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Monseau G, Landon-Cardinal O, Stenzel W, Schoindre Y, Mariampillai K, Barete S, Martel C, Masseau A, Meyer A, Terrier B, Guégan S, Verneuil L, Audia S, Livideanu CB, Hachulla E, Kahn JE, Lefevre G, Maurier F, Moulis G, Papo T, Dossier A, Descamps V, Salort-Campana E, Richard MA, Bergot E, Mortier L, Costedoat-Chalumeau N, Genot S, Perez F, Piette AM, Samson M, Schleinitz N, Zénone T, Lacoste M, de Boysson H, Madaule S, Rigolet A, Champtiaux N, Hervier B, Bouvier AM, Jooste V, Léonard-Louis S, Maisonobe T, Aouba A, Benveniste O, Bienvenu B, Allenbach Y. Systematic retrospective study of 64 patients with anti-Mi2 dermatomyositis: A classic skin rash with a necrotizing myositis and high risk of malignancy. J Am Acad Dermatol 2020; 83:1759-1763. [PMID: 32244015 DOI: 10.1016/j.jaad.2020.03.058] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Grégoire Monseau
- Département de Médecine Interne, Centre Hospitalier Universitaire de Caen, France
| | - Océane Landon-Cardinal
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France; Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 974, Paris, France; Department of Medicine, University of Montreal; Division of Rheumatology and Research Center, Centre Hospitalier de l'Université de Montréal, Quebec, Canada
| | - Werner Stenzel
- Department of Neuropathology, Charité-Universitätsmedizin, Berlin, Germany
| | - Yoland Schoindre
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France
| | - Kubéraka Mariampillai
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France; Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 974, Paris, France
| | - Stéphane Barete
- Université Pierre et Marie Curie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Département de Dermatologie, France
| | - Clothilde Martel
- Département de Médecine Interne et Polyclinique, Centre Hospitalier Universitaire de Limoges, France; Département de Médecine Interne-Gastroentérologie, Centre Hospitalier d'Albi, France
| | - Agathe Masseau
- Département de Médecine Interne, Centre Hospitalier Universitaire de Nantes, France
| | - Alain Meyer
- Département de Rhumatologie Centre de Référence des Maladies Autoimmunes et de Physiologie Exploration Fonctionnelle Musculaire, Hôpitaux Universitaires de Strasbourg, France
| | - Benjamin Terrier
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin Université Paris Descartes, Université Paris Descartes-Sorbonne Paris Cité, France
| | - Sarah Guégan
- Faculté de médecine Paris-Descartes, Service de Dermatologie, Hôpital Cochin, Unité Institut National de la Santé Et de la Recherche Médicale U1016, Biologie cutanée, Institut Cochin, France
| | - Laurence Verneuil
- Département de Dermatologie, Centre Hospitalier Universitaire de Caen, France
| | - Sylvain Audia
- Service de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Dijon-Bourgogne, Dijon, France
| | | | - Eric Hachulla
- Centre Hospitalier Universitaire Lille, Département de Médecine Interne et Immunologie Clinique, Centre de référence des Maladies Auto-Immunes Systémiques rares du Nord et Nord-Ouest, France
| | - Jean-Emmanuel Kahn
- Département de Médecine Interne, Hôpital Foch, Fédération des Etablissements Hospitaliers & d'Aide à la Personne, Suresnes, France
| | - Guillaume Lefevre
- Centre Hospitalier Universitaire Lille, Département de Médecine Interne et Immunologie Clinique, Centre de référence des Maladies Auto-Immunes Systémiques rares du Nord et Nord-Ouest, France
| | - François Maurier
- Service de Médecine Interne et Immunologie Clinique, Hôpitaux Privés de Metz site Belle-Isle, France
| | - Guillaume Moulis
- Département de Médecine Interne, Centre d'Investigation Clinique 1436, Centre Hospitalier Universitaire de Toulouse, France; Unité Mixte de Recherche 1027 Institut National de la Santé Et de la Recherche Médicale-Université de Toulouse, France
| | - Thomas Papo
- Département de Médecine Interne, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, France
| | - Antoine Dossier
- Département de Médecine Interne, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, France
| | - Vincent Descamps
- Department of Dermatology, Bichat Hospital, Paris 7 University, France
| | - Emmanuelle Salort-Campana
- Centre de référence des maladies neuromusculaires et de la Sclérose Latérale Amyotrophique, Hôpital de la Timone, Aix-Marseille université, Filière de santé maladies rares : maladies neuromusculaires, Marseille, France
| | - Marie-Aleth Richard
- Centre d'études et de recherche sur les services de santé et la qualité de vie 3279, Research Center in Health Services and Quality of Life Aix Marseille University, Dermatology Department, Universitary Hospital Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Emmanuel Bergot
- Département de Pneumologie, Centre Hospitalier Universitaire de Caen, France
| | - Laurent Mortier
- Département de Dermatologie, Centre Hospitalier Universitaire de Lille, France
| | - Nathalie Costedoat-Chalumeau
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Hôpital Cochin Université Paris Descartes, Université Paris Descartes-Sorbonne Paris Cité, France
| | - Séverine Genot
- Département Médecine Interne-Diabétologie-Endocrinologie, Centre Hospitalier de Martigues, France
| | - Florian Perez
- Département de Neurologie, Centre Hospitalier d'Albi, France
| | - Anne-Marie Piette
- Département de Médecine Interne, Hôpital Foch, Fédération des Etablissements Hospitaliers & d'Aide à la Personne, Suresnes, France
| | - Maxime Samson
- Service de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Dijon-Bourgogne, Dijon, France
| | - Nicolas Schleinitz
- Aix-Marseille université, Département de Médecine Interne, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, France
| | - Thierry Zénone
- Département de Médecine Interne, Centre Hospitalier de Valence, France
| | - Marie Lacoste
- Département de Médecine Interne et Polyclinique, Centre Hospitalier Universitaire de Limoges, France
| | - Hubert de Boysson
- Département de Médecine Interne, Centre Hospitalier Universitaire de Caen, France
| | - Serge Madaule
- Département de Médecine Interne-Gastroentérologie, Centre Hospitalier d'Albi, France
| | - Aude Rigolet
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France
| | - Nicolas Champtiaux
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France
| | - Baptiste Hervier
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France
| | - Anne-Marie Bouvier
- Registre Bourguignon des Cancers Digestifs, Institut National de la Santé Et de la Recherche Médicale U1231, Centre Hospitalier Universitaire Dijon-Bourgogne, Université de Bourgogne Franche Comté, Dijon, France
| | - Valérie Jooste
- Registre Bourguignon des Cancers Digestifs, Institut National de la Santé Et de la Recherche Médicale U1231, Centre Hospitalier Universitaire Dijon-Bourgogne, Université de Bourgogne Franche Comté, Dijon, France
| | - Sarah Léonard-Louis
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de Neuropathologie, Paris, France
| | - Thierry Maisonobe
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de Neuropathologie, Paris, France
| | - Achille Aouba
- Département de Médecine Interne, Centre Hospitalier Universitaire de Caen, France
| | - Olivier Benveniste
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France; Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 974, Paris, France
| | - Boris Bienvenu
- Département de Médecine Interne, Centre Hospitalier Universitaire de Caen, France
| | - Yves Allenbach
- Sorbonne Universités Pierre et Marie Curie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Département de médecine Interne et d'immunologie clinique, France; Institut National de la Santé Et de la Recherche Médicale, Unité Mixte de Recherche 974, Paris, France.
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Droz N, Gilardin L, Cacoub P, Berenbaum F, Wendling D, Godeau B, Piette AM, Dernis E, Ebbo M, Fautrel B, Le Guenno G, Mekinian A, Bernard-Chabert B, Costedoat-Chalumeau N, Descloux E, Michot JM, Radenne S, Rigolet A, Rivière S, Yvin JL, Thibault V, Thabut D, Pol S, Guillevin L, Mouthon L, Terrier B. Kinetic profiles and management of hepatitis B virus reactivation in patients with immune-mediated inflammatory diseases. Arthritis Care Res (Hoboken) 2013; 65:1504-14. [PMID: 23436730 DOI: 10.1002/acr.21990] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 02/13/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Immunosuppressive therapy may trigger hepatitis B virus (HBV) reactivation for increased morbidity and mortality. We aimed to describe HBV reactivation in patients receiving treatment for immune-mediated inflammatory diseases (IMIDs) and to evaluate a predefined algorithm for its prevention. METHODS Physicians submitted data for patients receiving treatment for IMIDs and exhibiting HBV reactivation, defined as an increase of >1 log10 IU/ml of HBV DNA levels or DNA reappearance. We systematically reviewed cases in the literature. RESULTS The 35 physician-collected patients had rheumatoid arthritis (n = 14), connective tissue disease (n = 7), vasculitis (n = 5), and other diseases (n = 9). At baseline, 65.7% of patients were positive for hepatitis B surface antigen (HBsAg), 31.4% had a history of HBV infection, and 2.9% had occult HBV infection. Reactivation occurred a median of 35 weeks (range 2-397 weeks) after the start of corticosteroid and/or immunosuppressive therapy. In all, 88.6% of patients were clinically asymptomatic, but 25.7% had severe hepatitis; none had fulminant hepatitis. Management was antiviral therapy for 91.4%, with discontinuation or decrease of immunosuppressive therapy for 45.7%. In pooling these 35 cases and 103 patients from the literature, 73.9% of patients were clinically asymptomatic, 33.3% had severe hepatitis, and 12.3% died and/or had fulminant hepatitis. Reactivation occurred early with rituximab or cyclophosphamide therapy and in HBsAg-positive/HBV DNA-positive patients. Using the predefined algorithm, 78% of patients with reactivation would have received preemptive antiviral therapy. CONCLUSION We provide new insights into HBV reactivation in patients receiving treatment for IMIDs. A predefined algorithm may be effective in reducing the risk of HBV reactivation in this population.
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Affiliation(s)
- Nina Droz
- Université Paris Descartes, AP-HP, Hôpital Cochin, Paris, France
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Fain O, Hamidou M, Cacoub P, Godeau B, Wechsler B, Pariès J, Stirnemann J, Morin AS, Gatfosse M, Hanslik T, Belmatoug N, Blétry O, Cevallos R, Delevaux I, Fisher E, Hayem G, Kaplan G, Le Hello C, Mouthon L, Larroche C, Lemaire V, Piette AM, Piette JC, Ponge T, Puechal X, Rossert J, Sarrot-Reynauld F, Sicard D, Ziza JM, Kahn MF, Guillevin L. Vasculitides associated with malignancies: analysis of sixty patients. ACTA ACUST UNITED AC 2008; 57:1473-80. [PMID: 18050165 DOI: 10.1002/art.23085] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To describe characteristics and outcomes of vasculitides associated with malignancies. METHODS The requirement for inclusion in this retrospective, 10-year study was development of vasculitis in patients with a progressing malignancy. Malignancies secondary to immunosuppressants used to treat vasculitis were excluded. The main characteristics of vasculitides were analyzed and compared according to the type of malignancy. RESULTS Sixty patients were included (male/female sex ratio 2.53, mean age 62.4 years). Mean followup duration was 45.2 months. Vasculitides were cutaneous leukocytoclastic (45%), polyarteritis nodosa (36.7%), Wegener's granulomatosis (6.7%), microscopic polyangiitis (5%), and Henoch-Schönlein purpura (5%). Malignancies were distributed as follows: hematologic in 63.1%, myelodysplastic syndrome (MDS) in 32.3%, lymphoid in 29.2%, and solid tumor in 36.9%. Vasculitides were diagnosed concurrently with malignancy in 38% of the cases. Manifestations of vasculitides were fever (41.7%), cutaneous involvement (78.3%), arthralgias (46.7%), peripheral neuropathy (31.7%), renal involvement (23.3%; 11.7% glomerulonephritis, 11.7% microaneurysms, 6.7% renal insufficiency), and antineutrophil cytoplasmic antibody (20.4%). Vasculitis treatments were corticosteroids (78.3%) and immunosuppressant(s) (41.7%). Vasculitis was cured in 65% of patients, but 58.3% died, with 1 death secondary to vasculitis. Independent of subtype, patients with vasculitides associated with MDS more frequently had renal manifestations (P = 0.02) and steroid dependence (P = 0.04) and achieved complete remission less often (P = 0.04) than patients with vasculitides associated with other malignancies. Patients with vasculitides associated with a solid tumor more frequently had peripheral neurologic involvement (P = 0.05). Patients with vasculitides associated with lymphoid malignancy had less frequent arthralgias (P = 0.01) and renal involvement (P = 0.02). CONCLUSION Vasculitides occurring during malignancies present distinctive features according to the vasculitis subtype and nature of the malignancy.
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Affiliation(s)
- Olivier Fain
- Assistance Publique Hôpitaux de Paris, Hôpital Jean-Verdier, Université Paris, Bondy, France.
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Girszyn N, Leport J, Arnaud L, Kahn JE, Piette AM, Bletry O. Maladie de Crohn à expression vulvopérinéale exclusive. Presse Med 2007; 36:1762-5. [PMID: 17587537 DOI: 10.1016/j.lpm.2007.02.037] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Accepted: 02/18/2007] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Vulvar involvement in Crohn's disease is uncommon. We report here a rare case of Crohn's disease affecting only the vulva and perineum. CASE A 55-year-old women had been followed at another hospital since 1995 for histology-proved Crohn's disease affecting only the vulvoperineal area. Treatment with infliximab led to a relapse in 2001. The patient was hospitalized because of a new vulvar and perineal flare-up, with major vulvar edema, aphthoid vulvar and perineal erosions and fissures. Findings from upper endoscopy and colonoscopy were normal. A biopsy sample of the ulcerated tissue showed inflammatory infiltration including histiocytes and macrophages. No microorganisms were found. The initial course was favorable, with systemic corticosteroid therapy and azathioprine. Clinical relapse during the corticosteroid tapering necessitated infliximab. DISCUSSION Vulvar localizations of Crohn's disease are uncommon. They may precede gastrointestinal involvement by many years or very rarely be isolated, as here. Typical clinical appearance includes edema and ulcerations. Other causes of granulomatous vulvar and perineal lesions must be ruled out. There is no consensus for its treatment. This case indicates that infliximab, which is used in fistulized Crohn's disease, can be useful for vulvar and perineal involvement. Physicians must recognize that on rare occasions vulvar involvement is possible without any gastrointestinal localization.
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Terrier B, Piette AM, Kerob D, Cordoliani F, Tancrède E, Hamidou L, Lebbé C, Blétry O, Kahn JE. Superficial venous thrombophlebitis as the initial manifestation of hypereosinophilic syndrome: study of the first 3 cases. ACTA ACUST UNITED AC 2007; 142:1606-10. [PMID: 17178987 DOI: 10.1001/archderm.142.12.1606] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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: 02/04/2023]
Abstract
BACKGROUND Superficial venous thrombophlebitis (SVT), often perceived as benign, can coexist with hypercoagulable states. Predisposing risk factors for SVT are similar to those observed for deep venous thrombosis. Association of eosinophilia with SVT is a rare situation that can reveal neoplasia, malignant blood disorders, or vasculitis, but it has never been described in hypereosinophilic syndrome (HES). We herein describe the clinical and biological features, outcome, and response to therapy of 3 patients with SVT associated with eosinophilia that revealed HES. OBSERVATIONS Superficial venous thrombophlebitis was the initial manifestation of HES in all 3 patients. The mean eosinophil count at diagnosis was 2.4 x 10(3)/muL. All patients received corticosteroids and anticoagulants as the initial treatment, with marked improvement of SVT and return of the eosinophil count to reference limits. All patients experienced relapse and remained dependent on corticosteroid therapy. Two patients received interferon alfa with dramatic regression of SVT, allowing a decrease in the dose of corticosteroids. CONCLUSIONS We report, to our knowledge, the first 3 cases of SVT related to HES. Superficial venous thrombophlebitis was difficult to treat, with dependence on corticosteroid therapy and partial efficacy of anticoagulant and antiplatelet therapy. Interferon alfa was effective in preventing relapse of SVT related to HES. Mechanisms implied in this thrombogenesis are multiple and remain speculative.
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Arnaud L, Kahn JE, Girszyn N, Piette AM, Bletry O. Takayasu's arteritis: An update on physiopathology. Eur J Intern Med 2006; 17:241-6. [PMID: 16762772 DOI: 10.1016/j.ejim.2005.12.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2005] [Revised: 12/11/2005] [Accepted: 12/19/2005] [Indexed: 11/22/2022]
Abstract
Takayasu's arteritis (TA) is a chronic large vessel vasculitis. The physiopathology of TA has not been completely elucidated, but it appears to be multifactorial and to mainly involve cellular immunity. The pathologic sequence could implicate stimulation from an antigen that triggers heat shock protein (HSP)-65 expression in aortic tissue which, in turn, induces MHC class I-related chain A (MICA). T-cells and natural killer (NK) cells expressing NKG2D receptors could recognize MICA, resulting in acute inflammation. Pro-inflammatory cytokines released from these infiltrating cells induce matrix metalloproteinases and amplify the inflammatory response, inducing more MHC antigen and costimulatory molecule expression on vascular cells and, thus, recruiting more mononuclear cells. Alpha-beta T-cells then infiltrate and specifically recognize one or a few autoantigens presented by a shared epitope associated with specific MHC on the dendritic cells (DC). These DC simultaneously cooperate to some extent with B-cells and determine a humoral immunity mainly constituted by anti-endothelial cell autoantibodies that could trigger complement-dependent cytotoxicity against endothelial cells. The use of corticosteroids and of other immunosuppressive agents can bring TA into remission in most patients. A better understanding of the immunological mechanisms responsible for the vascular injury has led to trials of anti-TNF-alpha agents with encouraging results. In the near future, new drugs specifically designed to target some of the mechanisms described above may be able to expand the physician's therapeutic arsenal in TA.
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Affiliation(s)
- Laurent Arnaud
- Department of Internal Medicine, Foch Hospital, 40 rue Worth, F-92150 Suresnes, France
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Affiliation(s)
- A Somogyi
- CHIC, 20, rue Armagis, 78100 Saint-Germain-en-Laye, France
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Dhote R, Simon J, Papo T, Detournay B, Sailler L, Andre MH, Dupond JL, Larroche C, Piette AM, Mechenstock D, Ziza JM, Arlaud J, Labussiere AS, Desvaux A, Baty V, Blanche P, Schaeffer A, Piette JC, Guillevin L, Boissonnas A, Christoforov B. Reactive hemophagocytic syndrome in adult systemic disease: report of twenty-six cases and literature review. ACTA ACUST UNITED AC 2003; 49:633-9. [PMID: 14558048 DOI: 10.1002/art.11368] [Citation(s) in RCA: 213] [Impact Index Per Article: 10.1] [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: 01/13/2023]
Abstract
OBJECTIVE To analyze specific clinical findings, underlying disorders, treatments, outcomes, and prognostic factors for reactive hemophagocytic syndrome (RHS) in systemic disease. METHODS Data were collected using standardized forms as part of a French national survey. Adult cases without an underlying malignancy, diagnosed on bone marrow or lymph node biopsy, were included. RESULTS Twenty-six cases (7 men, 19 women, mean age 47.4 +/- 17.7 years) were studied. Systemic diseases included systemic lupus erythematosus (n = 14), rheumatoid arthritis (n = 2), adult onset systemic Still's disease (n = 4), polyarteritis nodosa (n = 2), mixed connective tissue disease (n = 1), pulmonary sarcoidosis (n = 1), systemic sclerosis (n = 1), and Sjögren's syndrome (n = 1). RHS occurred in 2 distinct clinical settings in the course of systemic disease. RHS was associated with an active infection in 15 patients (bacterial infections, 10 cases; viral, 3 cases; tuberculosis, 1 case; and aspergillosis, 1 case) and with the onset of a systemic disease alone in 9 cases. Isolated RHS occurred in 2 cases. The overall mortality rate was 38.5%. Two factors were associated with mortality: corticosteroid treatment at the time of RHS diagnosis, and thrombocytopenia (odds ratio = 28, 95% confidence interval = 13.3-238.9). CONCLUSIONS When RHS occurs in the course of an active systemic disease (situation only reported in cases of systemic lupus or adult Still's disease), immunosuppressive therapy should be used. In contrast, when RHS is present concomitantly with an active infection, immunosuppressive therapy needs to be lowered and antibiotic therapy should be instituted.
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Izzedine H, Simon J, Piette AM, Lucsko M, Baumelou A, Charitanski D, Kernaonet E, Baglin AC, Deray G, Beaufils H. Primary chronic interstitial nephritis in Crohn's disease. Gastroenterology 2002; 123:1436-40. [PMID: 12404216 DOI: 10.1053/gast.2002.36613] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS In Crohn's disease, cases of interstitial nephritis with renal failure have been reported in connection with the use of mesalamine. METHODS We observed 4 patients with severe interstitial nephritis proven by examination of kidney biopsy specimens. Renal failure was discovered before or simultaneously with the diagnosis of Crohn's disease, and patients were not treated with mesalamine. Impairment of renal function progressed to end-stage renal failure in 3 of the 4 patients. RESULTS Our results show that the kidney can be an extraintestinal target of Crohn's disease. CONCLUSIONS Several unanswered questions remain concerning the frequency of interstitial nephritis in patients with Crohn's disease, as well as the exact role of mesalamine in the development of chronic interstitial nephritis.
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Affiliation(s)
- Hassane Izzedine
- Department of Nephrology, Pitié Hospital, and INSERM U423, Paris, France
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Larroche C, Scieux C, Honderlick P, Piette AM, Morinet F, Blétry O. Spontaneous resolution of hemophagocytic syndrome associated with acute parvovirus B19 infection and concomitant Epstein-Barr virus reactivation in an otherwise healthy adult. Eur J Clin Microbiol Infect Dis 2002; 21:739-42. [PMID: 12415473 DOI: 10.1007/s10096-002-0793-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 11/30/2022]
Abstract
Reported here is the case of a patient who spontaneously recovered from hemophagocytic syndrome associated with acute B19 infection and concomitant Epstein-Barr virus reactivation. The previously healthy 37-year-old-man was hospitalized after 10 days of high fever, arthralgia and arthritis and was determined to have hemophagocytic syndrome. Immunoglobulin (Ig) M antibodies to Epstein-Barr virus (EBV) capsid antigen, early antigen and parvovirus B19 (B19) were found. B19 DNA and low-level EBV DNA were detected in bone marrow, serum and peripheral blood mononuclear cells. The patient recovered spontaneously without any treatment. Two months later anti-B19 IgG antibodies were detected, while at 9-month follow-up, anti-B19 IgM antibodies were no longer detectable and B19 DNA had disappeared from serum. To the best of our knowledge, this is the first report of spontaneous resolution of hemophagocytic syndrome associated with acute B19 infection and concomitant EBV reactivation in an otherwise healthy adult.
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Affiliation(s)
- C Larroche
- Department of Internal Medicine, Hôpital Avicenne, Université Paris-Nord, 125 rue de Stalingrad, 93009 Bobigny, France.
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Piette AM, Le Guen Y, Couderc LJ, Blétry O. [Happiness is in the grass]. Rev Med Interne 2002; 23 Suppl 2:241s-243s. [PMID: 12108200 DOI: 10.1016/s0248-8663(02)80008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A M Piette
- Service de médecine interne, hôpital Foch, 40, rue Worth, 92151 Suresnes, France
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Abstract
We describe a 50-year-old man with relapsing polychondritis (RP) involving auricular cartilage, uveitis and hearing loss, who had an aneurysm of the anterior cerebral artery. Intracranial aneurysm is a rare manifestation of RP.
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Affiliation(s)
- M Coumbaras
- Department of Neuroradiology, Hôpital Foch, Suresnes, France
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Honderlick P, Thaler F, Cahen P, Couderc LJ, Glaisner S, Piette AM. [Microbiological diagnosis of bacteremia from a catheter: a simple method? Results of a retrospective study]. Pathol Biol (Paris) 2000; 48:467-9. [PMID: 10949842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Diagnosing catheter-related bloodstream infections is important but not always easy and a failure to make the diagnosis may have serious consequences. A high rate of unnecessary catheter removal is noted. We retrospectively compared the clinical and usual methods of microbiological diagnoses of catheter-related sepsis to the speed of detection of the catheter versus peripheral blood cultures using the Bact-Alert system. We analyzed 50 files of patients with central indwelling devices: 16 single lumen catheters and 34 implanted ports. Twenty-one catheters were classified as infected, and we observed an earlier positivity of catheter versus peripheral blood in all cases, but significant for 19 patients. According to standard diagnosis methods, 29 catheters were estimated non-infected, a more rapid detection of peripheral culture was reported for 17 specimens and, for another eight patients, the time of detection was equal to blood culture drawn from the catheter. In this group, four discrepancies were recorded with a differential time in favor of sepsis related to catheters ranging from 0.5 to 2 hours. Because of its simplicity and low cost, we believed that this method could be the first step of a diagnosis of catheter-related sepsis and could, therefore, avoid unjustified removal, in particular for the implanted ports for which the diagnostic methods are less codified than for catheters. A prospective study is ongoing; the design of the study focuses only on implanted ports.
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Abstract
INTRODUCTION Antiphospholipid syndrome is the most frequent cause of acquired thrombophilia. Aspirin may have some indications. CURRENT KONWLEDGE AND KEY POINTS: The usefulness of low doses of aspirin is now well demonstrated in the prevention of obstetric complications associated with antiphospholipid antibodies (especially pregnancy loss). When heparin is combined with low-dose aspirin, the recurrent rate of fetal loss is lower than 30%. In patients with arterial or venous thrombosis, there is a high rate of recurrence during the two first years except if high-dose warfarin was used (i.e., INR > or = 3). The association warfarin-aspirin in secondary prevention of thrombosis may be evaluated in prospective studies. It is not so clear in the literature and in our experience that warfarin is superior to aspirin in stroke recurrence prevention in patients with antiphospholipid antibodies, except in Sneddon's syndrome. There are no guidelines in primary thrombosis prevention in patients with antiphospholipid antibodies. In lupus patients, aspirin may not be sufficient after many years of follow-up in preventing a first episode of thrombosis. Prospective studies may be undertaken. Atherosclerotic patients with antiphospholipid antibodies are particularly exposed to the risk of thrombosis after revascularisation or angioplasty and stent implantation. Aspirin may have a place in those patients but these must be evaluated. FUTUR PROSPECTS AND PROJECTS: Except in prevention of obstetric complications, the usefulness of aspirin in patients with antiphospholipid antibodies must be evaluated in prospective studies.
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Affiliation(s)
- E Hachulla
- Service de médecine interne, hôpital Huriez, CHRU, Lille, France
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Affiliation(s)
- S D Qanadli
- Department of Radiology, Cardiovascular Unit, Ambroise Paré Hospital, René Descartes University, Paris V France.
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Abstract
BACKGROUND The antiphospholipid syndrome was individualized 12 years ago. Treatment was initially based on steroids, immunosuppressive drugs and intravenous immunoglobulin therapy. More recently, several retrospective studies have established that in most clinical conditions therapeutic doses of oral vitamin K antagonists (INR > or = 3) are sufficient to control the disease. THE ROLE OF IMMUNOGLOBULIN THERAPY However, high dose immunoglobulin therapy is still indicated in a few cases, especially in life-threatening immune peripheral thrombocytopenia, and in recurrent foetal loss: in the latter indication, immunoglobulin therapy alone is efficient in 80% of cases. FUTURE PROSPECTS Prospective studies are needed to assess the efficacy of intravenous immunoglobulin therapy in neurological complications occurring in spite of anticoagulant therapy, and in the context of repeated foetal losses when antithrombotic therapy with aspirin and subcutaneous heparin has failed.
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Affiliation(s)
- O Blétry
- Service de médecine interne, Hôpital Foch, Suresnes, France
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Gompel A, Frances C, Piette JC, Blanc AS, Cordoliani F, Piette AM. Ovarian failure with thalidomide treatment in complex aphthosis: comment on the concise communication by Ordi et al. Arthritis Rheum 1999; 42:2259-60. [PMID: 10524707 DOI: 10.1002/1529-0131(199910)42:10<2259::aid-anr41>3.0.co;2-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Piette AM, Ramanoelina J, Gepner P, Larroche C, Blétry O. [Systemic reaction induced my minocycline treatment: a report of four patients and a review of the literature]. Rev Med Interne 1999; 20:869-74. [PMID: 10573723 DOI: 10.1016/s0248-8663(00)80092-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 11/17/2022]
Abstract
We report four cases of the side effects of minocycline seen during the last two years in our department. There was one case of drug-related lupus and three cases of hypersensitivity reactions, including one eosinophilic pneumopathy with pericarditis, one nephropathy and one severe, pseudo-infectious episode of high fever, rash, lympadenopathy, hepatitis and eosinophilia. Minocycline is a tetracycline agent widely used for acne therapy in France and all over the world. During the last few years, there has been an increasing number of reports concerning systemic adverse reactions to minocycline, with on the one hand auto-immune disorders (lupus, autoimmune hepatitis, vascularitis with ANCA), occurring after a prolonged course of therapy and reported recently in the last few years, and on the other hand, hypersensitivity reactions (eosinophilic pneumopathies, hepatitis, nephropathies, myocarditis, serum sickness or pseudo-infectious reactions), occurring precociously in the course of therapy, and potentially severe. Although these side effects are uncommon in the context of the high number of patients who have been prescribed the drug, the first-line antibiotic therapy in acne must probably be reconsidered.
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Affiliation(s)
- A M Piette
- Service de médecine interne, Hôpital Foch, Suresnes, France
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Memain N, Larroche C, Dray JM, Piette AM, Blétry O. [Greek, but Olympiad impossible]. Rev Med Interne 1999; 20 Suppl 2:264s-266s. [PMID: 10422163 DOI: 10.1016/s0248-8663(99)80458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N Memain
- Service de médecine interne, hôpital Foch, Suresnes
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20
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Piette AM, Blétry O. [Involvement of large arteries by Horton's disease]. Rev Prat 1999; 49:609-12. [PMID: 10218397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Up to 15% of patients with temporal arteritis, may have large vessel involvement. The ascending aorta, aortic arch, subclavian and axillary arteries are most frequently involved. These localisations may be the presenting feature but usually, temporal arteritis is known or symptomatic at the time of large vessel involvement discovering. When corticosteroids are given in adequate doses, the response is favorable in most patients with limbs localisation but aortic localisation is associated with a markedly increased risk for the development of aneurysm and dissection which may cause death.
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Affiliation(s)
- A M Piette
- Service de médecine interne, Hôpital Foch, Suresnes
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Piette AM. [Prolonged fever]. Rev Infirm 1999:18-22. [PMID: 10532062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- A M Piette
- Service de Médecine Interne, Hôpital Foch, Suresnes
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Larroche C, Scieux C, Honderlick P, Piette AM, Blétry O. [Fever and polyarthralgia: a serology can obscure another...]. Rev Med Interne 1998; 19 Suppl 2:247s-250s. [PMID: 9775084 DOI: 10.1016/s0248-8663(98)80835-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- C Larroche
- Service de médecine interne, hôpital Saint-Louis, Paris
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Pradon C, Piette AM, Baglin AC, Pougheon M, Cosserat J, Gepner P, Corde M, Drupt F, Blétry O. La recherche des anticorps anti-SSa/SSa est-elle utile au cours du syndrome de Gougerot-Sjögren confirmé? Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80071-4] [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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Piette AM, Mourad JJ, Weill B, Thérond P, Gregoire AS, Blétry O. Effet des huiles de poisson sur les anticorps antiphospholipides. Étude prospective chez 24 patients. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80075-1] [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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Piette AM, Frances C, Hilliquin P, Graveleau P, Baglin AC, Maisonobe T, Menkes J, Kahan A, Piette JC, Blétry O. Aspect pseudo-sclérodermiforme de l'amylose AL : à propos de trois observations. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90081-9] [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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Fakhouri F, Gepner P, Piette AM, Kieffer E, Blétry O. Maladie de Takayasu et fibrose rétropéritonéale : association fortuite ou relation pathogénique ? Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90143-6] [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: 11/16/2022]
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Amoura Z, Papo T, Ninet J, Hatron PY, Guillaumie J, Piette AM, Blétry O, Dequiedt P, Talasczka A, Rondeau E, Dutel JL, Wechsler B, Piette JC. Systemic capillary leak syndrome: report on 13 patients with special focus on course and treatment. Am J Med 1997; 103:514-9. [PMID: 9428835 DOI: 10.1016/s0002-9343(97)00272-6] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Systemic capillary leak syndrome (SCLS) is a rare condition characterized by unexplained episodic capillary hyperpermeability due to a shift of fluid and protein from the intravascular to the interstitial space. This results in diffuse swelling, weight gain, and renal shut-down. From the first publication in 1960, only 34 cases have been reported. OBJECTIVE To collate enough patients to observe the natural history of the disease and evaluate the efficacy of empiric treatments. DESIGN Multicentric retrospective study. RESULTS Thirteen patients (6 women and 7 men) were collated with a mean follow-up of 6.4 years. Eight patients are still alive after a mean of 5.6 years (range 1 to 15). Three patients out of the 11 who were not lost to follow-up died; 1 during an attack and 2 because of a progression towards multiple myeloma. CONCLUSIONS Our series shows an improvement in the prognosis of SCLS due most likely to improved management during attacks. Some patients' disease could evolve into a multiple myeloma. Treatment is still empiric and no prophylactic therapy, including terbutaline associated with aminophylline, has clearly proven its efficacy.
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Affiliation(s)
- Z Amoura
- Service de Médecine Interne, Hôpital de la Pitié, Paris, France
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Papo T, Wechsler B, Bletry O, Piette AM, Godeau P, Piette JC. Pregnancy in relapsing polychondritis: Twenty-five pregnancies in eleven patients. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/art.8] [Citation(s) in RCA: 2] [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] [Indexed: 11/06/2022]
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Abstract
OBJECTIVE To determine maternal and fetal outcome in pregnant women with relapsing polychondritis (RP). METHODS Retrospective review of 11 records selected from among those of 116 female RP (Michet's criteria) patients. RESULTS In these 11 women, 25 pregnancies occurred after or concomitantly with the onset of RP. The mean (+/- SD) age at RP onset was 25 +/- 5 years (range 15-31). Therapeutic abortion was performed in 1 woman because of ongoing cyclophosphamide treatment. Disease flare occurred in 7 of 24 pregnancies, requiring treatment modification in 2 cases. RP was considered stable in 16 and asymptomatic in 1 of the 24. Treatment of RP was with nonsteroidal antiinflammatory drugs (2 of 24), steroids (13 of 24), dapsone (7 of 24), or plasma exchanges (1 of 24); no treatment was given in 8 of the 24 pregnancies. In 14 pregnancies, the course was uneventful. Ten pregnancies were complicated by ectopic nidation (n = 3), spontaneous abortion (n = 3), premature birth (n = 3), and premature rupture of membranes (n = 1). Eighteen normal children were born. CONCLUSION Pregnancy does not seem to modify the course of RP. Successful pregnancies may be achieved in women with RP. No RP was observed in the neonates.
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Affiliation(s)
- T Papo
- La Pitié-Salpêtrière Hospital, Paris, France
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Papo T, Wechsler B, Bletry O, Piette AM, Godeau P, Piette JC. Pregnancy in relapsing polychondritis. Twenty-five pregnancies in eleven patients. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/art.1780400708] [Citation(s) in RCA: 3] [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] [Indexed: 11/08/2022]
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Papo T, Le Thi Huong-Boutin D, Wiederkehr JL, Woehl-Kremer B, Wechsler B, Blétry O, Piette AM, Godeau P, Piette JC. Traitement de la granulomatose de Wegener par le VP16. Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80235-4] [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: 11/30/2022]
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Abgrall S, Piette AM, Graveleau P, Blétry O. [Leaving the table on the knees!]. Rev Med Interne 1997; 18 Suppl 3:277s-278s. [PMID: 9239380 DOI: 10.1016/s0248-8663(97)80579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- S Abgrall
- Service de médecine interne, CMC Foch, Suresnes
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Blanc AS, Grateau G, Baglin AC, Gepner P, Piette AM, Godeau P, Blétry O. Amyloses génétiques par dépôts de transthyrétine (TTR) simulant une amylose AL. À propos de sept cas autochtones (dont deux nouvelles mutations). Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80178-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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Blétry O, Piette AM, Grégoire AS, Mourad JJ, Weill B, Viard P, François D, Mabro M. Syndrome des antiphospholipides: la recherche d’APL par une technique de dépistage du commerce à une sensibilité insuffisante (étude prospective chez 25 patients). Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80167-1] [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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Piette JC, Piette AM. Management of the antiphospholipid syndrome. Main trends, unsolved questions, practical and educational aspects. Ann Med Interne (Paris) 1996; 147 Suppl 1:28-31. [PMID: 8952757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Therapeutic guidelines are progressively emerging in the antiphospholipid syndrome (APS). For primary APS, prevention of recurrent miscarriages is frequently achieved by a combination of heparin plus aspirin. Steroids should not be used in the absence of associated systemic lupus erythematosus. Long term warfarin aimed at an INR of 3-3.5 is effective for the secondary prevention of thrombosis. However, some doubt is raising regarding the pertinence of INR monitoring in patients with a lupus anticoagulant. Education is an important part of the management of patients with APS. Coincident risk factors for thrombosis have to be suppressed or controlled. Psychological aspects also need to be carely considered during the course of this chronic disorder.
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Affiliation(s)
- J C Piette
- Internal Medicine Unit, Hôpital Pitié-Salpêtrière, Paris, France
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Cosserat J, Barete S, Baglin AC, Durepaire H, Bodiguel E, Gepner P, Piette AM, Blétry O, Barrier J. [Fever, partial pituitary insufficiency and interstitial lung syndrome in a 35-year-old woman]. Rev Med Interne 1996; 17 Suppl 2:241s-244s. [PMID: 8760669 DOI: 10.1016/0248-8663(96)86464-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- J Cosserat
- Service de médecine interne, hôpital Foch, Suresnes
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Piette AM. [Beware: progestins elevate body temperature!]. Rev Med Interne 1995; 16:813-4. [PMID: 8570936 DOI: 10.1016/0248-8663(96)80794-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Cosserat J, Gepner P, Dubois C, Piette AM, Blétry O. Valvulopathies secondaires à la radiothérapie. Cinq observations. Rev Med Interne 1995. [DOI: 10.1016/0248-8663(96)86527-1] [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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Piette AM, Mourad JJ, Godmer P, Graveleau P, Gepner P, Cosserat J, Chapman A, Blétry O. Pachyméningite au cours de la maladie de Wegener: deux observations. Rev Med Interne 1995. [DOI: 10.1016/0248-8663(96)86686-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Piette AM, Darai E, Gepner P, Brousse C, Chapman A. [A new cause of prolonged fever of unknown origin: progesterone substitution therapy]. Presse Med 1994; 23:1699-702. [PMID: 7831252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Over the last 3 years, we examined 15 patients on progesterone substitution therapy who presented prolonged fever. Many explanations had been put forward before the diagnosis was suggested. We recall the thermogenic effect of progesterone. METHODS Based on a retrospective analysis, we reported the clinical and biological features of 15 patients with prolonged fever due to progesterone substitution therapy and prospectively followed the temperature curves of 9 menopaused women who received substitution therapy for the first time. RESULTS The 15 case reports were quite typical. Often onset occurred with an acute infectious episode. Following this episode, the patients continued to take their temperature and discovered persistent fever. The context was often one of anxiety-depression rich in functional symptomatology. Laboratory findings included a normal sedimentation rate in all patients. Several days after treatment withdrawal temperature returned to normal. The prospective study confirmed the thermogenetic effect of almost all progesterone substitution drugs. CONCLUSION The thermogenic effect of natural progesterone is well known but it must be recalled that all progesterone agents with 5-beta metabolites have the same effect. Since metabolic clearance is long, the thermogenic effect may persist for several days after withdrawal.
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Affiliation(s)
- A M Piette
- Service de Médecine interne, Centre médico-chirurgical Foch, Suresnes
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Boissier L, Brousse C, Piette AM, Gepner P, Chapman A. [Rheumatoid purpura revealing seroconversion in human immunodeficiency virus infection]. Presse Med 1994; 23:910. [PMID: 7937626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Abstract
This 20 year old white patient complained of progressive thickening of his fingers over a period of four years. The second, third and fifth fingers of each hand indeed appeared podgy. The soft tissue on each side of the first phalanx was swollen, firm without adherence to the bone. The skin of the interdigital space was hyperpigmented and lichenified. This case illustrates the clinical and histologic features of digital fibromatosis which are discussed.
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Affiliation(s)
- C Brousse
- Service de médecine interne, CMC Foch, Suresnes, France
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45
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Piette AM, Mourad JJ, Karmochkine M, Didon D, Gepner P, Graveleau P, Grenet D, Couderc LJ, Chapman A. [Antiphospholipid syndrome. 20 cases]. Presse Med 1994; 23:607-12. [PMID: 8029190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES We analyzed the clinical and biological characteristics as well as the clinical course and outcome observed in 20 patients with antiphospholipid antibodies and clinical signs including thrombosis or repeated spontaneous abortion to better identify the recently described antiphospholipid syndrome. METHODS We retrospectively studied all patients observed in our unit from 1981 to 1992 who fulfilled the following inclusion criteria: a) at least one episode of arterial or venous thrombosis and/or repeated spontaneous abortions, b) positive for antiphospholipid antibodies. RESULTS Twenty patients were included, 3 with systemic lupus erythematosus (according to the American Rheumatism Association criteria). Arterial or venous thrombosis occurred in 9 and 16 respectively, including exceptional cases of cerebral phlebitis and thrombosis of dermal capillaries. High blood pressure was recorded in 8. Only 1 or 2 types of antiphospholipid antibodies were found in most patients. Anticardiolipin, a circulating anticoagulant and a false-positive Bordet-Wassermann reaction were found together in only 3 out of 16. In addition, the antibody level varied independently from the thrombotic events. There was no case with a clinical course from primary antiphospholipid syndrome to systemic erythromatosus lupus. The effect to treatment on occurrence of new thrombotic events was studied. Three patients suffered one or more haemorrhagic events during antivitamin K treatment. CONCLUSION It is difficult to establish a differentiation between primary antiphospholipid syndrome, systemic lupus erythematosus and lupus-like syndromes, and precise methods of identifying antiphospholipid antibodies should be further developed.
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Affiliation(s)
- A M Piette
- Service de Médecine interne, Centre médico-chirurgical Foch, Suresnes
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Beaufils H, Simon J, Lucsko M, Baumelou A, Charitanski D, Kernaonet E, Piette AM. Insuffisance rénale liée à une néphropathie tubulo-interstitielle chronique révélatrice d'une maladie de Crohn. À propos de 4 cas. Rev Med Interne 1994. [DOI: 10.1016/s0248-8663(05)82598-6] [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: 11/30/2022]
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Santiago FA, Piette AM, Gepner P, Chapman A. Incidence saisonnière de la maladie de Horton : étude de 58 observations sur 10 ans. Rev Med Interne 1994. [DOI: 10.1016/s0248-8663(05)82670-0] [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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48
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Brousse C, Mignot L, Baglin AC, Bernard N, Piette AM, Gepner P, Chapman A. [Hyperthyroidism and hypersecretion of chorionic gonadotropin in gastric adenocarcinoma]. Rev Med Interne 1994; 15:830-3. [PMID: 7863118 DOI: 10.1016/s0248-8663(05)82840-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 01/27/2023]
Abstract
We report a case of hyperthyroidism complicating and revealing a metastatized adenocarcinoma of the stomach with high circulating levels of human chorionic gonadotropin and its beta component. To our knowledge, this is the first reported case of a non-trophoblastic tumor with hyperthyroidism and secreting quantities of these hormones. High circulating levels of beta component in such patients have been considered to be a sign of malignancy. The mechanisms of thyroid stimulation could be related to the biological activity of certain forms of the human chorionic gonadotropin.
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Affiliation(s)
- C Brousse
- Service de médecine interne, CMC Foch, Suresnes, France
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Lesprit P, Piette AM, Baumelou E, Epardeau B, Mignot L, Gepner P, Chapman A. Panniculitis and myelodysplasia: report of 2 cases. Eur J Med 1993; 2:500-2. [PMID: 8258054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- P Lesprit
- Service de Médecine Interne, Centre Médico-Chirurgical Foch, Suresnes, France
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Piette AM, Chapman A, Piette JC. Usefulness of urinary trypsin inhibitory activity in the elderly: possible explanations for conflicting results. Eur J Med 1993; 2:189-90. [PMID: 7505161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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