1
|
Kottler D, Dupechez L, Martin Silva N, Boutemy J, Dumont A, Maigné G, Aouba A, Dompmartin A. Efficacy, tolerance and acceptability of pulsed dye laser on facial and neckline telangiectasias in systemic scleroderma: a prospective open-label monocentric study in 21 patients. J COSMET LASER THER 2023; 25:77-85. [PMID: 38373440 DOI: 10.1080/14764172.2024.2313472] [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: 06/19/2022] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
Facial and neckline telangiectasias have an underestimated yet important impact on quality of life of patients with systemic scleroderma (SSc). This monocentric, prospective, open-label, intra-patient comparative study was conducted in 21 consecutive patients with SSc. Patients underwent 4 sessions of PDL 8 weeks apart. A final quadruple assessment was performed by several raters 2 months after the last session, based on the following criteria: change in telangiectasia number; subjective improvement score (LINKERT scale); impact on the quality of life (QoL; SKINDEX score); visual analog pain scale; adverse effects (AEs), including treatment discontinuation for PDL-induced purpura and patient satisfaction. The mean telangiectasia number decreased by 5 (32%) at the end of the protocol. Eighteen patients (85.7%) reported an improvement or a strong improvement, versus 73.81% for the expert committee. Immediate session pain (mean = 3.4/10) was slightly less than overall pain (mean = 4.6/10). Ten patients (47%) experienced at least one AE (oozing/crusts, edema, epidermal blistering), including PDL-induced purpura in 3 patients (14%). AEs were mostly transient (<1 week) and mild (CTCAE grade 1). All QoL parameters improved after treatment, and 85% of patients were satisfied.
Collapse
Affiliation(s)
- D Kottler
- Department of Dermatology, Caen, France
| | | | - N Martin Silva
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - J Boutemy
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - A Dumont
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - G Maigné
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - A Aouba
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - A Dompmartin
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| |
Collapse
|
2
|
Gérard M, de Boysson H, Morello R, Martin-Silva N, Leroux AC, Dumont A, Maigné G, Boutemy J, Khoy K, Mariotte D, Lobbedez T, Aouba A, Deshayes S. Early infectious risk in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis according to remission-induction therapy. Scand J Rheumatol 2023; 52:161-173. [PMID: 35048797 DOI: 10.1080/03009742.2021.2001929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Few comparative data exist on early infections secondary to remission-induction therapy (RIT) with rituximab (RTX) versus cyclophosphamide (CYC) in newly diagnosed anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients. We compared and analysed the rates and predictors of severe infection in such patients within the first 6 months following RIT. METHOD From the Caen University Hospital databases, we included all consecutive adults newly diagnosed with ANCA-positive granulomatosis with polyangiitis or microscopic polyangiitis between January 2006 and December 2019. We compared rates of survival without severe infection and survival without infections of any severity within 6 months of RIT and used a multivariate Cox analysis to identify predictors of infection. RESULTS We included 145 patients, 27 in the RTX and 118 in the CYC group. Patients in the RTX group more frequently had pneumococcal vaccination (p < 0.01) and creatinine < 150 µmol/L; other characteristics were comparable between the two groups. Overall, 37 severe infections and 65 infections of any severity were recorded. Rates of survival without severe infection were similar in both groups (p = 0.69), but survival without infections of any severity was lower in the RTX group (p = 0.005). In multivariate analysis, risk factors at diagnosis for severe infections included chronic urinary tract disease, dialysis, and absence of trimethoprim-sulfamethoxazole prophylaxis (p < 0.01 each). CONCLUSIONS Within 6 months of RIT, rates of survival without severe infection were similar in newly diagnosed ANCA-positive AAV patients treated with RTX or CYC, but survival rates without infections of any severity appeared to be lower with RTX treatment.
Collapse
Affiliation(s)
- M Gérard
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - H de Boysson
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| | - R Morello
- Functional Unit of Biostatistics and Clinical Research, CHU de Caen Normandie, Caen, France
| | - N Martin-Silva
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - A-C Leroux
- Department of Nephrology, Centre Hospitalier Mémorial, Saint-Lô, France
| | - A Dumont
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| | - G Maigné
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - J Boutemy
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France
| | - K Khoy
- Department of Immunology, CHU de Caen Normandie, Caen, France
| | - D Mariotte
- Department of Immunology, CHU de Caen Normandie, Caen, France
| | - T Lobbedez
- Department of Nephrology, CHU de Caen Normandie, Caen, France
| | - A Aouba
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| | - S Deshayes
- Department of Internal Medicine, CHU de Caen Normandie, Caen, France.,Faculty of Caen, Université de Caen Normandie (UNICAEN), Caen, France
| |
Collapse
|
3
|
Lavergne A, Dumont A, Deshayes S, Boutemy J, Maigné G, Martin-Silva N, Nguyen A, Aouba A, De Boysson H. Évaluation dans des conditions de vie réelle de l’efficacité et de la tolérance du méthotrexate dans l’artérite à cellules géantes. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
4
|
Dumont A, Labombarda F, Gallou S, Deshayes S, Nguyen A, Boutemy J, Martin-Silva N, Maigné G, Aouba A, De Boysson H. Effet préventif des bêta-bloquants sur le développement d’une dilatation aortique dans l’artérite à cellules géantes associée à une aortite. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
5
|
Gallou S, Castan P, Dumont A, Deshayes S, Maigné G, Nguyen A, Silva NM, Boutemy J, Aouba A, De Boysson H. Profils évolutifs des dilatations aortiques dans l’artérite à cellules géantes. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
6
|
Fuentes S, Chrétien B, Dolladille C, Alexandre J, Dumont A, Nguyen A, De Boysson H, Cheze S, Maigné G, Aouba A, Deshayes S. Purpura thrombopénique immunologique induit par les médicaments: actualisation de la liste des médicaments suspects à l’aide d’une base de pharmacovigilance internationale. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.212] [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: 11/27/2022]
|
7
|
Gérard M, De Boysson H, Morello R, Martin Silva N, Dumont A, Maigné G, Boutemy J, Khoy K, Mariotte D, Lobbedez T, Aouba A, Deshayes S. Risque infectieux associé au traitement d’induction des vascularites à ANCA : une étude rétrospective monocentrique française incluant 145 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Gérard M, De Boysson H, Morello R, Silva NM, Leroux AC, Dumont A, Maigné G, Boutemy J, Khoy K, Mariotte D, Lobbedez T, Aouba A, Deshayes S. POS0831 EARLY INFECTIOUS RISK IN PATIENTS WITH NEWLY-DIAGNOSED ANTI-NEUTROPHILCYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS ACCORDING TO THE REMISSION-INDUCTIONTHERAPY: A FRENCH MONOCENTRIC RETROSPECTIVE STUDY INCLUDING 145 PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Few comparative data exist on early infections secondary to remission-induction therapy (RIT) with rituximab versus cyclophosphamide in newly-diagnosed ANCA-associated vasculitis (AAV) patients.Objectives:We compared and analyzed the rate and predictors of severe infections in such patients within the first six months following RIT.Methods:We included, from the databases of Caen University Hospital, all consecutive adults newly-diagnosed with granulomatosis with polyangiitis or microscopic polyangiitis between January 2006 and December 2019. We compared the survival without severe infections (WSI) and the survival without infection of any severity (WIOAS) within 6 months from the RIT, and used a multivariate cox analysis to identify predictors of infection.Results:We included 145 patients, 27 in rituximab group and 118 in cyclophosphamide group. Patients in the rituximab group more frequently had pneumococcal vaccination (p<0.01) and creatinine level <150 µmol/L, while other characteristics, including Birmingham Vasculitis Activity Score, were comparable between both groups.Overall, 37 severe infections and 65 infections of any severity were recorded. The survival WSI was similar in both groups (p=0.69), but survival WIOAS was lower in rituximab group (p=0.005).In multivariate analysis, risk factors at diagnosis for severe infections were chronic urinary tract disease, dialysis and absence of prophylaxis with trimethoprim-sulfamethoxazole (p<0.01 each).Conclusion:The survival WIS within the 6 months following RIT was similar in patients with newly-diagnosed AAV treated by rituximab or cyclophosphamide, but survival WIOAS appeared to be lower within the 6 months following rituximab despite a better pneumococcal vaccination coverage.Figure 1.Comparison of the 6-month survival without severe infection (A) or without infection of any severity (B) in patients with newly-diagnosed ANCA-associated vasculitis treated by rituximab or cyclophosphamideDisclosure of Interests:None declared
Collapse
|
9
|
Deshayes S, Ly K, Rieu V, Maigné G, Silva NM, Manrique A, Monteil J, De Boysson H, Aouba A. POS0338 STEROID-SPARING EFFECT OF ANAKINRA IN GIANT-CELL ARTERITIS: A CASE SERIES WITH CLINICAL, BIOLOGICAL AND ICONOGRAPHIC LONG-TERM ASSESSMENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The treatment of giant cell arteritis (GCA) relies on corticosteroids but is burdened by a high rate of relapses and adverse effects. Anti-interleukin-6 treatments show a clear benefit with a significant steroid-sparing effect, but late relapses occur after treatment discontinuation. In addition to interleukin-6, interleukin-1 also appears to play a significant role in GCA pathophysiology.Objectives:We report herein the efficacy of anakinra, an interleukin-1 receptor antagonist, in 6 GCA patients exhibiting corticosteroid dependence or resistance, specifically analyzing the outcome of aortitis in 4 of them, and including the long-term follow-up of 2 previously described patients (1).Methods:This retrospective study analyzed the cases of all GCA patients treated with anakinra from the French Study Group for Large Vessel Vasculitis.Patients had to satisfy the following two criteria to be enrolled in this retrospective study. First, their diagnosis of GCA should be based on the fulfillment of at least 3 criteria of the American College of Rheumatology (ACR) for GCA or on the satisfaction of 2 of these criteria along with the demonstration of LVI on imaging. Second, patients should have received anakinra because of corticosteroid dependence or resistance.Corticosteroid dependence was defined as ≥2 relapses or the combination of 2 of the following criteria: a daily dose of oral prednisone >20 mg/day (or 0.3 mg/kg) at 6 months; a daily dose of oral prednisone >10 mg/day (or 0.2 mg/kg) at 12 months; and/or a treatment maintained >24 months because of a relapsing disease course. Corticosteroid resistance was defined as persistent increased inflammatory parameters at month 3 despite a steroid dosage over 0.5 mg/kg.Results:After a median duration of anakinra therapy of 19 [18–32] months, all 6 patients exhibited complete clinical and biological remission. Among the 4 patients with large-vessel involvement, 2 had a disappearance of aortitis under anakinra, and 2 showed a decrease in vascular uptake. After a median follow-up of 56 [48–63] months, corticosteroids were discontinued in 4 patients, and corticosteroid dosage could be decreased to 5 mg/day in 2 patients. One patient relapsed 13 months after anakinra introduction in the context of increasing the daily anakinra injection interval to every 48 hours. Three patients experienced transient injection-site reactions, and 1 patient had pneumonia.Figure 1.Steroid dosages before and after the introduction of anakinra in 6 patients with giant-cell arteritis and corticosteroid dependence or resistance. The black arrow indicates the time of anakinra introduction.Conclusion:In this short series, anakinra appears to be an efficient and safe steroid-sparing agent in refractory GCA, with a possible beneficial effect on large-vessel involvement.References:[1]Ly K-H, Stirnemann J, Liozon E, Michel M, Fain O, Fauchais A-L. Interleukin-1 blockade in refractory giant cell arteritis. Joint Bone Spine 2014;81:76–8.Disclosure of Interests:Samuel Deshayes: None declared, Kim LY: None declared, Virginie Rieu: None declared, Gwénola Maigné: None declared, Nicolas Martin Silva: None declared, Alain Manrique: None declared, Jacques Monteil: None declared, Hubert de Boysson Speakers bureau: Roche-Chugai, Grant/research support from: Roche-Chugai, Achille Aouba Grant/research support from: SOBI
Collapse
|
10
|
Nguyen A, Repesse Y, Ebbo M, Allenbach Y, Benveniste O, Vallat JM, Magy L, Deshayes S, Maigné G, de Boysson H, Karnam A, Delignat S, Lacroix-Desmazes S, Bayry J, Aouba A. IVIg increases interleukin-11 levels, which in turn contribute to increased platelets, VWF and FVIII in mice and humans. Clin Exp Immunol 2021; 204:258-266. [PMID: 33512707 DOI: 10.1111/cei.13580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/03/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 01/23/2023] Open
Abstract
The mechanisms of action of intravenous immunoglobulins (IVIg) in autoimmune diseases are not fully understood. The fixed duration of efficacy and noncumulative effects of IVIg in immune thrombocytopenia (ITP) and acquired von Willebrand disease (AVWD) suggest other mechanisms besides immunological ones. Additionally to the peripheral destruction of platelets in ITP, their medullary hypoproduction emerged as a new paradigm with rescue of thrombopoietin receptor agonists (TPO-RA). In an ITP mouse model, interleukin (IL)-11 blood levels increase following IVIg. IL-11 stimulates the production of platelets and other haemostasis factors; recombinant IL-11 (rIL-11) is thus used as a growth factor in post-chemotherapy thrombocytopenia. We therefore hypothesized that IVIg induces IL-11 over-production, which increases platelets, VWF and factor VIII (FVIII) levels in humans and mice. First, in an ITP mouse model, we show that IVIg or rIL-11 induces a rapid increase (72 h) in platelets, FVIII and VWF levels, whereas anti-IL-11 antibody greatly decreased this effect. Secondly, we quantify for the first time in patients with ITP, AVWD, inflammatory myopathies or Guillain-Barré syndrome the dramatic IL-11 increase following IVIg, regardless of the disease. As observed in mice, platelets, VWF and FVIII levels increased following IVIg. The late evolution (4 weeks) of post-IVIg IL-11 levels overlapped with those of VWF and platelets. These data may explain thrombotic events following IVIg and open perspectives to monitor post-IVIg IL-11/thrombopoietin ratios, and to assess rIL-11 use with or without TPO-RA as megakaryopoiesis co-stimulating factors to overcome the relative hypoproduction of platelets or VWF in corresponding autoimmune diseases, besides immunosuppressant.
Collapse
Affiliation(s)
- A Nguyen
- Department of Internal Medicine and Clinical Immunology, Normandy University, Caen, France
| | - Y Repesse
- Laboratory of Haematology and Haemostasis, Normandy University, Caen, France
| | - M Ebbo
- Department of Internal Medicine, Hôpital de la Timone, Assistance Publique des Hôpitaux de Marseille, Aix Marseille University, Marseille, France
| | - Y Allenbach
- Département de Médecine Interne et Immunologie Clinique, Hôpital Pitié-Salpêtrière, Paris, France
| | - O Benveniste
- Département de Médecine Interne et Immunologie Clinique, Hôpital Pitié-Salpêtrière, Paris, France
| | - J M Vallat
- Centre de Référence 'Neuropathies Périphériques Rares' et Service de Neurologie, Hôpital Universitaire Limoges, Limoges, France
| | - L Magy
- Centre de Référence 'Neuropathies Périphériques Rares' et Service de Neurologie, Hôpital Universitaire Limoges, Limoges, France
| | - S Deshayes
- Department of Internal Medicine and Clinical Immunology, Normandy University, Caen, France
| | - G Maigné
- Department of Internal Medicine and Clinical Immunology, Normandy University, Caen, France
| | - H de Boysson
- Department of Internal Medicine and Clinical Immunology, Normandy University, Caen, France
| | - A Karnam
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France
| | - S Delignat
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France
| | - S Lacroix-Desmazes
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France
| | - J Bayry
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France.,Indian Institute of Technology Palakkad, Palakkad, India
| | - A Aouba
- Department of Internal Medicine and Clinical Immunology, Normandy University, Caen, France
| |
Collapse
|
11
|
Deshayes S, Ly K, Rieu V, Maigné G, Martin Silva N, Manrique A, De Boysson H, Aouba A. Effet d’épargne cortisonique de l’anakinra dans l’artérite à cellules géantes : à propos de 6 patients. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.042] [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]
|
12
|
De Boysson H, Dumont A, Deshayes S, Audemard-Verger A, Boutemy J, Martin Silva N, Maigné G, Sultan A, Aouba A. Intégration des différentes formes cliniques et radiologiques dans les critères de classification de l’artérite à cellules géantes : proposition à partir d’une cohorte prospective monocentrique. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.043] [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]
|
13
|
Dumont A, Lecannuet A, Boutemy J, Maigné G, Martin-Silva N, Sultan A, Planchard G, Aouba A, De Boysson H. Caractéristiques et évolution des atteintes ophtalmologiques dans l’Artérite à Cellules Géantes : une étude cas-témoin. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
14
|
Monseau G, Savoye B, Maigné G, de Boysson H, Baldolli A, Verdon R, Aouba A, Richier Q, Roeser A, Salaun K, Nguekap O. [Anemia in a 35 year-old woman]. Rev Med Interne 2018; 40:191-194. [PMID: 30122259 DOI: 10.1016/j.revmed.2018.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/18/2018] [Indexed: 11/30/2022]
Affiliation(s)
- G Monseau
- Service de médecine interne, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France.
| | - B Savoye
- Service de médecine interne, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - G Maigné
- Service de médecine interne, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - H de Boysson
- Service de médecine interne, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - A Baldolli
- Service de maladies infectieuses et tropicales, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - R Verdon
- Service de maladies infectieuses et tropicales, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - A Aouba
- Service de médecine interne, CHU de Caen, université Normandie, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - Q Richier
- Service de dermatologie, Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - A Roeser
- Service de réanimation, CH Delafontaine, 2, rue du Dr Delafontaine, 93200 Saint-Denis, France
| | - K Salaun
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - O Nguekap
- Service de maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| |
Collapse
|
15
|
De Boysson H, Liozon E, Dumont A, Boutemy J, Martin-Silva N, Maigné G, Ly K, Aouba A. Formes systémiques d’artérite à cellules géantes : analyse bicentrique de 57 patients avec preuve histologique. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
16
|
De Boysson H, Liozon E, Lambert M, Boutemy J, Maigné G, Martin Silva N, Manrique A, Bienvenu B, Aouba A. Y’a t-il une place pour la répétition de la tomographie par émission de positron au cours du suivi de l’artérite à cellules géantes avec atteinte des gros vaisseaux ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.025] [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]
|
17
|
De Boysson H, Martin Silva N, De Moreuil C, Néel A, De Menthon M, Boutemy J, Maigné G, Guillevin L, Puéchal X, Bienvenu B, Aouba A. Les dermatoses neutrophiliques dans les vascularites associées aux ANCA. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.062] [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]
|
18
|
De Boysson H, Liozon E, Lambert M, Larivière D, Samson M, Boutemy J, Maigné G, Martin Silva N, Aouba A, Sacré K, Bienvenu B. Artérite à cellules géantes et accidents vasculaires cérébraux : étude cas-témoins multicentrique rétrospective. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.020] [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: 10/20/2022]
|
19
|
De Boysson H, Liozon E, Lambert M, Boutemy J, Martin Silva N, Maigné G, Aouba A, Bienvenu B. Artérite à cellules géantes : la présence d’une aortite modifie t’elle la prise en charge et l’évolution de la maladie ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.021] [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: 10/20/2022]
|
20
|
Decaux O, Carreiro M, Fleck E, Gaches F, Hamidou M, Maigné G, Ruggieri I, Delain JC, Crave JC. Incidence des événements indésirables après réintroduction sur le marché d’une immunoglobuline intraveineuse : analyse intermédiaire de l’étude GAMMATRACK. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.084] [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]
|
21
|
Noël N, Maigné G, Tertian G, Anguel N, Monnet X, Michot JM, Goujard C, Lambotte O. Hemolysis and schistocytosis in the emergency department: consider pseudothrombotic microangiopathy related to vitamin B12 deficiency. QJM 2013; 106:1017-22. [PMID: 23842487 DOI: 10.1093/qjmed/hct142] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Hemolytic anemia with thrombocytopenia and schistocytosis is suggestive of thrombotic thrombocytopenic purpura (TTP). However, these features can occur in the context of vitamin B12 deficiency. AIM To identify simple means of distinguishing between TTP and pseudothrombotic microangiopathies related to vitamin B12 deficiency (pseudo-TMA) at the bedside. DESIGN AND METHODS Retrospective study of patients with pseudo-TMA compared with patients with TTP. The patients with pseudo-TMA were further compared with other cases of cobalamin deficiency, in order to detect factors associated with microangiopathic hemolysis during vitamin B12 deprivation. RESULTS Seven patients with pseudo-TMA were compared with six patients with TTP. The pseudo-TMA patients had higher median lactate dehydrogenase (LDH) levels (7310 vs. 1460 IU/l, P = 0.01), a higher platelet count (73 vs.12.5 × 10(9)/l, P = 0.0023), a lower reticulocyte count (13.1 vs. 265.5 × 10(9)/l, P = 0.0012) and a lower neutrophil count (1.3 vs. 5.1 × 10(9)/l, P = 0.0023). When compared with 21 patients with vitamin B12 deficiency and anemia (but no schistocytosis), the pseudo-TMA patients were more likely to present with pernicious anemia [7 out of 21 (33.3%) vs. 5 out of 7 (71.4%), respectively] and had lower vitamin B12 levels (105 vs. 45 µmol/l, respectively). Vitamin supplementation led to hematological improvements in all pseudo-TMA patients. CONCLUSION In a context of mechanical hemolysis with thrombocytopenia in a patient admitted to the emergency department, very high LDH levels and a low reticulocyte count are strongly suggestive of pseudo-TMA and should prompt the physician to screen for cobalamin deficiency.
Collapse
Affiliation(s)
- N Noël
- MD, PhD, Service de Médecine Interne, Hôpital Bicêtre, 78, rue du Général Leclerc, F-94275 Le Kremlin Bicêtre cedex, France.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Canouï E, Maigné G, Jéru I, Amselem S, Koné-Paut I, Lambotte O. Atypical presentation of a cryopyrin-associated periodic syndrome, revealing a novel NLRP3 mutation. Clin Immunol 2013; 148:299-300. [PMID: 23811320 DOI: 10.1016/j.clim.2013.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 05/31/2013] [Indexed: 11/26/2022]
|
23
|
Affiliation(s)
- Goulven Rochcongar
- Department of Orthopaedic and Traumatology, CHU de Caen, avenue Côte-de-Nacre, 14003 Caen cedex 9, France.
| | | | | | | |
Collapse
|
24
|
Canoui E, Maigné G, Jéru I, Koné-Paut I, Lambotte O. De la psychiatrie au canakimumab : présentation tardive d’un syndrome périodique associé à la cryopyrine (CAPS). Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
25
|
Bellon N, Maigné G, Anguel N, Brunet M, Goujard C, Lambotte O. Association chondrite auriculaire et microangiopathie thrombotique : mode de début inhabituel pour un lupus érythémateux disséminé. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
26
|
Maigné G, Delaval R, Lambotte O. Occlusion artérielle et thrombocytose : penser au POEMS syndrome. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.272] [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: 10/20/2022]
|
27
|
Morin S, Maigné G, Osman D, Pallier C, Goujard C, Lambotte O. Syndrome d’activation macrophagique et maladie de Castelman : rechercher HHV8 malgré une sérologie négative : intérêt de la PCR. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
28
|
Maigné G, Martinez V, Thellier M, Bricaire F, Katlama C, Caumes E. Cryptosporidial diarrhoea in two HIV-infected patients: potential efficacy of rifampicin for successful treatment. AIDS 2007; 21:1221-2. [PMID: 17502738 DOI: 10.1097/qad.0b013e32810996cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|