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Parentelli AS, Boursier G, Cuisset L, Georgin-Lavialle S. [Genetic mosaicism in Systemic Auto-Inflammatory Diseases: A review of the literature]. Rev Med Interne 2024:S0248-8663(24)00566-6. [PMID: 38762439 DOI: 10.1016/j.revmed.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/07/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
Systemic auto-inflammatory diseases (SAIDs) are disorders associated with deregulation of innate immunity in which patients present classically with systemic inflammatory manifestations, in particular fever, skin-mucosal rashes, arthromyalgia and abdominal pain, with an increase in blood biomarkers of inflammation. At the time of their discovery, these diseases were associated with constitutional mutations in genes encoding proteins involved in innate immunity, and it was then considered that they had to begin in childhood. This dogma of constitutional mutations in SAIDs is no longer so unquestionable, since 2005 several cases of mosaicism have been reported in the literature, initially in cryopyrinopathies, but also in other SAIDs in patients with obvious clinical phenotypes and late onset of disease expression, in particular in the VEXAS syndrome (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic Syndrome) and very recently in MEVF gene. Next-generation sequencing techniques are more sensitive than Sanger for detecting mosaicisms. So, when a clinical diagnosis seems obvious but no constitutional mutation is found by low-depth genetic analysis, it is useful to discuss with expert geneticists whether to consider another genetic approach in a child or an adult. This modifies the situations in which clinicians can evoke these diseases. This review provides an update on mosaicism in SAIDs.
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Affiliation(s)
- A-S Parentelli
- Service de pédiatrie, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, Réunion.
| | - G Boursier
- Service de génétique moléculaire et cytogénomique, laboratoire de génétique des maladies rares et auto-inflammatoires, CHU de Montpellier, université de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France; Centre de référence des maladies auto-inflammatoires rares et de l'amylose inflammatoire (CEREMAIA), hôpital Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - L Cuisset
- Service de médecine génomique des maladies de système et d'organe, hôpital Cochin, Assistance publique-Hôpitaux de Paris, université Paris Cité, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - S Georgin-Lavialle
- Service de médecine interne, hôpital Tenon, Assistance publique-Hôpitaux de Paris, Sorbonne université, 4, rue de la Chine, 75020 Paris, France; Centre de référence des maladies auto-inflammatoires rares et de l'amylose inflammatoire (CEREMAIA), hôpital Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
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Elhani I, Aouba A, Riller Q, Vergneault H, Boursier G, Rieux-Laucat F, Hentgen V, Georgin-Lavialle S. L’haploinsuffisance de A20 : que doit connaître le clinicien? Rev Med Interne 2023:S0248-8663(23)01321-8. [PMID: 38160098 DOI: 10.1016/j.revmed.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
A20 Haploinsufficiency (HA20) is a monogenic autoinflammatory disease associated with an autosomal dominant mutation in the TNFAIP3 gene. It induces a defect in the inactivation of the pro-inflammatory NF-κB pathway. Less than 200 cases have been described worldwide. The clinical picture of the disease is essentially based on the association of recurrent fever and/or biologic inflammatory syndrome, aphtosis, often bipolar, and cutaneous folliculitis. However, the clinical spectrum of HA20 is very broad, including gastrointestinal (mainly colonic ulceration), articular, cutaneous, pericardial and lymph node involvement, as well as frequent association with organ-specific or non-specific autoimmune manifestations and/or autoantibodies, including antinuclear antibodies and anti-dsDNA. As a result, the diagnosis of a number of systemic or organic disorders, most notably Behçet's disease, Crohn's disease, and sometimes even systemic lupus, has been corrected to HA20 by molecular research for a heterozygous mutation with functional deficiency of TNFAIP3. Although the first signs of the disease often appear in the first years of life, the diagnosis is often made in adulthood and requires the involvement of both paediatric and adult physicians. Treatment for HA20 is not codified and relies on conventional or biological immunomodulators and immunosuppressants adapted to the patient's symptomatology. This review highlights the enormous diagnostic challenges in this autoinflammatory disease.
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Affiliation(s)
- I Elhani
- Centre de référence des maladies auto-inflammatoires rares et des amyloses, service de pédiatrie générale, hôpital de Versailles, Versailles, France; Sorbonne université, centre de recherche Saint-Antoine (CRSA) INSERM UMRS-938.
| | - A Aouba
- Département de médecine Interne et immunologie clinique, Normandie Univ, UNICAEN, UR4650 PSIR, CHU de Caen Normandie, Caen, France
| | - Q Riller
- Université Paris Cité, Institut Imagine, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, INSERM UMR 1163, 75015 Paris, France
| | - H Vergneault
- AP-HP, hôpital Tenon, Service de médecine interne, Paris, France
| | - G Boursier
- Centre national de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Montpellier, France; Laboratoire de Génétique des Maladies rares et autoinflammatoires, Service de Génétique moléculaire et cytogénomique, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - F Rieux-Laucat
- Université Paris Cité, Institut Imagine, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, INSERM UMR 1163, 75015 Paris, France
| | - V Hentgen
- Centre de référence des maladies auto-inflammatoires rares et des amyloses, service de pédiatrie générale, hôpital de Versailles, Versailles, France
| | - S Georgin-Lavialle
- Sorbonne université, centre de recherche Saint-Antoine (CRSA) INSERM UMRS-938; AP-HP, hôpital Tenon, Service de médecine interne, Paris, France.
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3
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Mertz P, Hentgen V, Boursier G, Delon J, Georgin-Lavialle S. [Monogenic auto-inflammatory diseases associated with actinopathies: A review of the literature]. Rev Med Interne 2023; 44:585-593. [PMID: 37596178 DOI: 10.1016/j.revmed.2023.06.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/06/2023] [Indexed: 08/20/2023]
Abstract
Auto-inflammatory diseases (AIDs) are diseases resulting from an inappropriate activation of innate immunity in the absence of any infection. The field of monogenic AIDs is constantly expanding, with the discovery of new pathologies and pathophysiological mechanisms thanks to pangenomic sequencing. Actinopathies with auto-inflammatory manifestations are a new emerging group of AIDs, linked to defects in the regulation of the actin cytoskeleton dynamics. These diseases most often begin in the neonatal period and combine to varying degrees a more or less severe primary immune deficiency, cytopenias (especially thrombocytopenia), auto-inflammatory manifestations (especially cutaneous and digestive), atopic and auto-immune manifestations. The diagnosis is to be evoked essentially in front of a cutaneous-digestive auto-inflammation picture of early onset, associated with a primary immune deficiency and thrombocytopenia or a tendency to bleed. Some of these diseases have specificities, including a risk of macrophagic activation syndrome or a tendency to atopy or lymphoproliferation. We propose here a review of the literature on these new diseases, with a proposal for a practical approach according to the main associated biological abnormalities and some clinical particularities. However, the diagnosis remains genetic, and several differential diagnoses must be considered. The pathophysiology of these diseases is not yet fully elucidated, and studies are needed to better clarify the inherent mechanisms that can guide the choice of therapies. In most cases, the severity of the picture indicates allogeneic marrow transplantation.
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Affiliation(s)
- P Mertz
- Service de rhumatologie, hôpitaux universitaires de Strasbourg, centre national de référence RESO, 67000 Strasbourg, France
| | - V Hentgen
- Service de pédiatrie, centre hospitalier de Versailles, centre de référence des maladies auto-inflammatoires et de l'amylose (CEREMAIA), 78150 Le Chesnay, France
| | - G Boursier
- Service de génétique moléculaire et cytogénomique, laboratoire de référence des maladies rares et auto-inflammatoires, CEREMAIA, IRMB, Inserm, CHU de Montpellier, université de Montpellier, Montpellier, France
| | - J Delon
- Université Paris Cité, institut Cochin, Inserm, CNRS, 75014 Paris, France
| | - S Georgin-Lavialle
- Service de médecine interne, DHU32D, département hospitalo-universitaire Inflammation, immunopathologie, biothérapie, hôpital Tenon, université Paris, Sorbonne université, Assistance publique-Hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France; CHU de Tenon, centre de référence des maladies auto-inflammatoires rares et de l'amylose inflammatoire (CEREMAIA), 75020 Paris, France.
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4
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Georgin-Lavialle S, Savey L, Cuisset L, Boursier G, Boffa JJ, Delplanque M, Bourguiba R, Monfort JB, Touitou I, Grateau G, Kone-Paut I, Hentgen V. French protocol for the diagnosis and management of familial Mediterranean fever. Rev Med Interne 2023; 44:602-616. [PMID: 37903671 DOI: 10.1016/j.revmed.2023.10.441] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/08/2023] [Indexed: 11/01/2023]
Abstract
Familial Mediterranean fever is the most common monogenic auto-inflammatory disease in the world. It mainly affects people originating from the Mediterranean region. The mutated gene is MEFV, which codes for pyrin. Transmission is autosomal recessive. Patients present with recurrent attacks of fever since childhood associated with abdominal and/or thoracic pain lasting an average of 2-3days and a biological inflammatory syndrome. Other symptoms include arthralgia or arthritis in large joints such as the knees and ankles, myalgia in the lower limbs and pseudo-erysipelas in the ankles. The most serious complication is inflammatory amyloidosis, which can lead to kidney failure. Treatment is based on colchicine, which helps to prevent flares and the onset of renal amyloidosis. This paper proposes national guidelines for the diagnosis, management and follow-up of familial Mediterranean fever in France, where we estimate there are between 5000 and 10,000 patients with the disease at all stages of life. The diagnosis is suspected on the basis of clinical and anamnestic factors and confirmed by genetic analysis. These guidelines also suggest a "treat-to-target" approach to disease management, particularly in case of suspected colchicine resistance - a very rare situation that should remain a diagnosis of elimination, especially after colchicine compliance has been verified. Two special situations are also addressed in these guidelines: kidney failure and pregnancy.
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Affiliation(s)
- S Georgin-Lavialle
- Internal Medicine, Sorbonne University, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France.
| | - L Savey
- Internal Medicine, Sorbonne University, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - L Cuisset
- Genetics, Cochin Hospital, Paris, France
| | - G Boursier
- Genetics, Montpellier University, Montpellier, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - J-J Boffa
- Nephrology, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - M Delplanque
- Internal Medicine, Sorbonne University, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - R Bourguiba
- Internal Medicine, Sorbonne University, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - J-B Monfort
- Dermatology, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - I Touitou
- Genetics, Montpellier University, Montpellier, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - G Grateau
- Internal Medicine, Sorbonne University, Tenon Hospital, Paris, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - I Kone-Paut
- Rhumatopediatry, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
| | - V Hentgen
- Paediatric Rheumatology, Versailles Hospital, Versailles, France; CEREMAIA: French National Reference Center for Auto-inflammatory Diseases and AA Amyloidosis, Paris, France
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Parentelli AS, Picard C, Boursier G, Melki I, Belot A, Smahi A, Georgin-Lavialle S. [Autoinflammatory diseases associated with RIPK1 mutations: A review of the literature]. Rev Med Interne 2022; 43:552-558. [PMID: 35786329 DOI: 10.1016/j.revmed.2022.06.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/19/2022]
Abstract
Autoinflammatory diseases related to RIPK1 mutations have been recently described. Two distinct clinical phenotypes have been reported and depend on the type and location of the mutation. When the mutation is recessive with loss of function, patients develop a combined phenotype of immune deficiency with recurrent bacterial and fungal infections and signs of early inflammatory bowel disease, non-erosive polyarthritis and growth retardation. On the other hand, when the mutation is dominant, gain of function, the manifestations are only auto-inflammatory with extensive lymphoproliferation, oral lesions such as aphthosis or ulcers, abdominal pain and hepatosplenomegaly. The mutations described for the dominant form affect only the cleavage site of caspase 8 and the clinical phenotype is called CRIA for Cleavage-Resistant RIPK1-Induced Autoinflammatory syndrome. The recessive form is severe and life-threatening requiring hematopoietic stem cell transplantation while the dominant form responds well to interleukin-6 receptor antagonists. Thus, RIPK1 mutations can induce various clinical manifestations with two distinct phenotypes. Although still rare, because of their recent description, these diseases can be suspected by an internist, in front of recurrent digestive features and will be increasingly diagnosed in the future through the integration of this gene in the diagnostic chips dedicated to autoinflammatory diseases and early inflammatory bowel diseases, using next generation sequencing.
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Affiliation(s)
- A S Parentelli
- Service des urgences pédiatriques, hôpital Robert-Debré, Assistance Publique des hôpitaux de Paris (AP-HP), 48, boulevard Sérurier, 75019 Paris, France; Institut Imagine, Inserm U1163, CNRS ERL 8254, université Paris Cité, Sorbonne Paris-Cité, Laboratoire d'excellence GR-Ex, Paris, France
| | - C Picard
- Centre d'études des déficits immunitaires (CEDI), département médico-universitaire BioPhyGen, hôpital Necker enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris Cedex 15, France; Université Paris Cité, Paris, France; Laboratoire d'Activation des Lymphocytes et Susceptibilité au virus EBV, Inserm UMR 1163, Institut Imagine, Paris, France; Centre de référence des déficits immunitaires héréditaires (CEREDIH), hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75743 Paris Cedex 15, France
| | - G Boursier
- Laboratoire de génétique des maladies rares et auto-inflammatoires, service de génétique moléculaire et cytogénomique, CHU de Montpellier, Université de Montpellier, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier Cedex 5, France; Centre de référence des maladies Auto-Inflammatoires rares et de l'Amylose Inflammatoire (CEREMAIA), hôpital de Tenon, AP-HP, 75020 Paris, France
| | - I Melki
- Service de pédiatrie générale, maladies infectieuses et médecine interne pédiatrique, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Centre de référence des rhumatismes et auto-immunité systémique de l'enfant (RAISE), hôpital Necker Enfants Malades, AP-HP, 149, rue de Sèvres, 75743 Paris Cedex 15, France
| | - A Belot
- CIRI, Inserm U1111, service de néphrologie, rhumatologie, dermatologie pédiatrique, hôpital Femme-Mère-Enfant, hospices civils de Lyon, université de Lyon 1, 69677 Bron, France; Centre de référence des rhumatismes et auto-immunité systémique de l'enfant (RAISE), hôpital Necker Enfants Malades, AP-HP, 149, rue de Sèvres, 75743 Paris Cedex 15, France
| | - A Smahi
- Institut Imagine, Inserm U1163, CNRS ERL 8254, université Paris Cité, Sorbonne Paris-Cité, Laboratoire d'excellence GR-Ex, Paris, France
| | - S Georgin-Lavialle
- Département de médecine interne, DHUI2B, département hospitalo-universitaire inflammation, immunopathologie, biothérapie, hôpital Tenon, université Paris 6, Pierre et Marie Curie, AP-HP, 4, rue de la Chine, 75020 Paris, France; Centre de référence des maladies Auto-Inflammatoires rares et de l'Amylose Inflammatoire (CEREMAIA), hôpital de Tenon, AP-HP, 75020 Paris, France.
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Van Schrojenstein Lantman M, Can Çubukçu H, Boursier G, Panteghini M, Bernabeu-Andreu F, Milinkovic N, Mesko Brguljan P, Linko S, Brugnon D, O'Kelly R, Kroupis C, Lohmander M, Šprongl L, Vanstapel F, Thelen M. M133 An approach for determining allowable between reagent lot variation. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.232] [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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Ladeveze M, Dumont Y, Boursier G, Batteux F, Mahe P, Bensimon Borrull A, Sarrabay G, Bollore K, Tuaillon E, Godreuil S, Jeziorski E. Case Report: Persistency Pneumococcal Polysaccharide in Cerebrospinal Fluid During a Post Pneumococcal Chronic Aseptic Meningitis: Coincidental or (Auto-)Inflammatory Embers. Front Pediatr 2022; 10:762457. [PMID: 35223689 PMCID: PMC8864159 DOI: 10.3389/fped.2022.762457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
We report the case of a 9-months-old boy that has presented a steroid-dependent post-pneumococcal chronic aseptic meningitis was associated with persistence of pneumococcal cell wall components in cerebrospinal fluid during more than 20 months. Suggesting that this antigenic persistence could be involved in post-infectious manifestations through innate immunity response.
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Affiliation(s)
- Manon Ladeveze
- Département Urgences Post-Urgences, CEREMAIA, CHU de Montpellier, Montpellier, France
| | - Yann Dumont
- Laboratoire de Bactériologie, CHU de Montpellier, Montpellier, France
| | - G Boursier
- Laboratoire de Génétique des Maladies Rares et Autoinflammatoires, Département de Génétique Médicale, Maladies Rares et Médecine Personnalisée, CEREMAIA, CHU de Montpellier, Univ Montpellier, Montpellier, France
| | - Frederic Batteux
- Plateforme d'ImmunoMonitoring Vaccinal (PIMV), Laboratoire d'Immunologie, Hôpital Cochin, Paris, France
| | - Perrine Mahe
- Département Urgences Post-Urgences, CEREMAIA, CHU de Montpellier, Montpellier, France
| | - Aurelie Bensimon Borrull
- Plateforme d'ImmunoMonitoring Vaccinal (PIMV), Laboratoire d'Immunologie, Hôpital Cochin, Paris, France
| | - Guillaume Sarrabay
- Laboratoire de Génétique des Maladies Rares et Autoinflammatoires, Département de Génétique Médicale, Maladies Rares et Médecine Personnalisée, CEREMAIA, CHU de Montpellier, Univ Montpellier, Montpellier, France
| | - Karine Bollore
- Plateforme Exploration de cellules rares en immunologie et infectiologie, CHU de Montpellier, Montpellier, France.,PCCEI, INSERM, Univ Montpellier, Montpellier, France
| | - Edouard Tuaillon
- Plateforme Exploration de cellules rares en immunologie et infectiologie, CHU de Montpellier, Montpellier, France.,PCCEI, INSERM, Univ Montpellier, Montpellier, France.,Laboratoire de virologie, CHU de Montpellier, Montpellier, France
| | - Sylvain Godreuil
- Laboratoire de Bactériologie, CHU de Montpellier, Montpellier, France.,UMR IRD224-CNRS5290-UM MIVEGEC, Univ Montpellier, Montpellier, France
| | - Eric Jeziorski
- Département Urgences Post-Urgences, CEREMAIA, CHU de Montpellier, Montpellier, France.,PCCEI, INSERM, Univ Montpellier, Montpellier, France
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8
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Georgin-Lavialle S, Terrier B, Guedon AF, Heiblig M, Comont T, Lazaro E, Lacombe V, Terriou L, Ardois S, Bouaziz JD, Mathian A, Le Guenno G, Aouba A, Outh R, Meyer A, Roux-Sauvat M, Ebbo M, Zhao LP, Bigot A, Jamilloux Y, Guillotin V, Flamarion E, Henneton P, Vial G, Jachiet V, Rossignol J, Vinzio S, Weitten T, Vinit J, Deligny C, Humbert S, Samson M, Magy-Bertrand N, Moulinet T, Bourguiba R, Hanslik T, Bachmeyer C, Sebert M, Kostine M, Bienvenu B, Biscay P, Liozon E, Sailler L, Chasset F, Audemard-Verger A, Duroyon E, Sarrabay G, Borlot F, Dieval C, Cluzeau T, Marianetti P, Lobbes H, Boursier G, Gerfaud-Valentin M, Jeannel J, Servettaz A, Audia S, Larue M, Henriot B, Faucher B, Graveleau J, de Sainte Marie B, Galland J, Bouillet L, Arnaud C, Ades L, Carrat F, Hirsch P, Fenaux P, Fain O, Sujobert P, Kosmider O, Mekinian A. Further characterization of clinical and laboratory features occurring in VEXAS syndrome in a large-scale analysis of multicenter case-series of 116 French patients. Br J Dermatol 2021; 186:564-574. [PMID: 34632574 DOI: 10.1111/bjd.20805] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND A new autoinflammatory syndrome related to somatic mutations of UBA1 was recently described and called VEXAS syndrome. OBJECTIVE To describe clinical characteristics, laboratory findings and outcomes of VEXAS syndrome. DESIGN Case-series. SETTING Patients referred to a French multicenter registry between November 2020 and May 2021. PATIENTS 116 patients with VEXAS syndrome. MEASUREMENTS Frequency and median of parameters and vital status, from diagnosis to the end of the follow-up. RESULTS Main clinical features were skin lesions (83.5%), non-infectious fever (63.6%), weight loss (62%), lung involvement (49.6%), ocular symptoms (38.8%), relapsing chondritis (36.4%), venous thrombosis (34.7%), lymph nodes (33.9%), and arthralgia (27.3%). Hematological disease was present in 58 cases (50%), considered as myelodysplastic syndrome (MDS, n= 58) and monoclonal gammapathy of unknown significance (n=12).UBA1 mutations included p.M41T (44.8%), p.M41V (30.2%), p.M41L (18.1%), and splice mutations (6.9%). After a median follow-up of 3.0 years, 18 patients died (15.5%), from infectious origin (n=9) and MDS progression (n=3). Unsupervised analysis identified 3 clusters: cluster 1 (47%) with mild-to-moderate disease; cluster 2 (16%) with underlying MDS and higher mortality rates; cluster 3 (37%) with constitutional manifestations, higher C-reactive protein levels and less frequent chondritis. Five-year probability of survival was 84.2% in cluster 1, 50.5 % in cluster 2, and 89.6% in cluster 3. UBA1 p.Met41Leu mutation was associated with a better prognosis. CONCLUSION VEXAS syndrome displays a large spectrum of organ manifestations and shows different clinical and prognostic profiles. It also raises a potential impact of the identified UBA1 mutation.
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Affiliation(s)
- S Georgin-Lavialle
- Sorbonne Université, AP-HP, Hôpital Tenon, service de médecine interne, CEREMAIA, F-75020, Paris, France
| | - B Terrier
- University of Paris, AP-HP, Cochin Hospital, Department of Internal Medicine, F-75014, Paris, France
| | - A F Guedon
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Hôpital Saint-Antoine, APHP, Paris
| | | | - T Comont
- University Hospital of Toulouse, Department of Internal Medicine and Clinical Immunology, Toulouse, France
| | - E Lazaro
- Department of Internal Medicine and Infectious Diseases, Hôpital Haut-Lévêque, Bordeaux, France
| | - V Lacombe
- Department of Internal Medicine, Angers University Hospital, Angers, France
| | - L Terriou
- Department of Internal Medicine, Lille University Hospital, Lille, France
| | - S Ardois
- Service de médecine interne, CHU de Rennes, Rennes, France
| | - J-D Bouaziz
- Université de Paris, Service de dermatologie, Hôpital Saint Louis, APHP, INSERM U944, Paris, France
| | - A Mathian
- Assistance Publique-Hôpitaux de Paris, Groupement Hospitalier Pitié-Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Paris, France
| | - G Le Guenno
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - A Aouba
- Caen Université, Hôpital de Caen, Department of Internal Medicine, Caen, France
| | - R Outh
- Service de médecine interne et générale, Centre Hospitalier de Perpignan, Perpignan, France
| | - A Meyer
- Service d'immunologie clinique et médecine interne, Nouvel Hôpital Civil, CHU Strasbourg
| | - M Roux-Sauvat
- GHND, Centre Hospitalier Pierre Oudot, 30 avenue du Médipôle, BP 40348, 38302 Bourgoin-Jallieu Cedex
| | - M Ebbo
- Aix Marseille Université, AP-HM, Hôpital de la Timone, Department of Internal Medicine, Marseille, France
| | - L P Zhao
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - A Bigot
- 19University of Tours, Tours, France, Department of Internal Medicine and Clinical
| | - Y Jamilloux
- University Hospital of Lyon, Hospices Civils de Lyon, Department of Internal Medicine and Clinical Immunology, Lyon, France
| | - V Guillotin
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - E Flamarion
- Université de Paris, Service de médecine interne, HEGP Paris, France
| | - P Henneton
- Service de Médecine Vasculaire, CHU Montpellier, 80 Av Augustin Fliche, Montpellier, 34090
| | - G Vial
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - V Jachiet
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France
| | - J Rossignol
- Université de Paris, Service d'hématologie, Necker Enfants Malades, Paris, France
| | - S Vinzio
- Univ. Grenoble Alpes, Inserm, U1036, CHU Grenoble Alpes, CEA, IRIG-BCI, 38000, Grenoble, France
| | - T Weitten
- Service de médecine interne, Centre Hospitalier (CHICAS), GAP, France
| | - J Vinit
- Service de médecine interne, Centre Hospitalier, Chalons, France
| | - C Deligny
- Service de Rhumatologie - Médecine Interne 5D · CHU de Martinique - Hôpital P. Zobda-Quitman, France
| | - S Humbert
- CHU de Besançon, Service de Médecine Interne, Besançon, France
| | - M Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - N Magy-Bertrand
- CHU de Besançon, Service de Médecine Interne, Besançon, France
| | - T Moulinet
- Department of Internal Medicine and Clinical Immunology, Regional Competence Center for Systemic and Autoimmune Rare Diseases, Nancy University Hospital, UMR 7365, IMoPA, Lorraine University, CNRS, Vandoeuvre-lès-Nancy, France
| | - R Bourguiba
- Sorbonne Université, AP-HP, Hôpital Tenon, service de médecine interne, CEREMAIA, F-75020, Paris, France
| | - T Hanslik
- AP-HP, Hôpital Ambroise Paris, service de médecine interne, Paris, France
| | - C Bachmeyer
- Sorbonne Université, AP-HP, Hôpital Tenon, service de médecine interne, CEREMAIA, F-75020, Paris, France
| | - M Sebert
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - M Kostine
- Department of Rheumatology, Hôpital Haut-Lévesque, Bordeaux, France
| | - B Bienvenu
- Hôpital Saint Joseph, service de médecine interne, Marseille, France
| | - P Biscay
- Clinique Mutualiste Pessac Médecine Interne, Pessac, France
| | - E Liozon
- Service de Médecine Interne, CHU Dupuytren, Limoges, France
| | - L Sailler
- University Hospital of Toulouse, Department of Internal Medicine, Toulouse, France
| | - F Chasset
- Sorbonne Université, Hôpital Tenon, service de dermatologie et allergologie et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75020, Paris, France
| | - A Audemard-Verger
- 19University of Tours, Tours, France, Department of Internal Medicine and Clinical
| | - E Duroyon
- Service d'Hématologie Biologique, DMU BioPhyGen GH AP-HP. Centre-University de Paris
| | - G Sarrabay
- Laboratory of Rare and Autoinflammatory Genetic Diseases and Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), CHU Montpellier, University of Montpellier, Montpellier, France
| | - F Borlot
- Service de médecine Interne, CH Béziers, France
| | - C Dieval
- Service de médecine interne et hématologie, CH régional, Rochefort, France
| | - T Cluzeau
- Hematology department, CHU of Nice, Cote d'Azur University, Nice, France
| | - P Marianetti
- CHU de REIMS, Service de médecine interne, maladies infectieuses, immunologie clinique
| | - H Lobbes
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - G Boursier
- Laboratory of Rare and Autoinflammatory Genetic Diseases and Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), CHU Montpellier, University of Montpellier, Montpellier, France
| | - M Gerfaud-Valentin
- University Hospital of Lyon, Hospices Civils de Lyon, Department of Haematology, Lyon, France
| | - J Jeannel
- Université de Paris, Service de médecine interne, HEGP Paris, France
| | - A Servettaz
- CHU de REIMS, Service de médecine interne, maladies infectieuses, immunologie clinique
| | - S Audia
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - M Larue
- APHP, Service de rhumatologie, Hôpital Henri Mondor, Créteil, France
| | - B Henriot
- Service de médecine interne, Centre Hospitalier René Pleven, Dinan, France
| | - B Faucher
- Aix Marseille Université, AP-HM, Hôpital de la Timone, Department of Internal Medicine, Marseille, France
| | - J Graveleau
- CHU de Nantes Hôtel Dieu, Service de Médecine Interne, Nantes, France
| | - B de Sainte Marie
- University Hospital Centre of Bordeaux, Saint Andre Hospital, Department of Internal Medicine and Clinical Immunology, F-33000 Bordeaux, France, CHU de Clermont-Ferrand, Hôpital Estaing, service de médecine interne, Clermont-Ferrand, France
| | - J Galland
- Service de médecine interne, hôpital Fleyriat, Centre hospitalier Bourg-en-Bresse, France
| | - L Bouillet
- Univ. Grenoble Alpes, Inserm, U1036, CHU Grenoble Alpes, CEA, IRIG-BCI, 38000, Grenoble, France
| | - C Arnaud
- University Hospital of Toulouse, Department of Internal Medicine, Toulouse, France
| | - L Ades
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - F Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Hôpital Saint-Antoine, APHP, Paris
| | - P Hirsch
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service d'hématologie biologique, F-75012, Paris, France
| | - P Fenaux
- APHP, Hematology department, CHU of Saint Louis, Paris, France
| | - O Fain
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France
| | - P Sujobert
- CHU de Besançon, Service de Médecine Interne, Besançon, France
| | - O Kosmider
- Service d'Hématologie Biologique, DMU BioPhyGen GH AP-HP. Centre-University de Paris
| | - A Mekinian
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France
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Chasset F, Fayand A, Moguelet P, Kouby F, Bonhomme A, Franck N, Goldman-Lévy G, Fraitag S, Barbaud A, Queyrel V, Touitou I, Boursier G, Sarrabay G, Dupin N, Francès C, Bessis D, Georgin-Lavialle S. Caractéristiques anatomocliniques des atteintes cutanées du déficit en adénosine déaminase 2 : étude de cohorte multicentrique rétrospective et revue systématique de la littérature. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rama M, Mura T, Kone-Paut I, Boursier G, Aouinti S, Touitou I, Sarrabay G. Is gene panel sequencing more efficient than clinical-based gene sequencing to diagnose autoinflammatory diseases? A randomized study. Clin Exp Immunol 2020; 203:105-114. [PMID: 32909274 DOI: 10.1111/cei.13511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/31/2020] [Accepted: 08/12/2020] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to compare the effectiveness of the gene-panel next-generation sequencing (NGS) strategy versus the clinical-based gene Sanger sequencing for the genetic diagnosis of autoinflammatory diseases (AIDs). Secondary goals were to describe the gene and mutation distribution in AID patients and to evaluate the impact of the genetic report on the patient's medical care and treatment. Patients with AID symptoms were enrolled prospectively and randomized to two arms, NGS (n = 99) (32-55 genes) and Sanger sequencing (n = 197) (one to four genes). Genotypes were classified as 'consistent/confirmatory', 'uncertain significance' or 'non-contributory'. The proportion of patients with pathogenic genotypes concordant with the AID phenotype (consistent/confirmatory) was significantly higher with NGS than Sanger sequencing [10 of 99 (10·1%) versus eight of 197 (4·1%)]. MEFV, ADA2 and MVK were the most represented genes with a consistent/confirmed genotype, whereas MEFV, NLRP3, NOD2 and TNFRSF1A were found in the 'uncertain significance' genotypes. Six months after the genetic report was sent, 54 of 128 (42·2%) patients had received effective treatment for their symptoms; 13 of 128 (10·2%) had started treatment after the genetic study. For 59 of 128 (46%) patients, the results had an impact on their overall care, independent of sequencing group and diagnostic conclusion. Targeted NGS improved the diagnosis and global care of patients with AIDs.
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Affiliation(s)
- M Rama
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Autoinflammatory Diseases Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - T Mura
- Medical Information Department, Montpellier University Hospital, Montpellier, France
| | - I Kone-Paut
- Department of Paediatric Rheumatology, CEREMAIA, Bicêtre Hospital, AP-HP, University of Paris Sud Saclay, AP-HP, Le Kremlin-Bicêtre, France
| | - G Boursier
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Autoinflammatory Diseases Unit, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - S Aouinti
- Department of Paediatric Rheumatology, CEREMAIA, Bicêtre Hospital, AP-HP, University of Paris Sud Saclay, AP-HP, Le Kremlin-Bicêtre, France
| | - I Touitou
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Autoinflammatory Diseases Unit, CHU Montpellier, Univ Montpellier, Montpellier, France.,IRMB, University of Montpellier, INSERM, CEREMAIA CHU Montpellier, Montpellier, France
| | - G Sarrabay
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Autoinflammatory Diseases Unit, CHU Montpellier, Univ Montpellier, Montpellier, France.,IRMB, University of Montpellier, INSERM, CEREMAIA CHU Montpellier, Montpellier, France
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11
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Schwob E, Bessis D, Boursier G, Kottler D, Guillot B, Lerisson M, Girard C. PASS: a rare syndrome within the autoinflammatory diseases that still lacks a genetic marker. J Eur Acad Dermatol Venereol 2020; 34:e478-e480. [PMID: 32215958 DOI: 10.1111/jdv.16385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/07/2020] [Accepted: 03/16/2020] [Indexed: 11/29/2022]
Affiliation(s)
- E Schwob
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - D Bessis
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - G Boursier
- INSERM, Department of Medical Genetics, Rare Diseases and Personalized Medicine, CEREMAIA, CHU Montpellier, University of Montpellier, Montpellier, France
| | - D Kottler
- Division of Dermatology, Bichat Hospital, Paris, France
| | - B Guillot
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - M Lerisson
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - C Girard
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
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12
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Boursier G. European young scientists: Training and career. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Baer S, Afenjar A, Smol T, Piton A, Gérard B, Alembik Y, Bienvenu T, Boursier G, Boute O, Colson C, Cordier MP, Cormier-Daire V, Delobel B, Doco-Fenzy M, Duban-Bedu B, Fradin M, Geneviève D, Goldenberg A, Grelet M, Haye D, Heron D, Isidor B, Keren B, Lacombe D, Lèbre AS, Lesca G, Masurel A, Mathieu-Dramard M, Nava C, Pasquier L, Petit A, Philip N, Piard J, Rondeau S, Saugier-Veber P, Sukno S, Thevenon J, Van-Gils J, Vincent-Delorme C, Willems M, Schaefer E, Morin G. Wiedemann-Steiner syndrome as a major cause of syndromic intellectual disability: A study of 33 French cases. Clin Genet 2018; 94:141-152. [PMID: 29574747 DOI: 10.1111/cge.13254] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022]
Abstract
Wiedemann-Steiner syndrome (WSS) is a rare syndromic condition in which intellectual disability (ID) is associated with hypertrichosis cubiti, short stature, and characteristic facies. Following the identification of the causative gene (KMT2A) in 2012, only 31 cases of WSS have been described precisely in the literature. We report on 33 French individuals with a KMT2A mutation confirmed by targeted gene sequencing, high-throughput sequencing or exome sequencing. Patients' molecular and clinical features were recorded and compared with the literature data. On the molecular level, we found 29 novel mutations. We observed autosomal dominant transmission of WSS in 3 families and mosaicism in one family. Clinically, we observed a broad phenotypic spectrum with regard to ID (mild to severe), the facies (typical or not of WSS) and associated malformations (bone, cerebral, renal, cardiac and ophthalmological anomalies). Hypertrichosis cubiti that was supposed to be pathognomonic in the literature was found only in 61% of our cases. This is the largest series of WSS cases yet described to date. A majority of patients exhibited suggestive features, but others were less characteristic, only identified by molecular diagnosis. The prevalence of WSS was higher than expected in patients with ID, suggesting than KMT2A is a major gene in ID.
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Affiliation(s)
- S Baer
- Service de Génétique Médicale, Hôpitaux Universitaires de Strasbourg, Institut Génétique Médicale d'Alsace, Strasbourg, France.,Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Afenjar
- Unité de Génétique, Hôpital Armand Trousseau-La Roche-Guyon, AP-HP, Paris, France
| | - T Smol
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - A Piton
- Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - B Gérard
- Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Y Alembik
- Service de Génétique Médicale, Hôpitaux Universitaires de Strasbourg, Institut Génétique Médicale d'Alsace, Strasbourg, France
| | - T Bienvenu
- Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France
| | - G Boursier
- Département Génétique Médicale, Laboratoire génétique moléculaire maladies auto inflammatoires et maladies rares, CHRU de Montpellier, Montpellier, France
| | - O Boute
- Service de Génétique Clinique, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - C Colson
- Service de Génétique Clinique, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - M-P Cordier
- Service de Génétique Médicale, Hospices Civils de Lyon, Lyon, France
| | - V Cormier-Daire
- Département de Génétique, INSERM UMR1163, Institut Imagine, Hôpital Necker-Enfants-Malades, Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Paris, France
| | - B Delobel
- Centre de Génétique Chromosomique, Groupe Hospitalier de l'Institut Catholique de Lille, Lille, France
| | - M Doco-Fenzy
- Service de Génétique, CHU de Reims, Reims, France
| | - B Duban-Bedu
- Centre de Génétique Chromosomique, Groupe Hospitalier de l'Institut Catholique de Lille, Lille, France
| | - M Fradin
- Service de Génétique Clinique, CHU Rennes, Rennes, France
| | - D Geneviève
- Département de Génétique Médicale, CHRU Montpellier, Faculté de Médecine de Montpellier-Nîmes, INSERM U1183, Montpellier, France
| | - A Goldenberg
- Service de Génétique Médicale, CHU de Rouen, Rouen, France
| | - M Grelet
- Département de Génétique Médicale, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - D Haye
- Service de Génétique Clinique, Unité Fonctionnelle de Génétique Médicale, CHU Paris-GH La Pitié Salpêtrière-Charles Foix, Paris, France
| | - D Heron
- Service de Génétique Clinique, Unité Fonctionnelle de Génétique Médicale, CHU Paris-GH La Pitié Salpêtrière-Charles Foix, Paris, France
| | - B Isidor
- Service de Génétique Médicale, CHU de Nantes, Nantes, France
| | - B Keren
- Unité Fonctionnelle de Génomique du Développement, Centre de Génétique Moléculaire et Chromosomique, CHU Paris-GH La Pitié Salpêtrière-Charles Foix, Paris, France
| | - D Lacombe
- Département de Génétique Médicale, CHU Bordeaux, Bordeaux, France
| | - A-S Lèbre
- Laboratoire de Génétique, Service de Génétique et Biologie de la Reproduction, CHU de Reims, Reims, France
| | - G Lesca
- Service de Génétique Médicale, Hospices Civils de Lyon, Lyon, France
| | - A Masurel
- Centre de Génétique, CHU Dijon, Hôpital d'Enfants, Dijon, France
| | | | - C Nava
- Unité Fonctionnelle de Génomique du Développement, Centre de Génétique Moléculaire et Chromosomique, CHU Paris-GH La Pitié Salpêtrière-Charles Foix, Paris, France
| | - L Pasquier
- Service de Génétique Clinique, CHU Rennes, Rennes, France
| | - A Petit
- Service de Génétique Clinique, CHU Amiens Picardie, Amiens, France
| | - N Philip
- Département de Génétique Médicale, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - J Piard
- Centre de Génétique Humaine, Université de Franche-Comté, CHU Besançon, Besançon, France
| | - S Rondeau
- Département de Génétique, INSERM UMR1163, Institut Imagine, Hôpital Necker-Enfants-Malades, Université Paris Descartes, Sorbonne Paris Cité, AP-HP, Paris, France
| | - P Saugier-Veber
- Département de Génétique, CHU Rouen, Inserm U1079, Institut pour la recherche et l'innovation en Biomédecine, Université de Rouen, Rouen, France
| | - S Sukno
- Service de Neuropédiatrie, Hôpital Saint Vincent de Paul, Groupe Hospitalier de l'Institut Catholique Lillois, Faculté Libre de Médecine, Lille, France
| | - J Thevenon
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - J Van-Gils
- Département de Génétique Médicale, CHU Bordeaux, Bordeaux, France
| | - C Vincent-Delorme
- Service de Génétique Clinique, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - M Willems
- Département de Génétique Médicale, CHRU Montpellier, Faculté de Médecine de Montpellier-Nîmes, INSERM U1183, Montpellier, France
| | - E Schaefer
- Service de Génétique Médicale, Hôpitaux Universitaires de Strasbourg, Institut Génétique Médicale d'Alsace, Strasbourg, France
| | - G Morin
- Service de Génétique Clinique, CHU Amiens Picardie, Amiens, France
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Boursier G, Avignon A, Kuster N, Boegner C, Leprieur E, Picandet M, Bargnoux AS, Badiou S, Dupuy AM, Cristol JP, Sultan A. P169: La Procalcitonine, témoin de l’accumulation de tissu adipeux au niveau abdominal. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70811-8] [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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