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Pouessel G, Tanno L, Beaudouin E, Chatain C, Corriger J, Demoly P, Flabbée J, Jacquier J, Larroche Y, Neukirch C, Leroy S, Mariotte D, le Mauff B, Mertes P, Thi N, Pouessel G, Tacquard C, Tanno L, Vitte J. Les sapeurs-pompiers en première ligne dans l’anaphylaxie ! Revue Française d'Allergologie 2022. [DOI: 10.1016/j.reval.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Corriger J, Beaudouin E, Rothmann R, Penven E, Haumonte Q, Thomas H, Picaud J, Nguyen-Grosjean VM, Corriger-Ippolito J, Braun F, De Talancé M, Auburtin B, Atain-Kouadio P, Borsa-Dorion A, Baugnon D, De Carvalho M, Jaussaud R, Nguyen-Thi PL, Bollaert PE, Demoly P, Tanno LK. Epidemiological Data on Anaphylaxis in French Emergency Departments. J Investig Allergol Clin Immunol 2018; 29:357-364. [PMID: 30411700 DOI: 10.18176/jiaci.0348] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although anaphylaxis has been considered a priority public health issue in the world allergy community, epidemiological data on morbidity and mortality remain suboptimal. We performed the first multicenter epidemiological study in French emergency departments (EDs). The study covered 7 EDs over a period of 1 year. The objectives were to identify areas that are amenable to change and to support ongoing national and international efforts for better diagnosis, management, and prevention of anaphylaxis. METHODS Ours was a descriptive study based on data routinely reported to French institutional administrative databases from 7 French public health institutions in the Lorraine region between January and December 2015. Data were collected based on the anaphylaxisrelated codes of the International Classification of Diseases (ICD)-10, and cases were clinically validated as anaphylaxis. RESULTS Of the 202 079 admissions to the EDs, 4817 had anaphylaxis-related codes; of these, 323 were clinically validated as anaphylaxis. Although 45.8% were severe, adrenaline was prescribed in only 32.4% of cases. Of the 323 cases, 57.9% were subsequently referred for an allergy work-up or evaluation (after or during hospitalization), and 17.3% were prescribed autoinjectable epinephrine. CONCLUSION Our results highlight an urgent need for improved public health initiatives with respect to recognition and treatment of anaphylaxis. We flag key problems that should be managed in the coming years through implementation of national and international actions.
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Affiliation(s)
- J Corriger
- Allergy Department, Hospital Emile Durkheim, Epinal, France.,Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - E Beaudouin
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - R Rothmann
- Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France
| | - E Penven
- Occupational Diseases Department, University Hospital, Vandoeuvre-lès-Nancy, France.,Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - Q Haumonte
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - H Thomas
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - J Picaud
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | | | - J Corriger-Ippolito
- Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France.,Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - F Braun
- Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France
| | - M De Talancé
- Emergency Department, Hospital Emile Durkheim, Epinal, France
| | - B Auburtin
- Pediatric Emergency Department, Hospital Emile Durkheim, Epinal, France
| | - P Atain-Kouadio
- Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - A Borsa-Dorion
- Pediatric Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - D Baugnon
- Emergency Department, Hospital of Verdun-Saint-Mihiel, Verdun, France
| | - M De Carvalho
- Biology and Immunology Laboratory, University Hospital, Vandoeuvre-lès-Nancy, France
| | - R Jaussaud
- Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - P L Nguyen-Thi
- Clinical Research Platform, ESPRI-BioBase Unit, University Hospital, Vandoeuvre-lès-Nancy, France
| | - P E Bollaert
- Medical Intensive Care Unit, University Hospital, Nancy, France
| | - P Demoly
- Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
| | - L K Tanno
- Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
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Bah A, Lateur GM, Kouevidjin BT, Bassinga JYS, Issa M, Jaafar A, Beaudouin E. Chronic anterior shoulder instability with significant Hill-Sachs lesion: Arthroscopic Bankart with remplissage versus open Latarjet procedure. Orthop Traumatol Surg Res 2018; 104:17-22. [PMID: 29248765 DOI: 10.1016/j.otsr.2017.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 11/10/2017] [Accepted: 11/16/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The objective of this study was to compare short-term shoulder stability after arthroscopic Bankart repair with remplissage versus the open Latarjet procedure in patients who had chronic anterior shoulder instability with a significant Hill-Sachs lesion. HYPOTHESIS The dislocation recurrence rate is higher after Bankart repair with remplissage than after open Latarjet. PATIENTS AND METHODS An observational non-randomised retrospective cohort study was conducted at two surgical centres in patients treated for chronic anterior shoulder instability with a significant Hill-Sachs defect between January 2009 and July 2014. The study compared 43 patients managed by arthroscopic Bankart repair and remplissage and 43 patients managed with open Latarjet. The two groups were matched on age at surgery and on follow-up duration. All patients were evaluated by independent observers based on a questionnaire including recurrences, range of motion, and functional outcomes (Shoulder Subjective Value [SSV], Walch-Duplay score, and Rowe score). RESULTS Mean follow-up was 47.3 months (range, 24-67 months). The recurrence rate at last follow-up was not significantly different between the two groups (9.3% versus 11.2%; P=0.67). The Bankart group had significantly greater loss of external rotation and a significantly higher proportion of patients with residual pain (21% versus 9%, P=0.023). The SSV, Walch-Duplay score, and Rowe score values were similar between groups. DISCUSSION In patients who had chronic anterior shoulder instability with a significant Hill-Sachs lesion, arthroscopic Bankart repair with remplissage and open Latarjet were reliable and safe procedures associated with low and similar recurrence rates. However, loss of external rotation and residual pain were significantly more common with the combined Bankart-remplissage procedure. LEVEL OF EVIDENCE III; comparative retrospective study.
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Affiliation(s)
- A Bah
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France.
| | - G M Lateur
- Sports orthopaedic surgery and traumatology, Grenoble university hospital, hôpital Sud, Grenoble, France
| | - B T Kouevidjin
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France
| | - J Y S Bassinga
- Orthopaedic and trauma surgery 1, Mohammed V de Rabat military training hospital, avenue des Forces-Armées-Royales, Hay Riad, 10100 Rabat, Morocco
| | - M Issa
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France
| | - A Jaafar
- Orthopaedic and trauma surgery 1, Mohammed V de Rabat military training hospital, avenue des Forces-Armées-Royales, Hay Riad, 10100 Rabat, Morocco
| | - E Beaudouin
- Secrétariat d'orthopédie, centre hospitalier métropole Savoie-de-Chambéry, 7, square Massalez, 73000 Chambéry, France
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Gloaguen A, Cesareo E, Vaux J, Valdenaire G, Ganansia O, Renolleau S, Pouessel G, Beaudouin E, Lefort H, Meininger C. Prise en charge de l’anaphylaxie en médecine d’urgence. Recommandations de la Société française de médecine d’urgence (SFMU) en partenariat avec la Société française d’allergologie (SFA) et le Groupe francophone de réanimation et d’urgences pédiatriques (GFRUP), et le soutien de la Société pédiatrique de pneumologie et d’allergologie (SP2A). Revue Française d'Allergologie 2017. [DOI: 10.1016/j.reval.2017.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Barnig C, Baron-Thurotte A, Barbaud A, Beaudouin E, de Blay F, Bonniaud P, Demoly P, Deschildre A, Didier A, Drouet M, Just J, Lavaud F, Mailhol C, Metz-Favre C, Neukirch C, Petit N, Perotin JM, Ponvert C, Sauvage C, Magnan A, Birnbaum J. Recommandations de la Société Française d’Allergologie. Indications des actes allergologiques en Hôpital de Jour. Revue Française d'Allergologie 2017. [DOI: 10.1016/j.reval.2017.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Pouessel G, Galand J, Beaudouin E, Renaudin JM, Labreuche J, Moneret-Vautrin DA, Deschildre A. The gaps in anaphylaxis diagnosis and management by French physicians. Pediatr Allergy Immunol 2017; 28:295-298. [PMID: 28178763 DOI: 10.1111/pai.12703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- G Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France.,Allergy Vigilance Network, Vandoeuvre les Nancy, France
| | - J Galand
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France
| | - E Beaudouin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - J M Renaudin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - J Labreuche
- EA 2694 - Santé publique: épidémiologie et qualité des soins, Department of Biostatistics, CHU Lille, Univ. Lille, Lille, France
| | | | - A Deschildre
- Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France.,Allergy Vigilance Network, Vandoeuvre les Nancy, France
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Deschildre A, Elegbédé CF, Just J, Bruyère O, Van der Brempt X, Papadopoulos A, Beaudouin E, Renaudin JM, Crepet A, Moneret-Vautrin DA. Peanut-allergic patients in the MIRABEL survey: characteristics, allergists' dietary advice and lessons from real life. Clin Exp Allergy 2016; 46:610-20. [PMID: 26588036 DOI: 10.1111/cea.12681] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/17/2015] [Accepted: 10/20/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The MIRABEL survey is an observational study on peanut allergy in France, Belgium and Luxemburg. The objectives are to provide data on a large population, to analyse the consumer behaviour, to study the presence of peanut traces in pre-packed foods with/without precautionary allergen labelling (PAL), and to combine these data to quantify allergic risk and produce a cost/benefit analysis. This paper reports a real-life observatory of 785 patients (< 16y: 86%): medical characteristics, eliciting doses (ED) in real life and in oral food challenges (OFC), factors associated with severe reactions, allergist dietary advice and patients' anxiety regarding their allergy. METHODS Age and symptoms at diagnosis, route of exposure, comorbidities, allergy tests, ED (OFC/real life; mg peanut protein), dietary advice about PAL, and anxiety score were recorded. RESULTS Median age was 3 years; 85% were declared allergic. Severe/potentially severe reactions were reported in 30% of the allergic patients: serious systemic reaction (15%), laryngeal angioedema (8%), shock (4%) and acute asthma (3%); 66% had atopic dermatitis, 58% asthma. Median ara h 2 sIgE level was 11.5 kUA/L. Of the 278 OFCs, 225 were positive (median ED: 67.3 mg). Real-life ED was < 100 mg in 44.3%. Severe reactions were significantly more frequent in teenagers and adults (P = 0.004), asthmatic patients (P = 0.033), and patients who reacted to inhalation (P < 0.001). No significant association was found for OFC ED or ara h 2 sIgE. Factors associated with strict avoidance advice including PAL were OFC ED < 100 mg (P < 0.001), but not severe reaction history (P = 0.051) or asthma (P = 0.34). Anxiety was significantly associated with strict avoidance (P < 0.001). CONCLUSION AND CLINICAL RELEVANCE Severe/potentially severe reactions, allergic comorbidities, and low EDs in real life are frequent in peanut-allergic patients. Asthma, teenage/adulthood and reaction to inhalation are associated with severe symptoms. PAL and criteria guiding dietary advice need to be improved.
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Affiliation(s)
- A Deschildre
- CHU Lille, Pediatric Pulmonology and Allergy Department, hôpital Jeanne de Flandre, Lille, France.,Allergy Vigilance Network, Vandoeuvre les Nancy, France
| | - C F Elegbédé
- Risk Assessment Department (DER), French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France.,French National Institute for Agricultural Research (INRA), Paris Institute of Technology for Life, Food and Environmental Sciences (AgroParisTech), UMR Economie Publique INRA-AgroParisTech, Paris, France
| | - J Just
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau, APHP; Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman, Liège, Belgium
| | - X Van der Brempt
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Allergopôle, Clinique Saint-Luc, Bouge (Namur), Belgium
| | - A Papadopoulos
- Risk Assessment Department (DER), French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - E Beaudouin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Allergy Department, Centre Hospitalier E Durkheïm, Epinal, France
| | - J-M Renaudin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Allergy Department, Centre Hospitalier E Durkheïm, Epinal, France
| | - A Crepet
- Risk Assessment Department (DER), French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - D-A Moneret-Vautrin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Allergy Department, Centre Hospitalier E Durkheïm, Epinal, France.,Lorraine University, Nancy, France
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Gloaguen A, Cesareo E, Vaux J, Valdenaire G, Ganansia O, Renolleau S, Pouessel G, Beaudouin E, Lefort H, Meininger C. Erratum to: Prise en charge de l’anaphylaxie en médecine d’urgence. Recommandations de la Société française de médecine d’urgence (SFMU) en partenariat avec la Société française d’allergologie (SFA) et le Groupe francophone de réanimation et d’urgences pédiatriques (GFRUP), et le soutien de la Société pédiatrique de pneumologie et d’allergologie (SP2A). Ann Fr Med Urgence 2016. [DOI: 10.1007/s13341-016-0693-1] [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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Pouessel G, Deschildre A, Beaudouin E, Birnbaum J, Neukirch C, Meininger C, Leroy S. À qui prescrire un dispositif auto-injectable d’adrénaline ? Position des groupes de travail « Anaphylaxie », « Allergie alimentaire », « Insectes piqueurs » sous l’égide de la Société française d’allergologie. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2016.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pouessel G, Deschildre A, Beaudouin E, Birnbaum J, Neukirch C, Meininger C, Leroy S. Conditions d’établissement du projet d’accueil individualisé pour l’enfant allergique : position des groupes de travail « anaphylaxie », « allergie alimentaire » et « insectes piqueurs » sous l’égide de la Société française d’allergologie. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2016.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pouessel G, Beaudouin E, Renaudin JM, Moneret-Vautrin AM, Deschildre A. Adherence to the guidelines for adrenaline auto-injector prescription should be improved. Pediatr Allergy Immunol 2016; 27:430-3. [PMID: 26845628 DOI: 10.1111/pai.12546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- G Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France. .,Allergy Vigilance Network, Vandoeuvre les Nancy, France. .,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille and Université Nord de France, Lille, France.
| | - E Beaudouin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - J M Renaudin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - A M Moneret-Vautrin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - A Deschildre
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille and Université Nord de France, Lille, France
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Richard C, Beaudouin E, Moneret-Vautrin DA, Kohler C, Nguyen-Grosjean VM, Jacquenet S. Severe anaphylaxis to Propofol: first case of evidence of sensitization to soy oil. Eur Ann Allergy Clin Immunol 2016; 48:103-6. [PMID: 27152608] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The growing worldwide prevalence of food allergies is drawing attention to the risk of allergenic proteins found in intravenous medicinal products, particularly anaesthetics. Propofol induced anaphylaxis has been described. The presence of soybean oil and egg lecithins in the lipid emulsion highlights their suspected responsibility in certain cases. We report a case of anaphylaxis to propofol in an adult patient without food allergy to soy, but with a latent sensitization to soy. An IgE-dependent allergy to propofol was established by a basophil activation test. Here, we document for the first time the existence of specific IgEs to a 65kDa protein, found in soybean oil and soy flour. In the absence of data on the reactogenic threshold for allergenic food proteins injected intravenously, a risk appears to be established and leads us to recommend a systematic detection for proteins in the refined soybean oil used in the pharmaceutical industry for intravenous products.
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Affiliation(s)
- C Richard
- Genclis SA, Biotechnology Company, 15 rue du Bois de la Champelle, Vandoeuvre-lès-Nancy, France. E-mail:
| | - E Beaudouin
- Department of Allergy, Emile Durkheim Hospital, 31 rue Thiers, Epinal, France
| | - D A Moneret-Vautrin
- Department of Allergy, Emile Durkheim Hospital, 31 rue Thiers, Epinal, France. Faculty of Medicine, Lorraine University, France. Deceased 27 March 2016
| | - C Kohler
- Laboratory of Immunology, University Hospital, Nancy, France
| | - V M Nguyen-Grosjean
- Department of Allergy, Emile Durkheim Hospital, 31 rue Thiers, Epinal, France
| | - S Jacquenet
- Genclis SA, Biotechnology Company, 15 rue du Bois de la Champelle, Vandoeuvre-lès-Nancy, France
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Pouessel G, Beaudouin E, Renaudin JM, Drumez E, Moneret-Vautrin DA, Deschildre A. Pratiques et adhésion aux recommandations pour la prescription des dispositifs auto-injectables d’adrénaline : enquête auprès des allergologues du réseau allergo-vigilance. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2015.10.006] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Barth J, Duparc F, Baverel L, Bahurel J, Toussaint B, Bertiaux S, Clavert P, Gastaud O, Brassart N, Beaudouin E, De Mourgues P, Berne D, Duport M, Najihi N, Boyer P, Faivre B, Meyer A, Nourissat G, Poulain S, Bruchou F, Ménard JF. Prognostic factors to succeed in surgical treatment of chronic acromioclavicular dislocations. Orthop Traumatol Surg Res 2015; 101:S305-11. [PMID: 26470802 DOI: 10.1016/j.otsr.2015.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 08/31/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Treatment of chronic acromioclavicular joint dislocation (ACJD) remains a poorly known and controversial subject. Given the many surgical options, it is not always easy to determine which steps are indispensable. METHODS This article reports a multicenter prospective study. The clinical and radiological follow-up involved a comparative analysis of the preoperative and postoperative data at 1 year, including pain (visual analogue scale), subjective functional incapacity (QuickDASH), and the objective Constant score, as well as a comparative analysis of vertical and horizontal movements measured on simple x-rays. RESULTS Based on a series of 140 operated ACJDs, we included 24 chronic ACJDs. The mean time to surgery was 46 weeks (range, 1 month to 4 years). The patients' mean age was 41 years, with a majority of males (75%), 72% of whom participated in recreational sports. Professionally, 40% of the subjects had jobs involving manual labor. We noted 40% grade III, 24% grade IV, and 36% grade V injury according to the Rockwood classification. In 92% of cases, coracoclavicular stabilization was provided by a double button implant, reinforced with a biological graft in 88% of the cases. In 29%, millimeters to centimeters of the distal clavicle were resected and acromioclavicular stabilization was associated in 54%. We observed complications in 33% of the cases. At 1 year postoperative, 21 patients underwent clinical and radiological follow-up (87.5%). Only 35% of the patients were satisfied or very satisfied, whereas 100% of them would recommend the operation. Full-time work was resumed in 91% of the cases and all sports could be resumed in 86%. The pre- and postoperative values at 1 year changed as follows: the mean Constant score improved from 61 to 87 (p=0.00002); the subjective QuickDASH score decreased from 41 to 9 (p=0.00002); and radiologically significant reduction of the initial displacement was observed in the vertical plane (p<10(-3)) and the horizontal plane (p=0.022). CONCLUSION In this study, the favorable prognostic factors found were: time to surgery less than 3 months (p=0.02), associated acromioclavicular stabilization, and postoperative immobilization with a sling extended to 6 weeks. However, resection of the distal clavicle did not influence the final result. LEVEL OF PROOF Level II prospective non-randomized comparative study.
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Affiliation(s)
- J Barth
- Centre ostéo-articulaire des Cèdres, parc Sud Galaxie, 5, rue des Tropiques, 38130 Échirolles, France.
| | - F Duparc
- CHU de Rouen, 76000 Rouen, France
| | - L Baverel
- Centre ostéo-articulaire des Cèdres, parc Sud Galaxie, 5, rue des Tropiques, 38130 Échirolles, France
| | - J Bahurel
- Clinique générale, 74000 Annecy, France
| | | | | | - P Clavert
- Service de chirurgie de l'épaule et du coude, CCOM, CHRU de Strasbourg, 67000 Strasbourg, France
| | - O Gastaud
- Hôpital Pasteur 2, institut universitaire de l'appareil locomoteur et du sport, CHU de Nice, 30, voie Romaine, CS51069, 06001 Nice cedex 1, France
| | - N Brassart
- Clinique de Cagne-sur-Mer, 06800 Cagne-sur-Mer, France
| | - E Beaudouin
- Centre hospitalier régional de Chambéry, 73000 Chambéry, France
| | | | - D Berne
- Clinique Kennedy, 26200 Montélimar, France
| | - M Duport
- Médipôle Garonne, 31000 Toulouse, France
| | - N Najihi
- CHU de Rennes, 35000 Rennes, France
| | - P Boyer
- Hôpital universitaire Xavier-Bichat, 75018 Paris, France
| | - B Faivre
- Hôpital universitaire Ambroise-Paré, 92100 Boulogne-Billancourt, France
| | - A Meyer
- CMC Paris V, 75005 Paris, France
| | - G Nourissat
- Chirurgie de l'épaule Groupe Maussins, 67, rue de Romainville, 75019 Paris, France
| | - S Poulain
- Polyclinique du Plateau, 21, rue de Sartrouville, 95870 Bezons, France
| | - F Bruchou
- Hôpital privé de l'Ouest Parisien, 78190 Trappes, France
| | - J F Ménard
- Unité biostatistique du CHU de Rouen, Rouen, France
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Barth J, Duparc F, Andrieu K, Duport M, Toussaint B, Bertiaux S, Clavert P, Gastaud O, Brassart N, Beaudouin E, De Mourgues P, Berne D, Bahurel J, Najihi N, Boyer P, Faivre B, Meyer A, Nourissat G, Poulain S, Bruchou F, Ménard JF. Is coracoclavicular stabilisation alone sufficient for the endoscopic treatment of severe acromioclavicular joint dislocation (Rockwood types III, IV, and V)? Orthop Traumatol Surg Res 2015; 101:S297-303. [PMID: 26514849 DOI: 10.1016/j.otsr.2015.09.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [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: 07/02/2015] [Accepted: 08/31/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The primary objective was to evaluate correlations linking anatomical to functional outcomes after endoscopically assisted repair of acute acromioclavicular joint dislocation (ACJD). HYPOTHESIS Combined acromioclavicular and coracoclavicular stabilisation improves radiological outcomes compared to coracoclavicular stabilisation alone. MATERIAL AND METHODS A prospective multicentre study was performed. Clinical outcome measures were pain intensity on a visual analogue scale (VAS), subjective functional impairment (QuickDASH score), and Constant's score. Anatomical outcomes were assessed on standard radiographs (anteroposterior view of the acromioclavicular girdle and bilateral axillary views) obtained preoperatively and postoperatively and on postoperative dynamic radiographs taken as described by Tauber et al. RESULTS Of 116 patients with acute ACJD included in the study, 48% had type III, 30% type IV, and 22% type V ACJD according to the Rockwood classification. Coracoclavicular stabilisation was achieved using a double endobutton in 93% of patients, and concomitant acromioclavicular stabilisation was performed in 50% of patients. The objective functional outcome was good, with an unweighted Constant's score ≥ 85/100 and a subjective QuickDASH functional disability score ≤ 10 in 75% of patients. The radiographic analysis showed significant improvements from the preoperative to the 1-year postoperative values in the vertical plane (decrease in the coracoclavicular ratio from 214 to 128%, p=10(-6)) and in the horizontal plane (decrease in posterior displacement from 4 to 0mm, p=5×10(-5)). The anatomical outcome correlated significantly with the functional outcome (absolute R value=0.19 and p=0.045). We found no statistically significant differences across the various types of constructs used. Intra-operative control of the acromioclavicular joint did not improve the result. Implantation of a biological graft significantly improved both the anatomical outcome in the vertical plane (p=0.04) and acromioclavicular stabilisation in the horizontal plane (p=0.02). The coracoclavicular ratio on the anteroposterior radiograph was adversely affected by a longer time from injury to surgery (p=0.02) and by a higher body mass index (BMI) (p=0.006). High BMI also had a negative effect on the difference in the distance separating the anterior edge of the acromion from the anterior edge of the clavicle between the injured and uninjured sides, as assessed on the axillary views (p=0.009). CONCLUSION This study demonstrates that acute ACJD requires stabilisation in both planes, i.e., at the coracoclavicular junction and at the acromioclavicular joint. Coracoclavicular stabilisation alone is not sufficient, regardless of the type of implant used. Implantation of a biological graft should be considered when the time from injury to surgery is longer than 10days. The weight of the upper limb should be taken into account, with 6weeks of immobilisation to unload the construct in patients who have high BMI values. LEVEL OF EVIDENCE II, prospective non-randomised comparative study.
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Affiliation(s)
- J Barth
- Centre ostéo-articulaire des cèdres, parc Sud-Galaxie, 5, rue des Tropiques, Echirolles, France.
| | - F Duparc
- Centre hospitalier universitaire de Rouen, Rouen, France
| | - K Andrieu
- Centre ostéo-articulaire des cèdres, parc Sud-Galaxie, 5, rue des Tropiques, Echirolles, France
| | - M Duport
- Médipôle Garonne, Toulouse, France
| | | | - S Bertiaux
- Centre hospitalier universitaire de Rouen, Rouen, France
| | - P Clavert
- Service de chirurgie de l'épaule et du coude, CCOM, CHRU de Strasbourg, Strasbourg, France
| | - O Gastaud
- Institut universitaire de l'appareil locomoteur et du sport, hôpital Pasteur 2, CHU de Nice, Nice, France
| | - N Brassart
- Clinique de Cagne-sur-Mer, Cagne-sur-Mer, France
| | - E Beaudouin
- Centre hospitalier régional de Chambéry, Chambéry, France
| | | | - D Berne
- Clinique Kennedy, Montélimar, France
| | - J Bahurel
- Clinique Générale d'Annecy, Annecy, France
| | - N Najihi
- Centre hospitalier universitaire de Rennes, Rennes, France
| | - P Boyer
- Hôpital universitaire Xavier-Bichat, Paris, France
| | - B Faivre
- Hôpital universitaire Ambroise-Paré, Boulogne-Billancourt, France
| | | | - G Nourissat
- Chirurgie de l'épaule, groupe Maussins, 67, rue de Romainville, Paris, France
| | - S Poulain
- Polyclinique du Plateau, Bezons, France
| | - F Bruchou
- Hôpital privé de l'ouest parisien, Trappes, France
| | - J F Ménard
- Unité biostatistique du CHU de Rouen, Rouen, France
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Sabouraud-Leclerc D, Beaudouin E, Chabbert A, Larue C, Donnou MD, Boulègue M, Nootens C, Moneret-Vautrin DA. Anaphylaxies alimentaires en milieu scolaire : à propos de 56 cas déclarés au réseau d’allergovigilance entre 2005 et 2015. Revue Française d'Allergologie 2015. [DOI: 10.1016/j.reval.2015.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Picaud J, Beaudouin E, Renaudin JM, Pirson F, Metz-Favre C, Dron-Gonzalvez M, Moneret-Vautrin DA. Anaphylaxis to diclofenac: nine cases reported to the Allergy Vigilance Network in France. Allergy 2014; 69:1420-3. [PMID: 24931488 DOI: 10.1111/all.12458] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2014] [Indexed: 11/29/2022]
Abstract
Nine cases of diclofenac hypersensitivity recorded by the Allergy Vigilance Network in France from 2002 to 2012 were studied. Data from history, symptoms, skin tests, basophil activation tests, and oral challenge (OC) were recorded. Grade 3 severe anaphylactic reactions occurred in seven cases of nine. IgE-dependent anaphylaxis was confirmed in six cases: positive intradermal tests (n = 4), a syndromic reaction during skin tests (n = 1), and one case with grade 1 reaction and negative skin tests had an anaphylactic shock to the OC. A nonimmune reaction was suspected in one case. An IgE-dependent mechanism may be the predominant cause of adverse reactions to diclofenac. Allergy skin tests must be carried out sequentially at the recommended concentrations. BATs may be helpful because they can support the diagnosis of anaphylaxis. Given the risks of a direct challenge to diclofenac, OC to aspirin should be performed first to exclude a nonimmunologic hypersensitivity to NSAIDs. Tests for specific IgEs to most frequently used NSAIDs such as diclofenac and ibuprofen are urgently needed.
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Affiliation(s)
- J. Picaud
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
| | - E. Beaudouin
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
| | - J. M. Renaudin
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
| | - F. Pirson
- Allergy Vigilance Network; Vandoeuvre les Nancy France
- Pneumology Department; Saint-Luc University Hospital; Bruxelles Belgium
| | - C. Metz-Favre
- Allergy Vigilance Network; Vandoeuvre les Nancy France
- Pneumology Department; New Civil Hospital; Strasbourg France
| | - M. Dron-Gonzalvez
- Allergy Vigilance Network; Vandoeuvre les Nancy France
- Allergy Vigilance Network; Martigues France
| | - D. A. Moneret-Vautrin
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
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Beaudouin E, Defendi F, Picaud J, Drouet C, Ponard D, Moneret-Vautrin DA. Iatrogenic angioedema associated with ACEi, sitagliptin, and deficiency of 3 enzymes catabolizing bradykinin. Eur Ann Allergy Clin Immunol 2014; 46:119-122. [PMID: 24853572] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
New concepts of idiopathic and iatrogenic angioedema underline the role of bradykinin, and the importance of catabolizing enzymes. A case is described of Angiotensin converting enzyme inhibitor (ACEi) and sitagliptin induced angioedema, where AO attacks decreased after the withdrawal of lisinopril but resolved only after the withdrawal of sitagliptin, an inhibitor of dipeptylpeptidase IV. ACE, aminopeptidase P and carboxypeptidase N were decreased down to 17%, 42%, 64% of median references values, and remained low one year after the interruption of these drugs: 56%, 28% and 50%, respectively. The combined deficiency of APP and CPN might enhance the inhibiting effect of the DPP IV inhibitor. The fact that this triple deficiency remained latent before and after the treatment indicates that searching for latent enzyme deficiencies should be carried out when there is intention to treat with a combination of drugs interfering with the bradykinin metabolism.
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Affiliation(s)
- E Beaudouin
- Service d'Allergologie, Centre Hospitalier E Durkheim, Epinal, France
| | - F Defendi
- French Reference Center for Angioedema, CREAK, Grenoble, France. Université Joseph Fourier, GREPI/AGIM CNRS FRE 3405, Grenoble, France
| | - J Picaud
- Service d'Allergologie, Centre Hospitalier E Durkheim, Epinal, France
| | - C Drouet
- French Reference Center for Angioedema, CREAK, Grenoble, France. Université Joseph Fourier, GREPI/AGIM CNRS FRE 3405, Grenoble, France
| | - D Ponard
- Laboratoire d'Immunologie IBP, Grenoble, France
| | - D A Moneret-Vautrin
- Service d'Allergologie, Centre Hospitalier E Durkheim, Epinal, France. Université de Lorraine Nancy, France
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Renaudin JM, Beaudouin E, Ponvert C, Demoly P, Moneret-Vautrin DA. Severe drug-induced anaphylaxis: analysis of 333 cases recorded by the Allergy Vigilance Network from 2002 to 2010. Allergy 2013; 68:929-37. [PMID: 23741979 DOI: 10.1111/all.12168] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND A few series of well-documented cases of severe drug-induced anaphylaxis (SDA) are available. METHODS Cases collected by the Allergy Vigilance Network from 2002 to 2010 were analyzed for clinical signs, causative drugs, and efficacy of a stepwise approach to diagnosis, using skin tests, laboratory tests, and oral challenges. RESULTS Three hundred and thirty-three cases concerned 300 adults (90.1%) and 33 children (9.9%): 206 females (61.9%) and 127 males (38.1%). Mean age was 42.7 ± 18 years. Anaphylactic shock (76.6%), severe systemic reactions (10.5%), acute laryngeal edema (9%), severe bronchospasm (2.1%), and six fatal cases (1.8%) were recorded. There were 270 cases (81.1%) of ambulatory anaphylaxis. Sixty-three cases (18.9%) occurred during anesthesia. Hospitalization was required in 94.8% of cases. 23.7% of patients were admitted to an intensive care unit. Epinephrine was used in 57.9% of cases. Eighty-four drugs were incriminated: antibiotics (49.6%), muscle relaxants, latex and anesthetics (15%), nonsteroidal anti-inflammatory drugs (10.2%), acetaminophen (3.9%), iodinated or magnetic resonance imaging contrast media (4.2%), immunotherapy and vaccines (3.9%), and other drugs (13%). Among antibiotics, amoxicillin (97 cases), other penicillins (four cases), cephalosporins (41 cases), quinolones (15 cases), and pristinamycin (seven cases) were the most common. The diagnosis of drug hypersensitivity was obtained by skin tests in 72.9%, laboratory tests only in 2.4% of cases, and oral challenges (OCs) only in 3.9% of cases. CONCLUSIONS Three hundred and thirty-three case reports provided data on drugs involved in severe anaphylaxis. The efficacy of skin tests and poor use of laboratory tests are underlined. Further progress may depend on OCs.
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Affiliation(s)
- J-M Renaudin
- Department of Allergy, E Durkheim Hospital, Epinal, France
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Guenard-Bilbault L, Moneret-Vautrin DA, Papadopoulos A, Beaumont P, Menetrey C, Beaudouin E, Gayraud J, Drouet M, Sansas B, Crepet A. Allergie à l’arachide en France : premiers résultats de l’étude pilote du programme MIRABEL : « Approche intégrée pour l’évaluation du risque et des coûts/bénéfices liés aux allergènes alimentaires ». Revue Française d'Allergologie 2012. [DOI: 10.1016/j.reval.2012.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Morisset M, Richard C, Astier C, Jacquenet S, Croizier A, Beaudouin E, Cordebar V, Morel-Codreanu F, Petit N, Moneret-Vautrin DA, Kanny G. Anaphylaxis to pork kidney is related to IgE antibodies specific for galactose-alpha-1,3-galactose. Allergy 2012; 67:699-704. [PMID: 22494361 DOI: 10.1111/j.1398-9995.2012.02799.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Carbohydrate-specific IgE antibodies present on nonprimate mammalian proteins were incriminated recently in delayed meat anaphylaxis. The aim of this study was to explore whether anaphylaxis to mammalian kidney is also associated with galactose-α-1,3-galactose (αGal)-specific IgE. METHODS Fourteen patients with anaphylaxis to pork or beef kidney underwent prick tests to meat and kidney. Some patients also underwent skin tests to Erbitux(®) (cetuximab). IgE antibodies to αGal, swine urine proteins, beef and pork meat, serum albumin proteins, cat, and rFel d 1 were measured by ImmunoCAP(®). The αGal levels were estimated in meats and kidney by ELISA inhibition assay. Cross-reactivity between αGal and pork kidney was studied with the ImmunoCAP(®) inhibition assay. RESULTS Among the 14 patients, 12 presented with anaphylactic shock. Reactions occurred within 2 h from exposure in 67% of patients. Associated risk factors were observed in 10 cases, and alcohol was the main cofactor. Three patients underwent an oral challenge to pork kidney, and anaphylaxis occurred after ingestion of small quantities (1-2 g). Prick tests to kidney were positive in 54% of patients. All tested patients showed positive skin tests to Erbitux(®). All patients tested positive for IgE to αGal, with levels ranging from 0.4 to 294 kU/l. IgE binding to αGal was inhibited by raw pork kidney extract (mean, 77%; range, 55-87%), which showed a high amount of αGal determinants. CONCLUSIONS Pork or beef kidney anaphylaxis is related to αGal IgE. Its peculiar severity could be due to an elevated content of αGal epitopes in kidney.
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Affiliation(s)
| | - C. Richard
- Genclis; SAS; Vandoeuvre-les-Nancy; France
| | - C. Astier
- INPL-ENSAIA; Nancy University; Vandœuvre-lès-Nancy; France
| | | | - A. Croizier
- Internal Medicine, Clinical Immunology and Allergy; University Hospital; Nancy; France
| | | | - V. Cordebar
- Internal Medicine, Clinical Immunology and Allergy; University Hospital; Nancy; France
| | | | | | | | - G. Kanny
- Internal Medicine, Clinical Immunology and Allergy; University Hospital; Nancy; France
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Moneret-Vautrin DA, Vitte J, Jacquenet S, Morisset M, Denery-Papini S, Renaudin JM, Codreanu F, Bonardel N, Fardeaux MF, Beaudouin E. Diagnostic de l’IgE-réactivité par analyse des composants moléculaires (test ISAC). Revue Française d'Allergologie 2011. [DOI: 10.1016/j.reval.2011.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Guilloux L, Benoit Y, Aimone-Gastin I, Ponvert C, Beaudouin E. [Control of the biological diagnostic assessment. Immunoglobulin E]. Ann Fr Anesth Reanim 2011; 30:294-304. [PMID: 21392931 DOI: 10.1016/j.annfar.2010.12.013] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- L Guilloux
- Unité d'immuno-allergologie, laboratoire Mérieux, avenue Tony-Garnier, Lyon, France.
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Hosotte M, Beaudouin E, Morisset M, Luyasu S, Renaudin JM, Petit N, Hans C, Mouton C, Kanny G. Angiœdèmes iatrogènes sous inhibiteurs de l’enzyme de conversion et sous sartans : à propos de 82 cas. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.247] [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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Moneret-Vautrin DA, Petit N, Parisot L, Dumont P, Morisset M, Beaudouin E, Bouillot F, Codreanu F, Cuny JM, Flabbee J, Frentz P, Hatahet R, Cordebar V, Renaudin JM, Croizier A, Aubert L, Kanny G, Jacquenet S, Bihain B. Efficacité et sécurité des protocoles de tolérance à l’arachide (immunothérapie orale). Étude pilote sur 51 patients. Revue Française d'Allergologie 2010. [DOI: 10.1016/j.reval.2010.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Morisset M, Drouet C, Beaudouin E, Luyasu S, Codreanu F, Petit N, Cordebar V, Renaudin JM, Moneret-Vautrin DA, Kanny G. Les anti-leucotriènes : un nouveau traitement de l’angiœdème récidivant idiopathique ? À propos de 25 cas traités par Montelukast. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.427] [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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Morisset M, Dumond P, Debouverie M, Beaudouin E, Renaudin JM, Codreanu F, Moneret-Vautrin DA, Kanny G. Allergie immédiate au cyclophosphamide et protocole d’accoutumance. À propos d’un cas. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.03.213] [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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Codreanu F, Morisset M, Renaudin J, Schuller A, Mouzita J, Beaudouin E, Moneret-Vautrin D, Kanny G. Drug Anaphylaxis As Presentation of Systemic Mastocytosis: About 7 Case Reports. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.126] [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] [Indexed: 11/26/2022]
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Renaudin J, Kanny G, Codreanu F, Beaudouin E, Moneret-Vautrin D. Severe Drug-Induced Anaphylaxis: Survey of Case Reports by Allergy Vigilance Network. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.160] [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] [Indexed: 11/17/2022]
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Morisset M, Moneret-Vautrin DA, Guenard L, Cuny JM, Frentz P, Hatahet R, Hanss C, Beaudouin E, Petit N, Kanny G. Oral desensitization in children with milk and egg allergies obtains recovery in a significant proportion of cases. A randomized study in 60 children with cow's milk allergy and 90 children with egg allergy. Eur Ann Allergy Clin Immunol 2007; 39:12-9. [PMID: 17375736] [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] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Food allergy is treated by avoidance diets in order to prevent anaphylactic reactions and to cure chronic associated symptoms. However, the natural history is left unchanged. OBJECTIVE To search for a beneficial effect of an oral desensitization protocol to allergenic foods in IgE-dependent milk or egg allergies in children. METHODS 60 children with documented cow's milk allergy (13 months-6.5 years), and 90 children with egg allergy (12 months-8 years), were consecutively included after 6-12 months of avoidance diet, if a SBPCFC to 60 ml milk (60 ml) or to 965 mg of raw egg white was negative. They were randomized for uninterrupted avoidance or oral desensitization (group A or OD). Six months later, a new SBPCFC was performed with, up to 200 ml of milk or 7g of raw egg white. Prick tests and specific IgE levels were carried out simultaneously. RESULTS Data were obtained for 57 children with CMA (30 A and 27 OD), and 84 children with EA (35 A and 49 OD). The two groups (AD or OD group) were similar with regard to means of ages, the size of PT wheals and the level of IgEs at baseline. MILK ALLERGY: A SBPCFC to milk was positive in 11.1% of those following OD vs. 40% after A (p < .025). The size of PT decreased after OD and increased after A (-3.4 mm vs. +0.84 mm; p < .002). EGG ALLERGY: The SBPCFC to egg was positive in 30.6% after OD vs. 48.6% after A (p < .1). After 6 months, in the OD group, the mean size of the PT and the level of specific IgE were significantly reduced compared to the A group. In the A group, the threshold of reactivity was often lower, or more serious symptoms were observed. CONCLUSION Oral desensitization helps the egg and milk allergic children to overcome their allergies. Since the avoidance of these foods is likely to increase sensitization as well as to lower the threshold of reactivity, an active treatment is required. Further attempts to standardize the procedures of oral desensitization are expected.
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Affiliation(s)
- M Morisset
- Internal Medicine, Clinical Immunology and Allergology, University Hospital of Nancy, Cedex, France
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Affiliation(s)
- E Beaudouin
- Service de médecine interne, immunologie clinique et allergologie, hôpital Central, CHU de Nancy, 9, avenue de Lattre-de-Tassigny, 54035 Nancy, France.
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Beaudouin E, Renaudin JM, Morisset M, Codreanu F, Kanny G, Moneret-Vautrin DA. Food-dependent exercise-induced anaphylaxis--update and current data. Eur Ann Allergy Clin Immunol 2006; 38:45-51. [PMID: 16711535] [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] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Exercise-induced anaphylaxis (EIA) is defined as the onset of allergic symptoms during, or immediately after, exercise, the clinical signs being various degrees of urticaria, angioedema, respiratory and gastrointestinal signs and even anaphylactic shock. Food-dependent exercise-induced anaphylaxis (FDEIA) introduces food in the syndrome and is revealed by a chronological sequence in which food intake, followed by exercise, induces symptoms after a varying period. When the food intake and the exercise are independent of each other, there are no symptoms. FDEIA is not very frequent. Identifying the culprit food allergen depends on the patient's eating habits. Crustaceans and wheat flour are the two commonest but others foods can be implicated. The patho-physiology of FDEIA has not been clearly established but it appears to result from degranulation of mast cells. As with food allergy, FDEIA diagnosis is based on interview, skin and biological tests and challenge. For the clinical signs of allergy, antihistamines, corticosteroids and epinephrine may be administered. Prophylaxis aims to prevent a recurrence; the patient should be given an emergency kit to deal with any recurrent episode. After the food allergen has been identified, it should be avoided for at least 4 to 5 hours before any exercise.
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Affiliation(s)
- E Beaudouin
- Department of Internal Medicine, Clinical Immunology and Allergology, University Hospital, Hôpital Central, Nancy, France
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Abstract
Severe anaphylaxis is a systemic reaction affecting two or more organs or systems and is due to the release of active mediators from mast cells and basophils. A four-grade classification routinely places 'severe' anaphylaxis in grades 3 and 4 (death could be graded as grade 5). Studies are underway to determine the prevalence of severe and lethal anaphylaxis in different populations and the relative frequencies of food, drug, latex and Hymenoptera anaphylaxis. These studies will also analyse the risk arising from the lack of preventive measures applied in schools (personalized management protocols) and from the insufficient use of self-injected adrenalin. Allergy-related conditions may account for 0.2-1% of emergency consultations. Severe anaphylaxis affects 1-3 per 10 000 people, but for the United States and Australia figures are even higher. It is estimated to cause death in 0.65-2% of patients, i.e. 1-3 per million people. An increased prevalence has been revealed by monitoring hospitalized populations by reference to the international classification of disease (ICD) codes. The relative frequency of aetiological factors of allergy (food, drugs, insects and latex) varies in different studies. Food, drug and Hymenoptera allergies are potentially lethal. The risk of food-mediated anaphylaxis can be assessed from the number of personalized management protocols in French schools: 0.065%. Another means of assessment may be the rate of adrenalin prescriptions. However, an overestimation of the anaphylaxis risk may result from this method (0.95% of Canadian children). Data from the literature leads to several possibilities. First, a definition of severe anaphylaxis should be agreed. Secondly, prospective, multicentre enquiries, using ICD codes, should be implemented. Moreover, the high number of anaphylaxis cases for which the aetiology is not identified, and the variation in aetiology in the published series, indicate that a closer cooperation between emergency specialists and allergists is essential.
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Affiliation(s)
- D A Moneret-Vautrin
- Department of Internal Medicine, Clinical Immunology and Allergology, University Hospital, Nancy Cedex, France
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Morisset M, Moneret-Vautrin D, Guénard L, Cuny J, Frentz P, Hatahet R, Hanss C, Beaudouin E, Petit N, Frémont S, Kanny G. Oral tolerance protocols improve the rate of recovery of cow milk and egg allergies: Randomized study in 60 children with cow's milk allergy and 90 children with egg allergy. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.263] [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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Kanny G, Guenard L, Demoly P, Ponvert C, Grand J, Gallen C, Chalmet P, Croizier A, Jacquier J, Morisset M, Auffret A, Cordebar V, Debavelaere C, Debavelaere C, Devoisins J, Nootens C, Petit N, Pirson F, Sorlin A, Andrier-Schmitt A, Andrier-Schmitt A, Beaudouin E, Bossé I, Buard M, Chappard C. Severe drug allergy: The first 100 cases declared to allergy vigilance network. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.745] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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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Moneret-Vautrin DA, Burnel D, Sainte-Laudy J, Beaudouin E, Croizier A. Allergy to nickel in dental alloys. Eur Ann Allergy Clin Immunol 2004; 36:311-2. [PMID: 15623246] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A case of oral allergy to dental alloys is presented, highlighting the interest of dosage of salivary nickel and of flow cytometry showing a selective CD4+ activation. The discrepancy between the rarity of oral allergy to dental alloys and the frequency of nickel sensitization and nickel-induced contact dermatitis leads to discuss the mechanisms of oral tolerance.
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Affiliation(s)
- D-A Moneret-Vautrin
- Department of Internal Medicine, Clinical Immunology and Allergology - University Hospital, Nancy
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Beaudouin E, Kanny G, Morisset M, Renaudin JM, Mertes M, Laxenaire MC, Mouton C, Jacson F, Moneret-Vautrin DA. Immediate hypersensitivity to chlorhexidine: literature review. Eur Ann Allergy Clin Immunol 2004; 36:123-6. [PMID: 15180352] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Chlorhexidine, an antiseptic belonging to family of biguanides, is used extensively in the medical and surgical environment. Late onset hypersensitivity and eczema occur regularly and are well documented events. Conversely, immediate hypersensitivity, sometimes taking the form of acute urticaria that can result in anaphylactic shock, is rarer. These manifestations can occur during contact of the skin or mucosa with chlorhexidine. Out of the fifty case reports of chlorhexidine-related anaphylaxis published worldwide over the past ten years, fifteen occurred during surgery. Signs generally appear from 15 to 45 minutes after the start of anesthesia. If there is any suspicion of immediate allergy to chlorhexidine, prick-tests or even intradermal reaction (IDR) techniques are highly recommended. In the event of confirmed allergy to chlorhexidine, strict eviction is required, bearing in mind that over a hundred medicinal products currently on the French market contain chlorhexidine.
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Affiliation(s)
- E Beaudouin
- Service de Médecine Interne, Immunologie Clinique et Allergologie, CHU de Nancy, Hôpital Central - 29, avenue de Lattre de Tassigny, 54035 Nancy, France
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Moneret-Vautrin DA, Kanny G, Morisset M, Rancé F, Fardeau MF, Beaudouin E. Severe food anaphylaxis: 107 cases registered in 2002 by the Allergy Vigilance Network. Eur Ann Allergy Clin Immunol 2004; 36:46-51. [PMID: 15061394] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND The prevalence of food allergies increases, relating to diet modifications. The consumption of new foods--exotic foods or foods originally used for animal feed, new proteins, neo allergens due to the use of new technologies and soon, Genetically Modified Foods--are in the spotlight. OBJECTIVE It is essential to develop a system of food allergy vigilance encompassing the full range of foods being consumed. Understanding this imperative leads logically to the suggestion of developing an allergy vigilance network taking advantage of the ongoing experience of allergists "on the ground". METHODS The French Allergy Vigilance Network is subscribed to by 302 allergologists (267 of whom are French). The aims of the Network are to record cases of severe anaphylaxis, to establish an epidemiological data bank from prospective multicenter studies, and to monitor the allergic risk from novel foods. RESULTS In 2002, 107 cases of severe anaphylaxis were recorded: anaphylactic shock--59.8% (one fatal), systemic reaction--18.7%, laryngeal angio-edema--15.9%, acute severe asthma--5.6% (one fatal). The main allergens identified were peanuts, nuts, shellfish, lupine flour and wheat flour. Action has been taken as a result: information by industry on inadequate labeling, withdrawal of wrongly labeled batches, and university hospital centers have been encouraged to establish the allergenic safety of their catering services. CONCLUSION Setting up such a network in other countries would lead to a significant advance in knowledge of the peculiarities of allergies relating to a wide variety of eating habits.
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Affiliation(s)
- D A Moneret-Vautrin
- Department of Internal Medicine, Clinical Immunology and Allergology, University Hospital, Avenue de Lattre de Tassigny, 54035 Nancy Cedex, France
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Beaudouin E, Kanny G, Blanloeil Y, Guilloux L, Renaudin JM, Moneret-Vautrin DA. Anaphylactic shock induced by gadoterate meglumine (DOTAREM). Eur Ann Allergy Clin Immunol 2003; 35:382-5. [PMID: 14768523] [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] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The use of contrast agent for magnetic resonance imaging improves the effectiveness of this diagnostic examination. Complexes of godolinium, which appear to be well tolerated, are used for this purpose. A few cases of anaphylactic shock have been attributed to these agents. We report a case of anaphylactic shock due to gadoterate meglumine (DOTAREM). While undergoing a magnetic resonance imaging examination, a 33-year-old nonatopic female patient became severely hypotensive, lost consciousness, and had generalized erythema immediately after the intravenous injection of this product. She recovered rapidly after she was given injection of epinephrine and her blood volume was restored with intravenous fluids. That DOTAREM had caused this immediate hypersensitivity reaction was proven by the positivity of prick-test and intradermal test at 10-3 (0.37 mg/ml) and in vitro leukocyte histamine release test. The results of these tests indicated that it was the gadoteric acid rather than the meglumine component of DOTAREM that was responsible: positivity of IDR at 10 mg/ml. Skin tests and leukocyte histamine release test to gadopentetate dimeglumine (MAGNEVIST) were negative. In addition of the exceptional character, this observation provides evidence for an immediate hypersensitivity without cross reactivity with gadopentetate dimeglumine.
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Affiliation(s)
- E Beaudouin
- Department of Internal Medicine, Clinical Immunology and Allergology, University Hospital, Hôpital Central, 54035 Nancy, France
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Beaudouin E, Carolus S, Flabbee J, Renaudin JM, Morisset M, Kanny G, Moneret-Vautrin DA. [Allergies in orthodontics]. Eur Ann Allergy Clin Immunol 2003; 35:344-51. [PMID: 14716963] [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] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
In contrast with work-related allergies amongst dentists and dental prosthetictists, allergies in patients followed in orthodontics concerning the materials placed in the mouth were rare. It may be a question of limited manifestations in the buccal cavity (urticaria, angio-oedema, stomatitis, chellitis), or more generalised manifestations (Quincke's oedema, eczema). The number of materials used in orthodontics is limited. The observations concerning metals are less numerous whilst those that concern the resins are exceptional. On the other hand, the risk linked to latex is very real. Allergy investigations require skin tests, sometimes to mucous tests and in some cases to provocation tests. Use of eviction measures may be not only the only diagnostic method but also a therapeutic method. Systematic search for an allergy to metal or a resin posed by the prosthetic material does not seem to be necessary. In the case of suspicion of latex, confirmed ultimately by an allergic history, this imposes start of the eviction measures.
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Affiliation(s)
- E Beaudouin
- Service de Médecine Interne, Immunologie Clinique et Allergologie, Hôpital Central, CHU de Nancy, 29, avenue de Lattre de Tassigny, CO no. 34, 54035, Nancy
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Morisset M, Moneret-Vautrin DA, Kanny G, Guénard L, Beaudouin E, Flabbée J, Hatahet R. Thresholds of clinical reactivity to milk, egg, peanut and sesame in immunoglobulin E-dependent allergies: evaluation by double-blind or single-blind placebo-controlled oral challenges. Clin Exp Allergy 2003; 33:1046-51. [PMID: 12911777 DOI: 10.1046/j.1365-2222.2003.01734.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.4] [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: 11/20/2022]
Abstract
BACKGROUND The prevalence of food anaphylaxis due to masked allergens has increased within the last 10 years. Contamination of manufactured products by food allergens is a key concern for food industries. OBJECTIVE To determine quantities eliciting reactions in patients who have an IgE-dependent food allergy, thanks to standardized oral provocation tests. To evaluate the subsequent levels of sensitivity required for the detection tests of allergens for egg, peanut, milk and sesame. METHODS Prick-in-prick tests, Cap system RAST, and single or double-blind placebo-controlled food challenges (SBPCFC or DBPCFC) were performed. The doses of natural food were gradually increased from 5 to 5000 mg for solid food and from 1 to 30 mL for peanut oil, sunflower oil, soy oil and sesame oil. RESULTS Data from 125 positive oral challenges to egg, 103 to peanut, 59 to milk and 12 to sesame seeds were analysed. Haemodynamic modifications were observed in 2%, 3%, 1.7%, and 8% of the oral challenges (OCs) to egg, peanut, milk and sesame, respectively. Respiratory symptoms were observed in 12%, 20%, 10% and 42% of egg, peanut milk and sesame allergies, respectively. A cumulative reactive dose inferior or equal to 65 mg of solid food or 0.8 mL of milk characterized 16%, 18%, 5% and 8% of egg, peanut, milk and sesame allergies, respectively. 0.8% of egg allergies, 3.9% of peanut allergies, and 1.7% of milk allergies reacted to 10 mg or less of solid food or to 0.1 mL for milk. The lowest reactive threshold has been observed at less than 2 mg of egg; 5 mg of peanut, 0.1 mL of milk and 30 mg of sesame seed. Ten out of 29 OC with peanut oil, two out of two OC with soy oil and three out of six OC with sunflower oil were positive. Five out six OC with sesame oil were positive: 1 and 5 mL induced an anaphylactic shock. CONCLUSION The risk of asthma and anaphylactic shock to sesame and peanut is confirmed. Minimal reactive quantities show that, in order to guarantee a 95% safety for patients who are allergic to egg, peanut and milk, and on the basis of consumption of 100 g of food, the detection tests should ensure a sensitivity of 10 p.p.m. for egg, 24 p.p.m. for peanut and 30 p.p.m. for milk proteins. Oil allergies being considered, the limit of sensitivity should fall to 5 p.p.m.
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Affiliation(s)
- M Morisset
- Internal Medicine, Clinical Immunology and Allergology, University Hospital Nancy, France
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Moneret-Vautrin DA, Romano MC, Kanny G, Morisset M, Beaudouin E, Parisot L, Croizier A, Hatahet R. [The individual reception project (IRP) for anaphylactic emergencies. The situation in France and French overseas territories in 2002]. Presse Med 2003; 32:61-6. [PMID: 12653027] [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: 03/01/2023] Open
Abstract
INTRODUCTION The management in schools of children with life-threatening or chronic diseases has led to the development of Individual Reception Projects (IRP) since 1993, notified in the state education ministry's circular letter. The aim of this study was to assess the status of such IRPs in France and the French Overseas Territories in the management of food allergy risks. METHOD The regional departments of educational promotion were contacted and the survey was run between May and June, 2002. The items of the questionnaire were: the number of IRPs for anaphylactic emergencies, details on the allergies themselves, an overview of the eventual existence of dialogue structures among school physicians, heads of schools, allergists, treatment prescribers and emergency protocols. RESULTS The total survey revealed 7482 IRP for anaphylactic reactions to food (14% of the total IRPs). The frequency of IRPs varied greatly depending on the regions. The Paris area represented 36.3% of the total. The Lorraine area: 5.6%, the Haute-Garonne: 5%, and the Bouches-du-Rhône: 3.3%. The IRPs represented 0.002 (Ardèche) to 0.33% (Alpes-de-Haute-Provence) of the school attending population. The mean level was of 0.065%; 71.6% of the IRPs concerned the 1st grade (1 IRP for 1091 children). In decreasing frequency, the allergens concerned were: peanuts, eggs, dried nuts, fish, dried peas and milk. Dialogue structures were established in 38 regions. DISCUSSION The IRPs have increased 4-fold since the circular letter in 1999. The enhanced prevalence of numerous (new) allergies to dried nuts and leguminous plants has been emphasized, and peanut allergies have been confirmed. The complexity of managing the IRPs and need for information and training of state education and municipal staff requires the further development of dialogue structures, which are still clearly insufficient.
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Affiliation(s)
- D A Moneret-Vautrin
- Service de médecine interne, immunologie clinique et allergologie, Hôpital Central 29 Avenue Maréchal de Lattre de Tassigny 54035 Nancy.
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Moneret-Vautrin D, Morisset M, Kanny G, Beaudouin E, Parisot L. Premier rapport du réseau français d'allergovigilance concernant l'anaphylaxie alimentaire grave. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80590-2] [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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Morisset M, Kanny G, Flabbée J, Beaudouin E, Parisot L, Moneret-Vautrin D. Analyse des facteurs de risque de choc anaphylactique par allergie alimentaire. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80495-7] [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: 10/25/2022]
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Kanny G, Durand PY, Beaudouin E, Chanliau J, Moneret-Vautrin DA, Kessler M. Hypersensitivity to icodextrin. Allergy 2002; 57:60-1. [PMID: 11991299] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- G Kanny
- Service de Médecine Interne, Immunologie Clinique et Allergologie, Center Hospitalier Universitaire, Hôpital Central, Nancy, France
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Kanny G, Chenuel B, Beaudouin E, Cabanis J, Blaise A, Moneret-Vautrin D. Les sulfites ne sont pas responsablesde toutes les réactions d'intolérance aux vins. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)80015-1] [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: 11/30/2022]
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