced fibroblast proliferation were higher in patients with active MPA and lung fibrosis (p<0.0001). A significant linear relationship between fibroblast proliferation, AOPP levels and HOCl production was observed only in patients with lung fibrosis. Oxidative stress, in particular the production of HOCl through the interaction of MPO with anti-MPO antibodies, could trigger the fibrotic process observed in MPA.
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Affiliation(s)
- P Guilpain
- Laboratoire d'Immunologie, EA, UPRES 1833, Pôle de Médecine Interne et CentreNational de Référence pour lesVascularites Nécrosantes et laSclérodermie Systémique, UniversitéParis Descartes, Faculté deMédecine, Pavillon Gustave Roussy, 4e étage, Hôpital Cochin, 8 rue Méchain, 75014, Paris, France
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Batalla AS, Benito D, Baumard S, Brodard V, Servettaz A, Jaussaud R, Strady C. [Epstein-Barr virus and cytomegalovirus primary infections: a comparative study in 52 immunocompetent adults]. Med Mal Infect 2010; 41:14-9. [PMID: 20832213 DOI: 10.1016/j.medmal.2010.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 06/15/2010] [Accepted: 07/26/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to compare epidemiological, clinical, and biological data of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) primary infections in immunocompetent adults, admitted in the infectious disease department of the Reims Teaching Hospital between 2000 and 2005. PATIENTS AND METHODS Inclusion criteria were the presence of anti-VCA IgM antibodies or the presence of CMV specific IgM antibodies and the absence of any other positive serology. Differences in reported percentage were compared with a Khi(2) test or Fischer's exact test, when appropriate. Continuous variables were compared with the Mann-Whitney Test. RESULTS There were no significant changes over the years in the numbers of EBV (n=32) and CMV (n=20) primary infections. The patient's mean age was 22.7 years (14-48 years) in EBV primary infections and 38.6 years (13-66 years) in CMV primary infections (P<0.01). The clinical variables significantly associated with primary EBV infection were sore throat and cervical lymphadenopathy (P<0.01). Arthromyalgia and respiratory manifestations were less frequent in EBV primary infection (P<0.01). The biological variables significantly associated with EBV primary infection were a marked alanine aminotransferase elevation and a marked lymphocytosis with atypical lymphocytes (P<0.001). Thrombopenia was less frequently associated with EBV primary infection (P<0.001). CONCLUSION Clinical and biological presentations of EBV and CMV primary infections were similar. The simultaneous serologic diagnosis of these two infections remains necessary to provide a specific diagnosis, for the most efficient patient care.
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Affiliation(s)
- A-S Batalla
- Service de médecine interne et des maladies infectieuses, hôpital Robert-Debré, avenue du Général-Koenig, Reims cedex, France
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Jaussaud R, Servettaz A, Lesaffre F, Garnotel R, Nazeyrollas P. Cardiopathie hypokinétique dilatée curable chez l’adulte : penser à la carnitine ! Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jaussaud R, Servettaz A, Tabary T, Noel V, Cohen J. Ascite révélatrice d’un angio-œdème héréditaire de type II et son évolution sur une décennie (lupus et grossesse…). Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Servettaz A, Noel V, Garcia T, Tourbah A, Jaussaud R. Myélite aiguë et névrite optique bilatérale évocatrices d’un syndrome de Devic chez une patiente atteinte de lupus érythémateux systémique : initiation possible par une vaccination grippale et une évolution spectaculaire sous rituximab. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Noel V, Dezirey N, Servettaz A, Marty H, Jaussaud R. Carence en vitamine D et effets extraosseux : étude monocentrique rétrospective de 270 patients hospitalisés et consultants. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Servettaz A, Noel V, Tabary T, Cohen J, Jaussaud R. Un déficit immunitaire commun variable associé à une maladie de Still. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jaussaud R, Servettaz A, Noel V, Tabary T, Cohen J, Macquart FX. Angiœdème acquis de type II rebelle avec gammapathie monoclonale IgM kappa traité avec succès par rituximab. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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NGuyen Y, Baumard S, Vernet-Garnier V, Servettaz A, De Champs C, Jaussaud R, Strady C. A-04 Épidémiologie descriptive des bactériémies à staphylocoque au CHU de Reims : 2008 versus 1993. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74330-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jaussaud R, Servettaz A, Tabary T, Cousson J, Vernet-Garnier V, Delmer A. Déficit immunitaire commun variable et polymorphisme génétique d’IRAK-1 chez un splénectomisé associés à un échec clinique de la vaccination antipneumococcique et de l’antibioprophylaxie. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jaussaud R, Voirin V, Vallé D, Servettaz A, Garnotel R, Ducasse A. Atteintes ophtalmologiques de la maladie de Fabry (MF). Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Servettaz A, Coppo P, Teixeira L, Coupel S, Guillevin L, Mouthon L. Des anticorps (Ac) anticellules endothéliales (AECA) sont présents chez les patients ayant une crise rénale sclérodermique et leurs cibles diffèrent de celles des Ac de patients atteints de microangiopathie thrombotique d'une autre origine. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Servettaz A, Guillaume C, Régent A, Noel V, Strady C, Jaussaud R. Leucoencéphalite progressive multifocale à JC virus chez deux patients non VIH atteints de granulomatose systémique. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Guilpain P, Servettaz A, Goulvestre C, Barrieu S, Chéreau C, Pagnoux C, Guillevin L, Weill B, Batteux F, Mouthon L. Effets pathogènes des anticorps antimyéloperoxydase au cours de la polyangéite microscopique. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Servettaz A, Guilpain P, Goulvestre C, Chéreau C, Hercend C, Nicco C, Guillevin L, Weill B, Mouthon L, Batteux F. Radical oxygen species production induced by advanced oxidation protein products predicts clinical evolution and response to treatment in systemic sclerosis. Ann Rheum Dis 2007; 66:1202-9. [PMID: 17363403 PMCID: PMC1955145 DOI: 10.1136/ard.2006.067504] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To investigate the role of reactive oxygen species (ROS) in the development of the various patterns of systemic sclerosis (SSc) and the mechanisms of ROS production by endothelial cells and fibroblasts. METHODS Production of hydrogen peroxide (H(2)O(2)), nitric oxide (NO) and cellular proliferation were determined following incubation of endothelial cells and fibroblasts with 56 SSc and 30 healthy sera. Correlations were established between those markers, the type and the severity of the clinical involvements, and the response to treatment. The factors leading to ROS production were determined. RESULTS H(2)O(2) production by endothelial cells and fibroblasts was higher after incubation with SSc sera than with normal sera (p<0.001) and with sera from SSc patients with severe complications than sera from other patients (p<0.05). Sera from patients with lung fibrosis triggered the proliferation of fibroblasts more than other SSc sera (p<0.001), whereas sera from patients with vascular complications exerted no proliferative effect on fibroblasts, but inhibited endothelial cell growth (p<0.05) and induced NO overproduction (p<0.05). Bosentan reduced NO release by 32%, whereas N-acetylcystein potentiated 5-fluorouracil (5FU) to inhibit fibroblast proliferation by 78%. Those serum-mediated effects did not involve antibodies but advanced oxidation protein products that selectively triggered cells to produce H(2)O(2) or NO. CONCLUSIONS SSc sera induce the production of different types of ROS that selectively activate endothelial cells or fibroblasts, leading to vascular or fibrotic complications. Assaying serum-induced ROS production allows clinical activity of the disease to be followed and appropriate treatments to be selected.
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Affiliation(s)
- A Servettaz
- Université Paris-Descartes, Faculté de Médecine, IFR Alfred Jost, Paris, France, and Service de Médecine Interne, Centre National de Référence Sclérodermie-Vascularites, AP-HP, Hôpital Cochin, Paris, France
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Tamby MC, Humbert M, Guilpain P, Servettaz A, Dupin N, Christner JJ, Simonneau G, Fermanian J, Weill B, Guillevin L, Mouthon L. Antibodies to fibroblasts in idiopathic and scleroderma-associated pulmonary hypertension. Eur Respir J 2006; 28:799-807. [PMID: 16774952 DOI: 10.1183/09031936.06.00152705] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to investigate the presence of anti-fibroblast antibodies in patients with idiopathic or scleroderma-associated pulmonary arterial hypertension (PAH) and healthy controls. PAH was documented by right-heart catheterisation (mean pulmonary artery pressure at rest >25 mmHg). Serum immunoglobulin (Ig)G and IgM reactivities of patients with idiopathic PAH (n = 35), scleroderma-associated PAH (n = 10), diffuse (n = 10) or limited cutaneous (n = 10) scleroderma without PAH and age- and sex-matched healthy individuals (n = 65) were analysed by cell-based ELISA and immunoblotting on normal human fibroblasts. As assessed by ELISA, 14 out of 35 (40%) patients with idiopathic PAH and three out of 10 (30%) patients with scleroderma-associated PAH expressed anti-fibroblast IgG antibodies. IgG from all individuals bound to one major 40-kDa protein band. IgG from patients with idiopathic PAH bound to two 25- and 60-kDa bands with a higher intensity than IgG from other individuals. In conclusion, immunoglobulin G anti-fibroblast antibodies are present in the serum of patients with pulmonary arterial hypertension. Immunoglobulin G from patients with idiopathic pulmonary arterial hypertension or scleroderma-associated pulmonary arterial hypertension express distinct reactivity profiles with fibroblasts antigens, suggesting distinct target antigens.
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Affiliation(s)
- M C Tamby
- Paris-Descartes University, Faculty of Medicine, Paris, France
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Tamby MC, Chanseaud Y, Humbert M, Fermanian J, Guilpain P, Garcia-de-la-Peña-Lefebvre P, Brunet S, Servettaz A, Weill B, Simonneau G, Guillevin L, Boissier MC, Mouthon L. Anti-endothelial cell antibodies in idiopathic and systemic sclerosis associated pulmonary arterial hypertension. Thorax 2005; 60:765-72. [PMID: 16135682 PMCID: PMC1747530 DOI: 10.1136/thx.2004.029082] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND It has previously been shown that IgG antibodies from patients with limited cutaneous systemic sclerosis (SSc) bind to specific microvascular endothelial cell antigens. Since patients with limited cutaneous SSc are prone to develop pulmonary arterial hypertension (PAH), and since endothelial cell activation is involved in the pathogenesis of idiopathic PAH (IPAH), a study was undertaken to examine the presence of anti-endothelial cell antibodies in patients with idiopathic or SSc associated PAH. METHODS PAH was confirmed by right heart catheterisation (mean pulmonary artery pressure at rest >25 mm Hg). Serum IgG and IgM reactivities were analysed by immunoblotting on human macrovascular and microvascular lung and dermal endothelial cells from patients with IPAH (n = 35), patients with PAH associated with SSc (n = 10), patients with diffuse (n = 10) or limited cutaneous (n = 10) SSc without PAH, and 65 age and sex matched healthy individuals. RESULTS IgG antibodies from patients with IPAH bound to a 36 kDa band in macrovascular endothelial cell extracts with a higher intensity than IgG from other patient groups and controls. IgG antibodies from patients with IPAH bound more strongly to a 58 kDa band in microvascular dermal endothelial cells and to a 53 kDa band in microvascular lung endothelial cells than IgG antibodies from other patients and controls. IgG antibodies from patients with limited cutaneous SSc with or without PAH, but not from other groups or from healthy controls, bound to two major bands (75 kDa and 85 kDa) in microvascular endothelial cells. CONCLUSION IgG antibodies from patients with idiopathic or SSc associated PAH express distinct reactivity profiles with macrovascular and microvascular endothelial cell antigens.
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Affiliation(s)
- M C Tamby
- Laboratoire d'Immunologie, Pavillon Gustave Roussy, UFR Cochin-Port Royal, 8 rue Méchain, 75014 Paris, France
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