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Joseph L, De Luna G, Bernit E, Cougoul P, Santin A, Faucher B, Habibi A, Garou A, Loko G, Mattioni S, Manceau S, Arlet JB, Lionnet F. A study of 28 pregnant women with sickle cell disease and COVID-19: elevated maternal and fetal morbidity rates. Haematologica 2024; 109:1562-1565. [PMID: 37855041 PMCID: PMC11063858 DOI: 10.3324/haematol.2023.283300] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023] Open
Abstract
Not available.
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Affiliation(s)
- Laure Joseph
- Biotherapy Department, French National Sickle Cell Disease Referral Center, Clinical Investigation Center, Hopital Necker, Labex GR-Ex, Assistance-Publique Hopitaux de Paris, Paris.
| | - Gonzalo De Luna
- Unite des maladies genetiques du globule rouge and Etablissement Francais du Sang, Hopital Henri Mondor, Assistance-Publique Hopitaux de Paris, Creteil
| | - Emmanuelle Bernit
- Antilles-Guyane Reference Center for Sickle-Cell Disease, Thalassemia and Other Red Blood Cell Disorders, Pointe a Pitre, Guadeloupe
| | - Pierre Cougoul
- Institut Universitaire du Cancer Toulouse Oncopole, Medecine Interne, Toulouse
| | - Aline Santin
- Department of Internal Medicine, Reference Center of Sickle cell Anemia, University Hospital Center of Tenon, Sorbonne University, Assistance-Publique Hopitaux de Paris, Paris
| | - Benoit Faucher
- Department of Internal Medicine, Aix Marseille Universite, Assistance-Publique Hopitaux de Marseille, Hopital de la Timone, Marseille
| | - Anoosha Habibi
- Sickle Cell Referral Center, Department of Internal Medicine, Henri-Mondor University Hospital, Assistance-Publique Hopitaux de Paris, U-PEC, Creteil
| | - Alain Garou
- Sickle Cell Referral Center, Centre Hospitalier de Mayotte, Mayotte
| | - Gylna Loko
- Sickle Cell Referral Center, Martinique Hospital, Martinique
| | - Sarah Mattioni
- Department of Internal Medicine, Reference Center of Sickle cell Anemia, University Hospital Center of Tenon, Sorbonne University, Assistance-Publique Hopitaux de Paris, Paris
| | - Sandra Manceau
- Biotherapy Department, French National Sickle Cell Disease Referral Center, Clinical Investigation Center, Hopital Necker, Labex GR-Ex, Assistance-Publique Hopitaux de Paris, Paris
| | - Jean Benoit Arlet
- Internal Medicine Department, French National Sickle Cell Disease Referral Center, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris, Paris
| | - François Lionnet
- Department of Internal Medicine, Reference Center of Sickle cell Anemia, University Hospital Center of Tenon, Sorbonne University, Assistance-Publique Hopitaux de Paris, Paris
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Joseph L, Manceau S, Borderie D, Patrat C, Arlet JB, Meunier B, Cavazzana M, Santulli P, Barraud-Lange V. Detrimental effects of sickle cell disease and hydroxycarbamide on ovarian reserve but uncertain impact on fertility. Blood Adv 2023; 7:4794-4798. [PMID: 36989137 PMCID: PMC10469061 DOI: 10.1182/bloodadvances.2022008859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
- Laure Joseph
- Biotherapy Department, French National Sickle Cell Referral Center, Clinical
Investigation Center, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris,
France
| | - Sandra Manceau
- Biotherapy Department, French National Sickle Cell Referral Center, Clinical
Investigation Center, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris,
France
- Laboratory of Excellence on Red Blood Cell Labex GR-Ex, Paris,
France
| | - Didier Borderie
- University of Paris Cité, Paris, France
- Automated Biological Diagnosis Department, AP-HP.Centre-University of Paris
Cité, Cochin Hospital, Paris, France
| | - Catherine Patrat
- University of Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP.Centre-University of Paris
Cité, Cochin Hospital, Paris, France
| | - Jean Benoit Arlet
- Internal Medicine Department, French National Sickle Cell Referral Center,
Hôpital Européen Georges Pompidou, Assistance-Publique Hôpitaux de Paris, Paris,
France
| | - Benoit Meunier
- Biotherapy Department, French National Sickle Cell Referral Center, Clinical
Investigation Center, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris,
France
| | - Marina Cavazzana
- Biotherapy Department, French National Sickle Cell Referral Center, Clinical
Investigation Center, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris,
France
- INSERM U1163, CNRS 8254, Institut IMAGINE, Hôpital Necker,
Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Pietro Santulli
- University of Paris Cité, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine,
AP-HP.Centre-University of Paris Cité, Cochin Hospital, Paris, France
- Department “Development, Reproduction and Cancer” Institut Cochin, INSERM
U1016, Paris, France
| | - Virginie Barraud-Lange
- University of Paris Cité, Paris, France
- Department of Reproductive Biology CECOS, AP-HP.Centre-University of Paris
Cité, Cochin Hospital, Paris, France
- Department “Development, Reproduction and Cancer” Institut Cochin, INSERM
U1016, Paris, France
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Orssaud C, Flamarion E, Michon A, Ranque B, Arlet JB. Relationship between paramacular thinning, cerebral vasculopathy, and hematological risk factors in sickle cell disease. Front Med (Lausanne) 2023; 10:1226210. [PMID: 37700770 PMCID: PMC10493280 DOI: 10.3389/fmed.2023.1226210] [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: 05/20/2023] [Accepted: 07/27/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose To identify risk factors for sickle cell maculopathy due to hematological parameters (especially anemia and hemolysis) or cerebral vasculopathy. Methods This retrospective study was conducted at a Referral Center. The follow-up included optical coherent tomography/optical coherent tomography angiography, neuro-radiological imaging, and a hematological assessment (hemoglobin, hemoglobin S level, reticulocytes, mean corpuscular volume, bilirubin, and lactate dehydrogenase). Results Hundred and thirty-two sickle cell patients were included. Maculopathy was observed in 127 eyes of SS patients and 10 eyes of SC patients (p < 0.001), unrelated to peripheral retinopathy. Cerebral vasculopathy was more frequent in SS patients (p < 0.001) and was also associated with the presence of maculopathy (p = 0.049), and it was related to peripheral retinopathy (p < 0.001). All biological parameters significantly differed according to the genotype (p < 0.001) but not according to the presence of cerebral vasculopathy or maculopathy. In the multivariate analysis, reticulocytes and bilirubin were associated with the presence of cerebral vasculopathy and maculopathy. Conclusion The data obtained were consistent with the role of anemia or hemolysis markers in cerebral vasculopathy and macular involvement. As a trend of hemolysis appears to be a risk factor for these complications, this validates the use of preventive plasmapheresis in these patients.
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Affiliation(s)
- Christophe Orssaud
- Functional Unity of Ophthalmology, ERN EYE, Ophthalmological Rare Diseases Center, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - Edouard Flamarion
- Internal Medicine Department, French National Sickle Cell Referral Center, European Hospital Georges Pompidou, Paris, France
| | - Adrien Michon
- Internal Medicine Department, French National Sickle Cell Referral Center, European Hospital Georges Pompidou, Paris, France
| | - Brigitte Ranque
- Internal Medicine Department, French National Sickle Cell Referral Center, European Hospital Georges Pompidou, Paris, France
- Faculty of Medicine Université Paris Cité, Paris, France
| | - Jean Benoit Arlet
- Internal Medicine Department, French National Sickle Cell Referral Center, European Hospital Georges Pompidou, Paris, France
- Université Paris Cité, INSERM UMR-S970, Paris, France
- Laboratoire d'Excellence sur le globule rouge GR-ex, Paris, France
- INSERM U, CNRS 8254, Institut IMAGINE, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France
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Leleu H, Arlet JB, Habibi A, Etienne-Julan M, Khellaf M, Adjibi Y, Pirenne F, Pitel M, Granghaud A, Sinniah C, De Montalembert M, Galacteros F. Epidemiology and disease burden of sickle cell disease in France: A descriptive study based on a French nationwide claim database. PLoS One 2021; 16:e0253986. [PMID: 34242255 PMCID: PMC8270152 DOI: 10.1371/journal.pone.0253986] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/16/2021] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Sickle cell disease (SCD) is a severe hematological disorder. The most common acute complication of SCD is vaso-occlusive crisis (VOC), but SCD is a systemic disease potentially involving all organs. SCD prevalence estimates rely mostly on extrapolations from incidence-based newborn screening programs, although recent improvements in survival may have led to an increase in prevalence, and immigration could account for a substantial number of prevalent patients in Europe. The primary objective of this study was to estimate SCD prevalence in France. METHODS A cross-sectional observational study was conducted using a representative sample of national health insurance data. SCD patients followed up in France between 2006 and 2011 were captured through hydroxyurea reimbursement and with the International Classification of Diseases (ICD-10) SCD specific code D570.1.2, excluding code D573 (which corresponds to sickle cell trait (SCT)). Nevertheless, we assumed that ICD-10 diagnosis coding for inpatient stays could be imperfect, with the possibility of SCT being miscoded as SCD. Therefore, prevalence was analyzed in two groups of patients [with at least one (G1) or two (G2) inpatient stay] based on the number of SCD-related inpatient stays in the six-year study period, assuming that SCT patients are rarely rehospitalized compared to SCD. The prevalence of SCD in the sample, which was considered to be representative of the French population, was then extrapolated to the general population. The rate of vaso-occlusive crisis (VOC) events was estimated based on hospitalizations, emergencies, opioid reimbursements, transfusions, and sick leave. RESULTS Based on the number of patients identified for G1 and G2, the 2016 French prevalence was estimated to be between 48.6 per 100,000 (G1) or 32,400 patients and 29.7 per 100,000 (G2) or 19,800 patients. An average of 1.51 VOC events per year were identified, with an increase frequency of 15 to 24 years of age. The average annual number of hospitalizations was between 0.70 (G1) and 1.11 (G2) per patient. Intensive care was observed in 7.6% of VOC-related hospitalizations. Fewer than 34% of SCD patients in our sample received hydroxyurea at any point in their follow-up. The annual average cost of SCD care is €5,528.70 (G1) to €6,643.80 (G2), with most costs arising from hospitalization and lab testing. CONCLUSION Our study estimates SCD prevalence in France at between 19,800 and 32,400 patients in 2016, higher than previously published. This study highlights the significant disease burden associated with vaso-occlusive events.
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Affiliation(s)
| | - Jean Benoit Arlet
- Internal Medicine Department, Sickle Cell Disease National Referral Center, Georges Pompidou European Hospital, Université de Paris, Paris, France
- * E-mail:
| | - Anoosha Habibi
- Sickle Cell Referral Center, Internal Medicine Unit, IMRB Team 2, UPEC, Labex GRex, Henri Mondor Hospital, Créteil, France
| | - Maryse Etienne-Julan
- Referral Center for Sickle Cell Disease, Pointe à Pitre Hospital, Antilles University, Guadeloupe, France
| | - Mehdi Khellaf
- Paris Est University, INSERM U955, APHP, Emergency Department, Henri Mondor Hospital, Créteil, France
| | | | - France Pirenne
- Etablissement Français du sang (EFS), Ile-de-France, Université Paris Est Créteil, Faculté de Médecine Créteil, Créteil, France
- Laboratory of Excellence GRex, INSERM U955, Créteil, France
| | | | | | | | - Mariane De Montalembert
- Department of General Pediatrics and Pediatric Infectious Diseases, Reference Center for Sickle Cell Disease, Necker Hospital for Sick Children, Paris, France
| | - Frédéric Galacteros
- Sickle Cell Referral Center, Internal Medicine Unit, IMRB Team 2, UPEC, Labex GRex, Henri Mondor Hospital, Créteil, France
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Guillem F, Dussiot M, Colin E, Suriyun T, Arlet JB, Goudin N, Marcion G, Seigneuric R, Causse S, Gonin P, Gastou M, Deloger M, Rossignol J, Lamarque M, Choucair ZB, Gautier EF, Ducamp S, Vandekerckhove J, Moura IC, Maciel TT, Garrido C, An X, Mayeux P, Mohandas N, Courtois G, Hermine O. XPO1 regulates erythroid differentiation and is a new target for the treatment of β-thalassemia. Haematologica 2020; 105:2240-2249. [PMID: 33054049 PMCID: PMC7556489 DOI: 10.3324/haematol.2018.210054] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/19/2019] [Indexed: 11/09/2022] Open
Abstract
β-thalassemia major (β-TM) is an inherited hemoglobinopathy caused by a quantitative defect in the synthesis of β-globin chains of hemoglobin, leading to the accumulation of free a-globin chains that aggregate and cause ineffective erythropoiesis. We have previously demonstrated that terminal erythroid maturation requires a transient activation of caspase-3 and that the chaperone Heat Shock Protein 70 (HSP70) accumulates in the nucleus to protect GATA-1 transcription factor from caspase-3 cleavage. This nuclear accumulation of HSP70 is inhibited in human β-TM erythroblasts due to HSP70 sequestration in the cytoplasm by free a-globin chains, resulting in maturation arrest and apoptosis. Likewise, terminal maturation can be restored by transduction of a nuclear-targeted HSP70 mutant. Here we demonstrate that in normal erythroid progenitors, HSP70 localization is regulated by the exportin-1 (XPO1), and that treatment of β-thalassemic erythroblasts with an XPO1 inhibitor increased the amount of nuclear HSP70, rescued GATA-1 expression and improved terminal differentiation, thus representing a new therapeutic option to ameliorate ineffective erythropoiesis of β-TM.
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Affiliation(s)
- Flavia Guillem
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Michaël Dussiot
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Elia Colin
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Thunwarat Suriyun
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Jean Benoit Arlet
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France; Service de Médecine Interne, Faculté de Médecine Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Nicolas Goudin
- US24, Cell Imaging Platform, Necker Federative Structure of Research (SFR-Necker), Paris, France
| | - Guillaume Marcion
- INSERM, Unité Mixte de Recherche 866, Equipe Labellisée Ligue Contre le Cancer and Association pour la Recherche contre le Cancer, and Laboratoire d'Excellence Lipoprotéines et Santé (LipSTIC), Dijon, France; Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
| | - Renaud Seigneuric
- INSERM, Unité Mixte de Recherche 866, Equipe Labellisée Ligue Contre le Cancer and Association pour la Recherche contre le Cancer, and Laboratoire d'Excellence Lipoprotéines et Santé (LipSTIC), Dijon, France; Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
| | - Sebastien Causse
- INSERM, Unité Mixte de Recherche 866, Equipe Labellisée Ligue Contre le Cancer and Association pour la Recherche contre le Cancer, and Laboratoire d'Excellence Lipoprotéines et Santé (LipSTIC), Dijon, France; Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France
| | - Patrick Gonin
- Gustave Roussy, Université Paris-Saclay, Plateforme d'Evaluation Préclinique-UMS 3655/US23, Villejuif, France
| | - Marc Gastou
- Laboratory of Excellence GRex, Paris, France; Gustave Roussy, Université Paris-Saclay, Plateforme d'Evaluation Préclinique-UMS 3655/US23, Villejuif, France; Université Paris 7 Denis Diderot-Sorbonne Paris Cité, Paris, France
| | - Marc Deloger
- Institut Curie, PSL Research University, INSERM, U 900, MINES, ParisTech, Paris, France
| | - Julien Rossignol
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Service d'Hématologie, Faculté de Médecine Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris Hôpital Necker, Paris, France; Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Mathilde Lamarque
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Zakia Belaid Choucair
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France
| | - Emilie Fleur Gautier
- Laboratory of Excellence GRex, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, and Plateforme de Proteomique Paris 5 (3P5), Paris, France
| | - Sarah Ducamp
- Laboratory of Excellence GRex, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, and Plateforme de Proteomique Paris 5 (3P5), Paris, France
| | - Julie Vandekerckhove
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France
| | - Ivan C Moura
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Thiago Trovati Maciel
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Carmen Garrido
- INSERM, Unité Mixte de Recherche 866, Equipe Labellisée Ligue Contre le Cancer and Association pour la Recherche contre le Cancer, and Laboratoire d'Excellence Lipoprotéines et Santé (LipSTIC), Dijon, France; Faculty of Medicine and Pharmacy, University of Burgundy, Dijon, France; Centre Anticancéreux George François Leclerc, Dijon, France
| | - Xiuli An
- Red Cell Physiology Laboratory, New York Blood Center, New York, NY, USA
| | - Patrick Mayeux
- Laboratory of Excellence GRex, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, and Plateforme de Proteomique Paris 5 (3P5), Paris, France
| | - Narla Mohandas
- Red Cell Physiology Laboratory, New York Blood Center, New York, NY, USA
| | - Geneviève Courtois
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France
| | - Olivier Hermine
- INSERM UMR 1163, CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Paris, France; Imagine Institute, Université Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France; Laboratory of Excellence GRex, Paris, France; Service d'Hématologie, Faculté de Médecine Paris Descartes, Sorbonne Paris-Cité et Assistance Publique-Hôpitaux de Paris Hôpital Necker, Paris, France.
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Marcombes C, Lafont E, Jullien V, Flamarion E, Dion J, Costedoat-Chalumeau N, Pouchot J, Arlet JB. [Sickle cell trait complications: A case series of 6 patients]. Rev Med Interne 2020; 41:583-590. [PMID: 32768266 DOI: 10.1016/j.revmed.2020.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/03/2019] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Patients with sickle cell trait (SCT) are commonly considered as asymptomatic carriers. However, some clinical manifestations may occur. METHODS Here we present a retrospective descriptive study about SCT subjects with at least one complication diagnosed in a sickle cell disease referral center, in Paris, between 2008 and 2019. We also performed a literature review on the complications of SCT subjects. RESULTS Six patients (between 19 and 65 years old) were included. SCT was already known only for 4 of them at the time of the complication. Four patients presented with a splenic infarct after a stay in high altitude or a plane trip, one of them was associated with papillary necrosis; one patient had isolated papillary necrosis, and the last one had splenic sequestration. These complications happened for most of them after exposure to an unusual situation of hypoxia or deshydratation. Five out of 6 patients had a marked elevated C reactive protein. CONCLUSION SCT may cause acute ischemic complications in a context of prolonged hypoxia or dehydration. The most commonly reported are the splenic infarct and the renal papillary necrosis. A study of hemoglobin should be considered in these clinical situations in patients with compatible ethnic origin.
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Affiliation(s)
- C Marcombes
- Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France
| | - E Lafont
- Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France; Faculté de médecine Paris Descartes, Université de Paris, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - V Jullien
- Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France
| | - E Flamarion
- Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France
| | - J Dion
- Faculté de médecine Paris Descartes, Université de Paris, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - N Costedoat-Chalumeau
- Faculté de médecine Paris Descartes, Université de Paris, 15 Rue de l'École de Médecine, 75006 Paris, France; Département de médecine interne, Hôpital Cochin (AP-HP), rue Saint Jacques, 75014 Paris, France
| | - J Pouchot
- Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France; Faculté de médecine Paris Descartes, Université de Paris, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - J B Arlet
- Département de médecine interne, Centre de référence des syndromes drépanocytaires majeurs de l'adulte, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris, France; Faculté de médecine Paris Descartes, Université de Paris, 15 Rue de l'École de Médecine, 75006 Paris, France.
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7
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Arlet JB, Le Thi Huong DB, Pouchot J, Piette JC. [Current concepts on the physiopathology of adult-onset Still's disease]. Rev Med Interne 2004; 26:549-56. [PMID: 15996569 DOI: 10.1016/j.revmed.2004.11.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Accepted: 11/29/2004] [Indexed: 11/25/2022]
Abstract
PURPOSE Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown origin. It is characterized by hectic fever, evanescent rash, polyarthralgias or polyarthritis, sore throat, hepatosplenomegaly, lymphadenopathy, polynuclear leukocytosis, liver cytolysis, and high serum level of ferritin with low glycosylated fraction. CURRENT KNOWLEDGE AND KEY POINTS An increased serum level of ferritin, IL-8, IL-6, IL-18 and TNF-alpha indicates that macrophages are highly activated in AOSD. Interleukin 18 (IL-18) seems to be a key cytokine in the pathogenesis of AOSD. Serum IL-18 levels are increased in AOSD patients compared to other systemic inflammatory diseases such as rheumatoid arthritis and they are well correlated with serum ferritin levels and disease activity. IL-18 could cause acute liver injury and arthritis. Macrophages could be activated by infectious agents such as viruses and by an inadequate control of T cell response secondary to depressed Natural Killer lymphocyte function, similarly to that observed in systemic juvenile idiopathic arthritis. Sustained macrophage activation can lead to the hemophagocytic syndrome, a severe complication of both AOSD and systemic juvenile idiopathic arthritis. FUTURE PROSPECTS Cytotoxic cell functions should be probably studied in AOSD as they were in the hemophagocytic syndrome and systemic juvenile idiopathic arthritis because AOSD, characterised by a marked macrophage activation may be related to an immunological deficiency.
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Affiliation(s)
- J B Arlet
- Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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Affiliation(s)
- J B Arlet
- Service des Maladies Infectieuses et Tropicales, 1 avenue Claude Vellefaux, 75475 Paris 10, France
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Abstract
INTRODUCTION Ankylosing spondylitis is a chronic inflammatory disorder that is rarely associated with severe systemic manifestations. EXEGESIS We report the case of a 29-year-old man presenting with an atypical ankylosing spondylitis. The patient presented with a high spiking fever, a marked weight loss, and an unusual increase of acute phase response markers. Such features are rarely associated with ankylosing spondylitis and the review of the few similar reported cases in the literature showed that this presentation is usually associated with a severe disease course, and an asymmetrical joint involvement that is unresponsive to nonsteroidal anti-inflammatory agents. CONCLUSION Clinicians should be aware of this unusual presentation of ankylosing spondylitis, which should be included in the list of aetiologies of fever of unknown origin, to avoid useless diagnostic procedures. The severity of the disease course may lead to the consideration of a more aggressive treatment strategy.
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Affiliation(s)
- J B Arlet
- Service de médecine interne, hôpital Louis-Mourier, 178, rue des Renouillers, 92700 Colombes, France
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