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Jarrot PA, Mirouse A, Ottaviani S, Cadiou S, Salmon JH, Liozon E, Parreau S, Michaud M, Terrier B, Gavand PE, Trefond L, Lavoiepierre V, Keraen J, Rekassa D, Bouldoires B, Weitten T, Roche D, Poulet A, Charpin C, Grobost V, Hermet M, Pallure M, Wackenheim C, Karkowski L, Grumet P, Rogier T, Belkefi N, Pestre V, Broquet E, Leurs A, Gautier S, Gras V, Gilet P, Holubar J, Sivova N, Schleinitz N, Durand JM, Castel B, Petrier A, Arcani R, Gramont B, Guilpain P, Lepidi H, Weiller PJ, Micallef J, Saadoun D, Kaplanski G. Polymyalgia rheumatica and giant cell arteritis following COVID-19 vaccination: Results from a nationwide survey. Hum Vaccin Immunother 2024; 20:2334084. [PMID: 38563792 PMCID: PMC10989707 DOI: 10.1080/21645515.2024.2334084] [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: 01/17/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
We conducted a national in-depth analysis including pharmacovigilance reports and clinical study to assess the reporting rate (RR) and to determine the clinical profile of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in COVID-19-vaccinated individuals. First, based on the French pharmacovigilance database, we estimated the RR of PMR and GCA cases in individuals aged over 50 who developed their initial symptoms within one month of receiving the BNT162b2 mRNA, mRNA-1273, ChAdOx1 nCoV-19, and Ad26.COV2.S vaccines. We then conducted a nationwide survey to gather clinical profiles, therapeutic management, and follow-up data from individuals registered in the pharmacovigilance study. A total of 70 854 684 COVID-19 vaccine doses were administered to 25 260 485 adults, among which, 179 cases of PMR (RR 7. 1 cases/1 000 000 persons) and 54 cases of GCA (RR 2. 1 cases/1 000 000 persons) have been reported. The nationwide survey allowed the characterization of 60 PMR and 35 GCA cases. Median time to the onset of first symptoms was 10 (range 2-30) and 7 (range 2-25) days for PMR and GCA, respectively. Phenotype, GCA-related ischemic complications and -large vessel vasculitis as well as therapeutic management and follow-up seemed similar according to the number of vaccine shots received and when compared to the literature data of unvaccinated population. Although rare, the short time between immunization and the onset of first symptoms of PMR and GCA suggests a temporal association. Physician should be aware of this potential vaccine-related phenomenon.
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Affiliation(s)
- Pierre-André Jarrot
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
| | - Adrien Mirouse
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Sébastien Ottaviani
- Department of Rheumatology, DMU Locomotion, Hôpital Bichat-Claude Bernard, APHP, Université de Paris, Paris, France
| | - Simon Cadiou
- Department of Rheumatology, CHU de Rennes, Université de Rennes 1, Rennes, France
| | - Jean-Hugues Salmon
- Department of Rheumatology, Hôpital de La Maison Blanche, Université de Reims, Reims, France
| | - Eric Liozon
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Simon Parreau
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Martin Michaud
- Department of Internal Medicine, Clinique Saint-Exupery, Toulouse, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Disease, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre, Université Paris Cité, Paris, France
| | | | - Ludovic Trefond
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Virginie Lavoiepierre
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jeremy Keraen
- Department of Internal Medicine, Hôpital de Cornouaille, Quimper, France
| | - Daniel Rekassa
- Department of Rehabilitation, Centre Thermal, Greoux Les Bains, France
| | | | - Thierry Weitten
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Damien Roche
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Antoine Poulet
- Department of Internal Medicine, Hôpital Saint-Joseph, Marseille, France
| | - Caroline Charpin
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Vincent Grobost
- Department of Internal Medicine, Hôpital Estaing, Clermont-Ferrand, France
| | - Marion Hermet
- Department of Internal Medicine, Hôpital de Vichy, Vichy, France
| | - Magali Pallure
- Department of Rheumatology, Hôpital de Cannes Simone Veil, Cannes, France
| | - Chloe Wackenheim
- Department of Internal Medicine, Medipole Hôpital Privé, Villeurbanne, France
| | - Ludovic Karkowski
- Department of Internal Medicine, Hôpital d’Instruction des Armées Sainte-Anne, Toulon, France
| | - Pierre Grumet
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Thomas Rogier
- Department of Internal Medicine and Systemic Disease, Hôpital François Mitterand, Dijon, France
| | - Nabil Belkefi
- Department of Internal Medicine, CH de Melun, Melun, France
| | - Vincent Pestre
- Department of Internal Medicine and Infectious Disease, CH d’Avignon, Avignon, France
| | | | - Amélie Leurs
- Department of Internal Medicine and Infectious Disease, CH de Dunkerque, Dunkerque, France
| | - Sophie Gautier
- Department of Pharmacology, centre régional de pharmacovigilance Nord Pas de Calais, CHRU de Lille, Lille, France
| | - Valérie Gras
- Department of Clinical Pharmacology, Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, Amiens, France
| | - Pierre Gilet
- Regional Center of Pharmacovigilance, CHRU de Nancy, Hôpital Central, Nancy, France
| | - Jan Holubar
- Department of Internal Medicine, CHU de Nîmes, Nîmes, France
| | - Nadia Sivova
- Department of Internal Medicine, CH de Tourcoing, Tourcoing, France
| | - Nicolas Schleinitz
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jean-Marc Durand
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Brice Castel
- Department of Internal Medicine, CH de Tarbes, Tarbes, France
| | | | - Robin Arcani
- Department of Internal Medicine and Therapeutics Department, Hôpital de La Timone, Marseille, France
| | - Baptiste Gramont
- Department of Internal Medicine, CHU de Saint-Etienne, Saint-Etienne, France
| | - Philippe Guilpain
- Department of Internal Medicine, CHU Saint-Eloi, Montpellier, France
| | - Hubert Lepidi
- Pathological Laboratory, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | | | - Joelle Micallef
- Department of Clinical Pharmacology and pharmacosurveillance, Regional Pharmacovigilance Center of Marseille, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Gilles Kaplanski
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
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Rossignol J, Ouedrani A, Livideanu CB, Barete S, Terriou L, Launay D, Lemal R, Greco C, Frenzel L, Meni C, Bodemere-Skandalis C, Polivka L, Collange AF, Hachichi H, Bouzourine S, Messaoud DN, Negretto M, Vendrame L, Jambou M, Gousseff M, Durupt S, Lega JC, Durand JM, Gaudy C, Damaj G, Gourin MP, Hamidou M, Bouillet L, Le Mouel E, Maria A, Zunic P, Cabrera Q, Vincent D, Lavigne C, Riviere E, Gourguechon C, Courbebaisse M, Lebeaux D, Parfait B, Friedlander G, Brignier A, Lhermitte L, Molina TJ, Bruneau J, Agopian J, Dubreuil P, Ranta D, Mania A, Arock M, Staropoli I, Tournilhac O, Lortholary O, Schwartz O, Chatenoud L, Hermine O. Effective Anti-SARS-CoV-2 Immune Response in Patients With Clonal Mast Cell Disorders. J Allergy Clin Immunol Pract 2022; 10:1356-1364.e2. [PMID: 35074600 PMCID: PMC8780123 DOI: 10.1016/j.jaip.2021.12.038] [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] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/05/2021] [Accepted: 12/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mast cells are key players in innate immunity and the TH2 adaptive immune response. The latter counterbalances the TH1 response, which is critical for antiviral immunity. Clonal mast cell activation disorders (cMCADs, such as mastocytosis and clonal mast cell activation syndrome) are characterized by abnormal mast cell accumulation and/or activation. No data on the antiviral immune response in patients with MCADs have been published. OBJECTIVE To study a comprehensive range of outcomes in patients with cMCAD with PCR- or serologically confirmed coronavirus disease 2019 and to characterize the specific anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune response in this setting. METHODS Clinical follow-up and outcome data were collected prospectively over a 12-month period by members of the French Centre de Référence des Mastocytoses rare disease network. Anti-SARS-CoV-2-specific T-cell activity was measured with an ELISA, and humoral responses were evaluated by assaying circulating levels of specific IgG, IgA, and neutralizing antibodies. RESULTS Overall, 32 patients with cMCAD were evaluated. None required noninvasive or mechanical ventilation. Two patients were admitted to hospital for oxygen and steroid therapy. The SARS-CoV-2-specific immune response was characterized in 21 of the 32 patients. Most had high counts of circulating SARS-CoV-2-specific, IFN-γ-producing T cells and high titers of neutralizing antispike IgGs. The patients frequently showed spontaneous T-cell IFN-γ production in the absence of stimulation; this production was correlated with basal circulating tryptase levels (a marker of the mast cell burden). CONCLUSIONS Patients with cMCADs might not be at risk of severe coronavirus disease 2019, perhaps due to their spontaneous production of IFN-γ.
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Affiliation(s)
- Julien Rossignol
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Amani Ouedrani
- Paris University, Necker-Enfants Malades Institute, CNRS UMR 8253 and INSERM UMR1151, Necker-Enfants Malades University Hospital, Paris, France; Laboratory of Immunoregulation and Immunopathology, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Cristina Bulai Livideanu
- French Reference Center for Mastocytosis (CEREMAST), Department of Dermatology, Hôpital Larrey, Toulouse University Hospital, Toulouse, France
| | - Stéphane Barete
- French Reference Center for Mastocytosis (CEREMAST), Department of Dermatology, Pitié-Salpêtrière University Hospital, APHP, Paris, France
| | - Louis Terriou
- University Lille, INSERM, CHU Lille, Department of Internal Medicine and Clinical Immunology, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - David Launay
- University Lille, INSERM, CHU Lille, Department of Internal Medicine and Clinical Immunology, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Richard Lemal
- Adult Clinical Hematology, Clermont-Ferrand University Hospital, INSERM CIC501, EA 7453-Université Clermont Auvergne, Clermont-Ferrand, France
| | - Celine Greco
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Laurent Frenzel
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Cecile Meni
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Christine Bodemere-Skandalis
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Laura Polivka
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Anne-Florence Collange
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Hassiba Hachichi
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Sonia Bouzourine
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Djazira Nait Messaoud
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Mathilde Negretto
- French Reference Center for Mastocytosis (CEREMAST), Department of Dermatology, Hôpital Larrey, Toulouse University Hospital, Toulouse, France
| | - Laurence Vendrame
- Paris University, Necker-Enfants Malades Institute, CNRS UMR 8253 and INSERM UMR1151, Necker-Enfants Malades University Hospital, Paris, France
| | - Marguerite Jambou
- Paris University, Necker-Enfants Malades Institute, CNRS UMR 8253 and INSERM UMR1151, Necker-Enfants Malades University Hospital, Paris, France
| | - Marie Gousseff
- Department of Internal Medicine, Bretagne Atlantique Hospital, Vannes, France
| | - Stéphane Durupt
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Lega
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Hospices Civils de Lyon, Lyon, France
| | - Jean-Marc Durand
- Department of Internal Medicine, Aix-Marseille University, Timone University Hospital, Marseille, France
| | - Caroline Gaudy
- Department of Internal Medicine, Aix-Marseille University, Timone University Hospital, Marseille, France
| | - Gandhi Damaj
- Haematology Institute, Normandy University School of Medicine, Caen, France
| | | | - Mohamed Hamidou
- Department of Internal Medicine, Hôtel-Dieu University Hospital, Nantes, France
| | - Laurence Bouillet
- Clinical Immunology/Internal Medicine Department, National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
| | - Edwige Le Mouel
- Department of Internal Medicine and Clinical Immunology, Rennes University Hospital, Rennes, France
| | - Alexandre Maria
- Department of Internal Medicine, Montpellier University Hospital, Montpellier, France
| | - Patricia Zunic
- Department of Haematology, Sud Réunion University Hospital, Saint Pierre, La Réunion, France
| | - Quentin Cabrera
- Department of Haematology, Sud Réunion University Hospital, Saint Pierre, La Réunion, France
| | - Denis Vincent
- Department of Pneumology and Internal Medicine, Caremeau University Hospital, Nimes, France
| | - Christian Lavigne
- Department of Internal Medicine, Angers University Hospital, Angers, France
| | - Etienne Riviere
- Department of Internal Medicine, Bordeaux University Hospital, Haut-Lévêque Hospital, Pessac, France
| | | | - Marie Courbebaisse
- Paris University, Necker-Enfants Malades Institute, CNRS UMR 8253 and INSERM UMR1151, Necker-Enfants Malades University Hospital, Paris, France; Department of Physiology-Functional Renal Explorations, Hôpital Européen Georges Pompidou University Hospital, Paris, France
| | - David Lebeaux
- Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France; Université de Paris, Paris, France
| | - Béatrice Parfait
- Centre de Ressources Biologiques, Hôpital Cochin, Paris, France; Paris University, Institut Cochin INSERM UMR1016, Paris, France
| | - Gérard Friedlander
- Paris University, Necker-Enfants Malades Institute, CNRS UMR 8253 and INSERM UMR1151, Necker-Enfants Malades University Hospital, Paris, France
| | - Anne Brignier
- Therapeutic Apheresis Unit, Saint-Louis University Hospital, APHP, Paris, France
| | - Ludovic Lhermitte
- Laboratory of Onco-Hematology, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Thierry Jo Molina
- Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France; Pathology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Julie Bruneau
- Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France; Pathology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Julie Agopian
- CRCM, [Signaling, Hematopoiesis and Mechanism of Oncogenesis, CEREMAST, AFIRMM], INSERM U1068, Marseille, France; Institut Paoli-Calmettes, Marseille, France; Aix-Marseille Univ, UM105, Marseille, France; CNRS, UMR7258, Marseille, France
| | - Patrice Dubreuil
- CRCM, [Signaling, Hematopoiesis and Mechanism of Oncogenesis, CEREMAST, AFIRMM], INSERM U1068, Marseille, France; Institut Paoli-Calmettes, Marseille, France; Aix-Marseille Univ, UM105, Marseille, France; CNRS, UMR7258, Marseille, France
| | - Dana Ranta
- Department of Haematology, Nancy University Hospital, Nancy, France
| | - Alexandre Mania
- Adult Clinical Hematology, Clermont-Ferrand University Hospital, INSERM CIC501, EA 7453-Université Clermont Auvergne, Clermont-Ferrand, France
| | - Michel Arock
- Laboratory of Haematology, Pitié-Salpêtrière University Hospital, Paris, France
| | - Isabelle Staropoli
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris, France
| | - Olivier Tournilhac
- Adult Clinical Hematology, Clermont-Ferrand University Hospital, INSERM CIC501, EA 7453-Université Clermont Auvergne, Clermont-Ferrand, France
| | - Olivier Lortholary
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France
| | - Olivier Schwartz
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris, France
| | - Lucienne Chatenoud
- Paris University, Necker-Enfants Malades Institute, CNRS UMR 8253 and INSERM UMR1151, Necker-Enfants Malades University Hospital, Paris, France; Laboratory of Immunoregulation and Immunopathology, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Olivier Hermine
- French Reference Center for Mastocytosis (CEREMAST), Necker-Enfants Malades University Hospital, APHP, Paris, France; Paris University, Imagine Institute, INSERM U1163, Necker-Enfants Malades University Hospital, Paris, France.
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Briantais A, De Sainte Marie B, Campana-Salort E, Kaplanski G, Durand JM, Bertin D, Bardin N, Ebbo M, Schleinitz N. Considering the level of myositis-specific autoantibodies could improve the precision of multiplex assay : lesson from patients with multiple positive results. Semin Arthritis Rheum 2021; 52:151871. [PMID: 34404513 DOI: 10.1016/j.semarthrit.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Antoine Briantais
- Department of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, CHU La Timone, Aix Marseille University, Marseille, France.
| | - Benjamin De Sainte Marie
- Department of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, CHU La Timone, Aix Marseille University, Marseille, France
| | - Emmanuelle Campana-Salort
- Department of Neurology, Neuromuscular and ALS Reference Center, Assistance Publique - Hôpitaux de Marseille, CHU La Timone, Aix Marseille University, Marseille, France
| | - Gilles Kaplanski
- Department of Internal Medicine and Clinical Immunology, Assistance Publique - Hôpitaux de Marseille, CHU La Conception, Aix Marseille University, Marseille, France
| | - Jean-Marc Durand
- Department of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, CHU La Timone, Aix Marseille University, Marseille, France
| | - Daniel Bertin
- Department of Biological Immunology, Assistance Publique - Hôpitaux de Marseille, CHU La Conception, Aix Marseille University, Marseille, France
| | - Nathalie Bardin
- Department of Biological Immunology, Assistance Publique - Hôpitaux de Marseille, CHU La Conception, Aix Marseille University, Marseille, France
| | - Mikael Ebbo
- Department of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, CHU La Timone, Aix Marseille University, Marseille, France
| | - Nicolas Schleinitz
- Department of Internal Medicine, Assistance Publique - Hôpitaux de Marseille, CHU La Timone, Aix Marseille University, Marseille, France
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Baron SA, Pascale LM, Million M, Briantais A, Durand JM, Hadjadj L, Rolain JM. Whole genome sequencing to decipher the virulence phenotype of hypervirulent Klebsiella pneumoniae responsible for liver abscess, Marseille, France. Eur J Clin Microbiol Infect Dis 2020; 40:1073-1077. [PMID: 33184752 DOI: 10.1007/s10096-020-04080-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/18/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Abstract
We described three clinical cases of pyogenic liver abscess caused by hypervirulent Klebsiella pneumoniae (hvKp) successfully treated by prolonged antibiotherapy, in which one case was complicated by endophthalmitis. Whole genome sequencing helped to confirm the diagnosis of these hvKp strains, which belong to clonal complexes CC86 and CC23 and carried hvKp-associated genes (magA and/or rmpA). This syndrome is increasingly reported in France and Europe and raises questions about the source of infection.
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Affiliation(s)
- Sophie Alexandra Baron
- IRD, APHM, MEPHI, Faculté de Médecine et de Pharmacie, Aix Marseille Univ, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France.,IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France
| | - Léa-Marie Pascale
- IRD, APHM, MEPHI, Faculté de Médecine et de Pharmacie, Aix Marseille Univ, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France.,IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France
| | - Matthieu Million
- IRD, APHM, MEPHI, Faculté de Médecine et de Pharmacie, Aix Marseille Univ, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France.,IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France
| | - Antoine Briantais
- Service de Médecine Interne, Hôpital La Timone, APHM, Marseille, France
| | - Jean-Marc Durand
- Service de Médecine Interne, Hôpital La Timone, APHM, Marseille, France
| | - Linda Hadjadj
- IRD, APHM, MEPHI, Faculté de Médecine et de Pharmacie, Aix Marseille Univ, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France.,IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France
| | - Jean-Marc Rolain
- IRD, APHM, MEPHI, Faculté de Médecine et de Pharmacie, Aix Marseille Univ, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France. .,IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France. .,IRD, APHM, MEPHI, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix Marseille Univ, 19-21 boulevard Jean Moulin, 13385, Marseille, CEDEX 05, France.
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Briantais A, Dalmas JB, Swiader L, Poullin P, Durand JM. Recurrent hypothyroidism and thrombopenic thrombotic purpura. Ann Endocrinol (Paris) 2020; 81:518-519. [PMID: 32822654 DOI: 10.1016/j.ando.2020.07.1111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/06/2020] [Accepted: 07/24/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Antoine Briantais
- Internal Medicine department, Timone Hospital, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - Jean Baptiste Dalmas
- Internal Medicine department, Timone Hospital, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - Laure Swiader
- Internal Medicine department, Timone Hospital, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - Pascale Poullin
- Hemapheresis department, La Conception Hospital, Aix-Marseille University, 136, rue Saint-Pierre, 13005 Marseille cedex 05, France
| | - Jean-Marc Durand
- Internal Medicine department, Timone Hospital, Aix-Marseille University, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
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Escoda T, Seguier J, Swiader L, Briantais A, Sampo M, Harlé JR, Durand JM. [Purtscher-like retinopathy associated with adult onset still disease: Case report and review of the literature]. Rev Med Interne 2020; 41:279-283. [PMID: 31983549 DOI: 10.1016/j.revmed.2019.12.024] [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: 05/06/2019] [Revised: 11/25/2019] [Accepted: 12/22/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Putscher-like retinopathy is a retinal disease that is similar to the syndrome initially described in 1910 by Purtscher, but occurring in a non-traumatic context. CASE REPORT We describe a case of acute, Putscher-like retinopathy in a 48-year-old woman experiencing adult onset Still's disease. The diagnosis was based on fundus examination and fluorescein angiography. Based on a review of the literature, we discuss the current available data on the pathophysiology of this syndrome and its prognostic significance. The treatment remains controversial. CONCLUSION When visual functional signs appear during adult Still's disease, it is necessary to evoke Putscher-like retinopathy, and to ask for an ophthalmological expertise.
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Affiliation(s)
- T Escoda
- Service de médecine Interne, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
| | - J Seguier
- Service de médecine Interne, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
| | - L Swiader
- Service de médecine Interne, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
| | - A Briantais
- Service de médecine Interne, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
| | - M Sampo
- Service d'ophtalmologie, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
| | - J R Harlé
- Service de médecine Interne, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
| | - J M Durand
- Service de médecine Interne, hôpital La Timone, Assistance publique, hôpitaux de Marseille, Aix-Marseille université, 13005 Marseille, France.
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Picard V, Guitton C, Thuret I, Rose C, Bendelac L, Ghazal K, Aguilar-Martinez P, Badens C, Barro C, Bénéteau C, Berger C, Cathébras P, Deconinck E, Delaunay J, Durand JM, Firah N, Galactéros F, Godeau B, Jaïs X, de Jaureguiberry JP, Le Stradic C, Lifermann F, Maffre R, Morin G, Perrin J, Proulle V, Ruivard M, Toutain F, Lahary A, Garçon L. Clinical and biological features in PIEZO1-hereditary xerocytosis and Gardos channelopathy: a retrospective series of 126 patients. Haematologica 2019; 104:1554-1564. [PMID: 30655378 PMCID: PMC6669138 DOI: 10.3324/haematol.2018.205328] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/15/2019] [Indexed: 01/16/2023] Open
Abstract
We describe the clinical, hematologic and genetic characteristics of a retrospective series of 126 subjects from 64 families with hereditary xerocytosis. Twelve patients from six families carried a KCNN4 mutation, five had the recurrent p.Arg352His mutation and one had a new deletion at the exon 7-intron 7 junction. Forty-nine families carried a PIEZO1 mutation, which was a known recurrent mutation in only one-third of the cases and private sequence variation in others; 12 new probably pathogenic missense mutations were identified. The two dominant features leading to diagnosis were hemolysis that persisted after splenectomy and hyperferritinemia, with an inconstant correlation with liver iron content assessed by magnetic resonance imaging. PIEZO1-hereditary xerocytosis was characterized by compensated hemolysis in most cases, perinatal edema of heterogeneous severity in more than 20% of families and a major risk of post-splenectomy thrombotic events, including a high frequency of portal thrombosis. In KCNN4-related disease, the main symptoms were more severe anemia, hemolysis and iron overload, with no clear sign of red cell dehydration; therefore, this disorder would be better described as a ‘Gardos channelopathy’. These data on the largest series to date indicate that PIEZO1-hereditary xerocytosis and Gardos channelopathy are not the same disease although they share hemolysis, a high rate of iron overload and inefficient splenectomy. They demonstrate the high variability in clinical expression as well as genetic bases of PIEZO1-hereditary xerocytosis. These results will help to improve the diagnosis of hereditary xerocytosis and to provide recommendations on the clinical management in terms of splenectomy, iron overload and pregnancy follow-up.
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Affiliation(s)
- Véronique Picard
- Laboratoire d'Hématologie, Center Hospitalier Universitaire (CHU) Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre.,Université Paris Sud Paris Saclay, Faculté de Pharmacie, Chatenay Malabry
| | - Corinne Guitton
- Service de Pédiatrie Générale, CHU Bicêtre et Filière MCGRE, AP-HP, Le Kremlin-Bicêtre
| | - Isabelle Thuret
- Service de Pédiatrie, Hôpital La Timone, Aix Marseille University, Marseille
| | - Christian Rose
- Service d'Oncologie et d'Hématologie, Hôpital Saint Vincent de Paul, Lille
| | - Laurence Bendelac
- Laboratoire d'Hématologie, Center Hospitalier Universitaire (CHU) Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre
| | - Kaldoun Ghazal
- Laboratoire de Biochimie, CHU Bicêtre, AP-HP, Le Kremlin-Bicêtre
| | | | | | - Claire Barro
- Laboratoire d'Hématologie Biologique, CHU Grenoble, Grenoble
| | | | - Claire Berger
- Service d'Hématologie-Oncologie Pédiatrique, CHU, Saint-Etienne
| | | | | | | | | | - Nadia Firah
- Service de Pédiatrie, Centre Hospitaliere (CH) Pau
| | - Frédéric Galactéros
- Centre de Référence des Syndromes Drépanocytaires Majeurs, Hôpital Henri-Mondor, AP-HP, Créteil
| | - Bertrand Godeau
- Service de Médecine Interne, CHU Henri Mondor, AP-HP, Créteil
| | - Xavier Jaïs
- Service de Pneumologie, CHU Bicêtre, AP-HP, Le Kremlin-Bicêtre
| | | | | | | | - Robert Maffre
- Laboratoire d'Hématologie, Center Hospitalier Universitaire (CHU) Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre
| | | | | | - Valérie Proulle
- Laboratoire d'Hématologie, Center Hospitalier Universitaire (CHU) Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre
| | - Marc Ruivard
- Service de Médecine Interne, CHU Estaing, Clermont-Ferrand
| | | | | | - Loïc Garçon
- Laboratoire d'Hématologie, Center Hospitalier Universitaire (CHU) Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre .,Equipe d'Accueil 4666 HEMATIM Université de Picardie Jules Verne and Service d'Hématologie Biologique, CHU Amiens, France
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Seguier J, Gelsi-Boyer V, Ebbo M, Hamidou Z, Charbonnier A, Bernit E, Durand JM, Harlé JR, Vey N, Schleinitz N. Autoimmune diseases in myelodysplastic syndrome favors patients survival: A case control study and literature review. Autoimmun Rev 2018; 18:36-42. [PMID: 30408583 DOI: 10.1016/j.autrev.2018.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 07/07/2018] [Accepted: 07/13/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND We conducted a monocentric retrospective study of patients with myelodysplastic syndromes (MDS) and autoimmune or inflammatory disorders (AIMs) and a literature review. We analyzed the association with subgroups of the WHO 2016 MDS classification and patient's survival in a case control study. Risk factors associated with survival were analyzed by uni- and multivariate analysis. RESULTS From all MDS patients 11% presented with AIMs. These were heterogeneous and the most frequent where polyarthritis (25%) and autoimmune cytopenias (17%). No difference for frequency and type of AIMs was observed for the WHO 2016 MDS subgroups (p = .3). In the case control study WHO classification, karyotype abnormalities, IPSS-R and IPSS were similar in both groups. The overall survival from MDS diagnosis was better in the group with AIMs [10.3 ± 0.6 (IC95% 6.2-12.9) versus 4.8 ± 1.1 years (IC95% 4.2-8.7), p = .04]. The better survival was restricted to MDS with low or intermediate-1 IPSS [11.1 ± 1.5 (IC95% 9.9-NR) versus 8.7 ± 1.3 years (IC95% 4.8-10.3), p = .006]. The better survival was only observed when AIMs diagnosis was timely associated or appeared after MDS diagnosis (p = .04). Factors associated with a better overall survival and survival without AML were steroid dependence [respectively HR = 0.042, p = .003, (IC95% 0.005-0.33) and HR = 0.07, p = .002, (IC95% 0.013-0.39)], a diagnosis of AIMs and MDS timely associated [respectively HR = 0.05, p = .009, (IC95% 0.006-0.478) and HR = 0.1, p = .008, (IC95% 0.018-0.54)] or a diagnosis of AIMs after MDS [respectively HR = 0.024, p = .009, (IC95% 0.001-0.39) and HR = 0.04, p = .008, (IC95% 0.003-0.43)]. CONCLUSION Autoimmune and inflammatory diseases associated to MDS are heterogeneous. AIMs diagnosed after or concomitantly to MDS seems associated with a better survival. Prospective studies are necessary to demonstrate that autoimmunity is associated to a better control of the MDS clone.
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Affiliation(s)
- Julie Seguier
- Aix-Marseille Univ, APHM, Medecine Interne Hôpital de la Timone, Marseille, France
| | | | - Mikael Ebbo
- Aix-Marseille Univ, APHM, Medecine Interne Hôpital de la Timone, Marseille, France
| | - Zeinab Hamidou
- Aix-Marseille Univ, APHM, EA 3279, Département de santé publique, Marseille, France
| | - Aude Charbonnier
- Institut Paoli-Calmettes, Département d'Hématologie, Marseille, France
| | - Emmanuelle Bernit
- Aix-Marseille Univ, APHM, Medecine Interne Hôpital de la Timone, Marseille, France
| | - Jean-Marc Durand
- Aix-Marseille Univ, APHM, Medecine Interne Hôpital de la Timone, Marseille, France
| | - Jean-Robert Harlé
- Aix-Marseille Univ, APHM, Medecine Interne Hôpital de la Timone, Marseille, France
| | - Norbert Vey
- Aix-Marseille Univ, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Nicolas Schleinitz
- Aix-Marseille Univ, APHM, Medecine Interne Hôpital de la Timone, Marseille, France.
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Affiliation(s)
- P Lefevre
- Department of Haemobiology, Marseille, France
| | - F George
- Laboratory of Haematology, Hôpital de la Conception, Marseille, France
| | - J M Durand
- Department of Haemobiology, Marseille, France
| | - J Sampol
- Laboratory of Haematology, Hôpital de la Conception, Marseille, France
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Grimaldi-Bensouda L, Rossignol M, Koné-Paut I, Krivitzky A, Lebrun-Frenay C, Clet J, Brassat D, Papeix C, Nicolino M, Benhamou PY, Fain O, Costedoat-Chalumeau N, Courcoux MF, Viallard JF, Godeau B, Papo T, Vermersch P, Bourgault-Villada I, Breart G, Abenhaim L, Abbas F, Abdelmoumni A, Hilliquin P, Requeda E, Adoue D, Brassat D, Agard C, Masseau A, Aladjidi N, Clet J, Fernandes H, Lemasson G, Perel Y, Raymond I, Richer O, Vital A, Allain-Launay E, Bru M, Nicolino M, Thomas C, Altman JJ, Amsallem D, Aras N, Boukari L, Dubrel M, Fain O, Letellier E, Lucidarme N, Mekinian A, Morin AS, Stirnemann J, Atlan C, Audry D, Augustin J, Bakir R, Bartolucci P, Chevalier X, Godeau B, Guillaud C, Khellaf M, Limal N, Lousteau V, Mahevas M, Méliksetyan G, Michel M, Roumier M, Bayart S, Bonnet F, Decaux O, Bekherraz A, Brihaye B, Dachez R, Daugas E, Hayem G, Meyer O, Papo T, Pasqualoni E, Sacre K, Travert F, Bellon H, Beltrand J, Lefrere F, Simon A, Benhamou PY, Benveniste O, Bolgert F, Costedoat-Chalumeau N, De Paz R, Demeret S, Fautrel B, Jacqueminet S, Louapre C, Maillart E, Morel N, Papeix C, Rigabert J, Bensaid P, Berger C, Berquin P, Le Moing AG, Berroir S, Besson G, Boutte C, Casez O, Bonnotte B, Audia S, Bossu-Estour C, Bourgarit A, Dupuy A, Keshmandt H, Bourre B, Brac A, Perrin A, Pondarré C, Villar-Fimbel S, Bruckert I, Cosson A, Magy-Bertrand N, Tisserand G, Camu W, Carlander B, Morales RJ, Cances C, Pasquet M, Castilla Lievre MA, Chabroux S, Charif M, Chatelus E, Sibilia J, Chevrant-Breton J, Clavel S, Bille-Turc F, Cohen J, Courcoux MF, Leverger G, Machet L, Cuisset JM, Cony-Makhoul P, Darsy P, Favre S, Giraud P, Leitenschenck L, Monteiro I, Morati C, DeSeze J, Dinulescu M, Dhaoui T, Dommange-Romero F, Drevard E, Dupuis C, Dumuis ML, Durand JM, Farad S, Lecomte P, Pierre P, Fouyssac F, Gaudin P, Gautier A, Gellen-Dautremer J, Jarrin I, Richette P, Georget E, Gras P, Moreau T, Giraud E, Hacini M, Mayer A, Guillaumat C, Guillaume S, Guitton C, Kone-Paut I, Marsaud C, Rossi L, Guyot MH, Hassler P, Heimfert C, Heinzlef O, Hillion B, Hocquelet C, Husson H, Ichai P, Jeziorski E, Deslandre CJ, Le Guern V, Kamenov K, Kerlan V, Lemoine P, Misery L, Pan-Petesch B, Krivitzky A, Labauge P, Rodier M, Lacade C, Razafimahefa B, Lachgar K, Larmarau MP, Leblanc T, Lebrun-Frenay C, Lefèbvre P, Lejoyeux P, Leske C, Ly K, Magy L, Mansuy S, Marechaud R, Martin Negrier ML, Sole G, Maupetit J, Mazingue F, Mochon S, Moktar B, Morcamp D, Morlet-Barla N, Nicolas G, Pautot V, Pellier I, Verret JL, Outteryck O, Vermersch P, Pallot-Prades B, Paquet JM, Puechal X, Sortais A, Pelletier J, Rico A, Pez D, Stankoff B, Quittet P, Rémy C, Roba E, Rosario H, Roudaut N, Sonnet E, Ruel M, Sebban S, Schaepelynck P, Simonin MJ, Vial C, Viallard JF, Ladedan I, Zenone T. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun 2017; 79:84-90. [DOI: 10.1016/j.jaut.2017.01.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/08/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
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Benzaquen M, Lebowitz D, Belenotti P, Durand JM, Serratrice J. Acute pancreatitis and pneumonia due to Mycoplasma pneumoniae: a case report. BMC Res Notes 2016; 9:397. [PMID: 27506562 PMCID: PMC4979111 DOI: 10.1186/s13104-016-2196-y] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/31/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mycoplasma pneumoniae is a bacterium responsible for 15 to 40 % of acute community-acquired pneumonia in children and 20 % of adult cases. Several extrapulmonary manifestations have been reported. We report a rare case of an adult patient suffering from pneumonia associated with an acute pancreatitis in the setting of Mycoplasma pneumoniae infection. CASE PRESENTATION A 28-year-old Caucasian woman was referred for anorexia lasting for 1 week. Her past medical history was notable for congenital hydrocephalus with consecutive ventriculo-peritoneal shunt, epilepsia and paraparesis. The patient rapidly deteriorated, presenting with dyspnea, tachypnea, productive cough, abdominal pain, and onset of fever. C-reactive protein was at 270 mg/L, with a rise in serum lipase (670 UI/L, N: 13-60). A computed-tomography scan showed an acute interstitial edematous pancreatitis without necrosis, consistent with grade C on the Balthazar score. Thoracic sections revealed diffuse parenchymal consolidations combined with ground glass opacities. Calcium and triglyceride levels were normal. There was no history of recent trauma, alcoholic intake or drug intoxication. Mycoplasma pneumoniae serological assay showed an elevated IgM titer (22 UA/mL), compatible with recent infection, and cold agglutinins were present. A diagnosis of acute pancreatitis and diffuse interstitial pneumonia caused by an infection with Mycoplasma pneumoniae was considered. Respiratory and abdominal evolution was quickly favorable after initiation of clarithromycin 500 mg bid. CONCLUSIONS The relationship between Mycoplasma pneumoniae infection and acute pancreatitis has been debated in the literature for many years. This observation, supported by clinical, biological and radiological features, is an additional argument in favor of a non-fortuitous association.
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Affiliation(s)
- Michael Benzaquen
- Service de Dermatologie, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13015, Marseille, France.
| | - Dan Lebowitz
- Service de Médecine interne générale, Hôpitaux Universitaires de Genève, 1205, Geneva, Switzerland
| | - Pauline Belenotti
- Service de Médecine interne, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13005, Marseille, France
| | - Jean-Marc Durand
- Service de Médecine interne, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13005, Marseille, France
| | - Jacques Serratrice
- Service de Médecine interne, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, 13005, Marseille, France.,Service de Médecine interne générale, Hôpitaux Universitaires de Genève, 1205, Geneva, Switzerland
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Grimaldi-Bensouda L, Nordon C, Michel M, Viallard JF, Adoue D, Magy-Bertrand N, Durand JM, Quittet P, Fain O, Bonnotte B, Morin AS, Morel N, Costedoat-Chalumeau N, Pan-Petesch B, Khellaf M, Perlat A, Sacre K, Lefrere F, Abenhaim L, Godeau B. Immune thrombocytopenia in adults: a prospective cohort study of clinical features and predictors of outcome. Haematologica 2016; 101:1039-45. [PMID: 27229715 DOI: 10.3324/haematol.2016.146373] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/24/2016] [Indexed: 11/09/2022] Open
Abstract
This prospective observational cohort study aimed to explore the clinical features of incident immune thrombocytopenia in adults and predictors of outcome, while determining if a family history of autoimmune disorder is a risk factor for immune thrombocytopenia. All adults, 18 years of age or older, recently diagnosed with immune thrombocytopenia were consecutively recruited across 21 hospital centers in France. Data were collected at diagnosis and after 12 months. Predictors of chronicity at 12 months were explored using logistic regression models. The association between family history of autoimmune disorder and the risk of developing immune thrombocytopenia was explored using a conditional logistic regression model after matching each case to 10 controls. One hundred and forty-three patients were included: 63% female, mean age 48 years old (Standard Deviation=19), and 84% presented with bleeding symptoms. Median platelet count was 10×10(9)/L. Initial treatment was required in 82% of patients. After 12 months, only 37% of patients not subject to disease-modifying interventions achieved cure. The sole possible predictor of chronicity at 12 months was a higher platelet count at baseline [Odds Ratio 1.03; 95%CI: 1.00, 1.06]. No association was found between outcome and any of the following features: age, sex, presence of either bleeding symptoms or antinuclear antibodies at diagnosis. Likewise, family history of autoimmune disorder was not associated with incident immune thrombocytopenia. Immune thrombocytopenia in adults has been shown to progress to a chronic form in the majority of patients. A lower platelet count could be indicative of a more favorable outcome.
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Affiliation(s)
| | | | - Marc Michel
- Centre de Référence des Cytopénies Auto-Immunes de l'Adulte, Service de Médecine Interne, CHU Henri Mondor, Créteil, France
| | - Jean-François Viallard
- Service de Médecine Interne, Hôpital Haut-Lévêque, Pessac; Université Bordeaux 2, Bordeaux, France
| | | | | | - Jean-Marc Durand
- Service de Médecine Interne, Hôpital de la Timone, Marseille, France
| | - Philippe Quittet
- Département d'Hématologie Clinique, Hôpital St-Eloi, Montpellier, France
| | - Olivier Fain
- Service de Médecine Interne, Hôpital Saint Antoine; Hôpitaux Universitaires de l'Est Parisien, AP-HP Université Paris 6, Paris, France
| | - Bernard Bonnotte
- Service de Médecine Interne et Immunologie Clinique, INSERM 1098, CHU Bocage Central, Dijon, France
| | - Anne-Sophie Morin
- Service de Médecine Interne CHU Jean Verdier, Université Paris 13, Assistance Publique-Hôpitaux de Paris (AP-HP), Bondy, France
| | - Nathalie Morel
- Service de Médecine Interne, Hôpital Cochin, Paris, France
| | | | | | - Mehdi Khellaf
- Service des Urgences, Centre Hospitalier Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | | | - Karim Sacre
- Université Paris-Diderot, Paris; Assistance Publique Hôpitaux de Paris; INSERUM U1149, Paris, France
| | | | | | - Bertrand Godeau
- Centre de Référence des Cytopénies Auto-Immunes de l'Adulte, Service de Médecine Interne, CHU Henri Mondor, Créteil, France
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van Laar JM, Farge D, Sont JK, Naraghi K, Marjanovic Z, Larghero J, Schuerwegh AJ, Marijt EWA, Vonk MC, Schattenberg AV, Matucci-Cerinic M, Voskuyl AE, van de Loosdrecht AA, Daikeler T, Kötter I, Schmalzing M, Martin T, Lioure B, Weiner SM, Kreuter A, Deligny C, Durand JM, Emery P, Machold KP, Sarrot-Reynauld F, Warnatz K, Adoue DFP, Constans J, Tony HP, Del Papa N, Fassas A, Himsel A, Launay D, Lo Monaco A, Philippe P, Quéré I, Rich É, Westhovens R, Griffiths B, Saccardi R, van den Hoogen FH, Fibbe WE, Socié G, Gratwohl A, Tyndall A. Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial. JAMA 2014; 311:2490-8. [PMID: 25058083 DOI: 10.1001/jama.2014.6368] [Citation(s) in RCA: 454] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE High-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HSCT) have shown efficacy in systemic sclerosis in phase 1 and small phase 2 trials. OBJECTIVE To compare efficacy and safety of HSCT vs 12 successive monthly intravenous pulses of cyclophosphamide. DESIGN, SETTING, AND PARTICIPANTS The Autologous Stem Cell Transplantation International Scleroderma (ASTIS) trial, a phase 3, multicenter, randomized (1:1), open-label, parallel-group, clinical trial conducted in 10 countries at 29 centers with access to a European Group for Blood and Marrow Transplantation-registered transplant facility. From March 2001 to October 2009, 156 patients with early diffuse cutaneous systemic sclerosis were recruited and followed up until October 31, 2013. INTERVENTIONS HSCT vs intravenous pulse cyclophosphamide. MAIN OUTCOMES AND MEASURES The primary end point was event-free survival, defined as time from randomization until the occurrence of death or persistent major organ failure. RESULTS A total of 156 patients were randomly assigned to receive HSCT (n = 79) or cyclophosphamide (n = 77). During a median follow-up of 5.8 years, 53 events occurred: 22 in the HSCT group (19 deaths and 3 irreversible organ failures) and 31 in the control group (23 deaths and 8 irreversible organ failures). During the first year, there were more events in the HSCT group (13 events [16.5%], including 8 treatment-related deaths) than in the control group (8 events [10.4%], with no treatment-related deaths). At 2 years, 14 events (17.7%) had occurred cumulatively in the HSCT group vs 14 events (18.2%) in the control group; at 4 years, 15 events (19%) had occurred cumulatively in the HSCT group vs 20 events (26%) in the control group. Time-varying hazard ratios (modeled with treatment × time interaction) for event-free survival were 0.35 (95% CI, 0.16-0.74) at 2 years and 0.34 (95% CI, 0.16-0.74) at 4 years. CONCLUSIONS AND RELEVANCE Among patients with early diffuse cutaneous systemic sclerosis, HSCT was associated with increased treatment-related mortality in the first year after treatment. However, HCST conferred a significant long-term event-free survival benefit. TRIAL REGISTRATION isrctn.org Identifier: ISRCTN54371254.
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Affiliation(s)
- Jacob M van Laar
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Dominique Farge
- Internal Medicine and Vascular Disease Unit, AP-HP Hôpital Saint-Louis, Paris 7 University, France
| | - Jacob K Sont
- Department of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands
| | - Kamran Naraghi
- Department of Rheumatology, The James Cook University Hospital, Middlesbrough, United Kingdom
| | - Zora Marjanovic
- Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP Hôpital Saint-Antoine, Paris 6 University, Paris, France
| | - Jérôme Larghero
- Clinical Investigation Center in Biotherapies and Cell Therapy Unit, AP-HP Hôpital Saint-Louis, Paris 7 University, France
| | - Annemie J Schuerwegh
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Erik W A Marijt
- Department of Hematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Madelon C Vonk
- Department of Rheumatology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Anton V Schattenberg
- Department of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Marco Matucci-Cerinic
- Department of Biomedicine, Division of Rheumatology AOUC and Department of Experimental and Clinical Medicine, University of Florence, Florence
| | - Alexandre E Voskuyl
- Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Thomas Daikeler
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Ina Kötter
- Department of Internal Medicine II, University Hospital, Tübingen, Germany
| | - Marc Schmalzing
- Department of Internal Medicine II, University Hospital, Tübingen, Germany
| | - Thierry Martin
- Department of Clinical Immunology, Strasbourg University Hospital, Strasbourg, France
| | - Bruno Lioure
- Service d'Hématologie et d'Oncologie, Unité de Greffe de Cellules Souches Hématopoïétiques, Centre Hospitalier Universitaire Hautepierre, Strasbourg, France
| | - Stefan M Weiner
- 2.Medizinische Abteilung Krankenhaus der Barmherzigen Brüder Trier, Trier, Germany
| | - Alexander Kreuter
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth Hospital Oberhausen, Oberhausen,Germany
| | - Christophe Deligny
- Service Médecine Interne, Hôpital Pierre Zobda Quitman, Fort-de France, Martinique
| | - Jean-Marc Durand
- Department of Internal Medicine CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Klaus P Machold
- Klinische Abteilung für Rheumatologie, Medizinische Universität, Vienna, Austria
| | | | - Klaus Warnatz
- Division of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Freiburg, Germany
| | - Daniel F P Adoue
- Service Médecine Interne, Centre Hospitalier Universitaire Toulouse
| | - Joël Constans
- Service Médecine Interne et Médecine Vasculaire, Hôpital St-André, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Hans-Peter Tony
- Department of Rheumatology and Clinical Immunology, University of Würzburg Medical Center, Würzburg, Germany
| | | | - Athanasios Fassas
- Department of Hematology, Cell and Gene Therapy Center, George Papanicolaou Hospital, Thessaloniki, Greece
| | - Andrea Himsel
- Department of Rheumatology, University Hospital Frankfurt, Frankfurt, Germany
| | - David Launay
- Service de Médecine Interne, Hôpital Claude-Huriez, Lille, France
| | - Andrea Lo Monaco
- Section and Unit of Rheumatology, Department of Medical Sciences, University of Ferrara, Italy
| | - Pierre Philippe
- Service de Médecine Interne, Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, France
| | - Isabelle Quéré
- Department of Internal Medicine, Montpellier University Hospital, Montpellier, France
| | - Éric Rich
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Rene Westhovens
- Skeletal Biology and Engineering Research Center, Department of Development and Regeneration KU Leuven, Rheumatology, University Hospitals, Leuven, Belgium
| | - Bridget Griffiths
- Department of Rheumatology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Riccardo Saccardi
- Department of Hematology, Careggi University Hospital, Florence, Italy
| | | | - Willem E Fibbe
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands
| | - Gérard Socié
- Hematology/Transplantation, AP-HP Hôpital Saint-Louis, Paris 7 University, France
| | - Alois Gratwohl
- Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Alan Tyndall
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
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Mahévas M, Ebbo M, Audia S, Bonnotte B, Schleinitz N, Durand JM, Chiche L, Khellaf M, Bierling P, Roudot-Thoraval F, Godeau B, Michel M. Efficacy and safety of rituximab given at 1,000 mg on days 1 and 15 compared to the standard regimen to treat adult immune thrombocytopenia. Am J Hematol 2013; 88:858-61. [PMID: 23798363 DOI: 10.1002/ajh.23518] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/22/2013] [Accepted: 06/11/2013] [Indexed: 01/19/2023]
Abstract
Rituximab (RTX) is used off-label to treat immune thrombocytopenia (ITP) but the regimen now commonly used in rheumatoid arthritis has not been evaluated in ITP. The aim of this large French multicenter retrospective study was to compare the efficacy and safety of two RTX regimens in adult's ITP. The efficacy of two (RTX) regimens: standard therapy of 375 mg/m(2) weekly for 4 weeks vs. a rheumatoid arthritis (RA) regimen of 1,000 mg on days 1 and 15, to treat ITP was compared. We included adults patients with previously primary ITP treated with RTX instead of treated primary ITP. (CR) was defined as a platelet count >100 × 10(9) /L, and a response (R) by a platelet count of >30 × 10(9) /L with a least a doubling of the baseline value. Of the 107 patients included, 61 (57%) received the standard regimen and 46 (43%) the RA regimen. Baseline characteristics and overall response rates at 3 month (M3) and 12 months (M12) were not significantly different between the groups. At M12, 22/61 patients (36%) treated with the standard regimen and 23/46 (50%) with the RA regimen achieved an overall response (R + CR). The initial pattern of response at M3 was associated with a later pattern of response by M12 in both groups. In multivariate analysis, both a younger age and a low number of previous therapies were associated with a higher likelihood of overall response at M12. Tolerance was good and comparable between the two groups. The RA regimen is an effective and safe alternative to the standard regimen to treat adults with ITP.
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Affiliation(s)
- Matthieu Mahévas
- Department of Internal Medicine, Centre de référence des cytopénies auto-immunes de l'adulte, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris; Université Paris Est Créteil; Créteil France
- Etablissement Français du Sang Ile de France, Inserm U955, Créteil, Hôpital Henri Mondor; Paris France
| | - Mikael Ebbo
- Department of Internal Medicine; Hôpital de La Conception, Assistance publique-Hôpitaux de Marseille; Marseille France
| | - Sylvain Audia
- Department of Internal Medicine; Hôpital universitaire Dijon; France
| | - Bernard Bonnotte
- Department of Internal Medicine; Hôpital universitaire Dijon; France
| | - Nicolas Schleinitz
- Department of Internal Medicine; Hôpital de La Conception, Assistance publique-Hôpitaux de Marseille; Marseille France
| | - Jean-Marc Durand
- Department of Internal Medicine; Hôpital de La Conception, Assistance publique-Hôpitaux de Marseille; Marseille France
| | - Laurent Chiche
- Department of Internal Medicine; Hôpital de La Conception, Assistance publique-Hôpitaux de Marseille; Marseille France
| | - Medhi Khellaf
- Department of Internal Medicine, Centre de référence des cytopénies auto-immunes de l'adulte, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris; Université Paris Est Créteil; Créteil France
| | - Philippe Bierling
- Department of Internal Medicine, Centre de référence des cytopénies auto-immunes de l'adulte, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris; Université Paris Est Créteil; Créteil France
- Etablissement Français du Sang Ile de France, Inserm U955, Créteil, Hôpital Henri Mondor; Paris France
| | | | - Bertrand Godeau
- Department of Internal Medicine, Centre de référence des cytopénies auto-immunes de l'adulte, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris; Université Paris Est Créteil; Créteil France
| | - Marc Michel
- Department of Internal Medicine, Centre de référence des cytopénies auto-immunes de l'adulte, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris; Université Paris Est Créteil; Créteil France
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15
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Khellaf M, Viallard JF, Hamidou M, Cheze S, Roudot-Thoraval F, Lefrere F, Fain O, Audia S, Abgrall JF, Michot JM, Dauriac C, Lefort S, Gyan E, Niault M, Durand JM, Languille L, Boutboul D, Bierling P, Michel M, Godeau B. A retrospective pilot evaluation of switching thrombopoietic receptor-agonists in immune thrombocytopenia. Haematologica 2013; 98:881-7. [PMID: 23445876 DOI: 10.3324/haematol.2012.074633] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Romiplostim and eltrombopag, the first thrombopoietic receptor-agonists with demonstrated efficacy against immune thrombocytopenia in prospective controlled studies, were recently authorized in most countries for adults with chronic immune thrombocytopenia. So far, no data are available about the potential contribution of switching from romiplostim to eltrombopag or vice versa in terms of efficacy or tolerance. Efficacies and tolerance profiles were evaluated for 46 patients who sequentially received both drugs, switching from one to the other. The reasons for switching were: lack of efficacy for 23 patients, platelet-count fluctuations for 11, side effects for 4, and 8 patients' preferences. For 50-80% of the patients, switching from romiplostim to eltrombopag or eltrombopag to romiplostim effectively impacted the platelet count, with fluctuations disappearing in 54% and side effects resolved in 100%. In 80% of the patients, the 2 thrombopoietic receptor-agonists achieved similar response patterns. Our results confirmed that switching from one thrombopoietic receptor-agonist to the other could be beneficial in clinical practice for patients with severe chronic immune thrombopenia who failed to respond or experienced adverse events to the first. (Clinical Trials.gov identifier: NCT01618734).
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Affiliation(s)
- Mehdi Khellaf
- Department of Internal Medicine, Centre Hospitalier Universitaire (CHU) Henri-Mondor, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris-Est Créteil (UPEC), Créteil, France
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16
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Chiche L, Brescianini A, Mancini J, Servy H, Durand JM. Evaluation of a prototype electronic personal health record for patients with idiopathic thrombocytopenic purpura. Patient Prefer Adherence 2012; 6:725-34. [PMID: 23077409 PMCID: PMC3474173 DOI: 10.2147/ppa.s36320] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients with rare diseases often lack information about the disease itself and appropriate health care, leading to poor quality of life. Personal health records provide health information which can then be shared between multiple health care providers. Personal health records may also offer a tool for capturing patients' reported outcomes, thus enhancing their empowerment and improving communication with health care professionals. We conducted a pilot study to evaluate the usability of Sanoia, a freely accessible personal health record, which was customized for patients with the rare disease, idiopathic thrombocytopenic purpura (ITP). METHODS The Sanoia interface was expanded with ITP-specific tools. A prospective study was conducted at the referent center to evaluate the usability of this new interface (referred to here as the "tool") by patients. Forty-three patients were randomized into groups to use or to not use the tool. Its use was evaluated by a specific questionnaire and by surveying individual patient adherence profiles. Evaluation of health-related quality of life using the ITP patient assessment questionnaire, was performed at baseline and after 1, 3, and 6 months via postal mail. RESULTS The groups were similar at inclusion in terms of characteristics, including global quality of life. During the study period, the tool was used to update the personal records of 19/28 patients (68%), with a median of two connections to the tool (range 1-12) plus access by various health care professionals (n = 22). In addition, 15/19 (78%) patients used the "personal notes" section at least once. We observed no significant changes in quality of life between patients with or without the tool during the study period. CONCLUSION This pilot study demonstrates the good usability of the new customized Sanoia interface for patients with ITP. Additional studies will increase its usability further, and its interface could be adapted for use with other rare chronic diseases.
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Affiliation(s)
- Laurent Chiche
- Service de Médecine Interne, Centre de Compétence pour la prise en charge des Cytopénies Auto-immunes, Hôpital de la Conception, Marseille
- Correspondence: Laurent Chiche, Service de Médecine Interne, CHU Conception, 147 Boulevard Baille, 13005 Marseille, France, Tel +33 49138 3762, Fax +33 49 138 3768, Email
| | - Alessandra Brescianini
- Service de Médecine Interne, Centre de Compétence pour la prise en charge des Cytopénies Auto-immunes, Hôpital de la Conception, Marseille
| | - Julien Mancini
- Service de Santé Publique, Hôpital de la Timone, Marseille
| | - Hervé Servy
- Association AIMSU, Maison des Associations, La Ciotat, France
| | - Jean-Marc Durand
- Service de Médecine Interne, Centre de Compétence pour la prise en charge des Cytopénies Auto-immunes, Hôpital de la Conception, Marseille
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17
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Brah S, Chiche L, Fanciullino R, Bornet C, Mancini J, Schleinitz N, Jean R, Kaplanski G, Harlé JR, Durand JM. Efficacy of rituximab in immune thrombocytopenic purpura: a retrospective survey. Ann Hematol 2011; 91:279-85. [PMID: 21710166 DOI: 10.1007/s00277-011-1283-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 06/15/2011] [Indexed: 11/30/2022]
Abstract
We conducted a retrospective survey to assess prescription practice, response rates to rituximab, and the predictive indicators for a response to rituximab therapy in patients with primary or secondary immune thrombocytopenic purpura (ITP). Data were collected retrospectively from 40 consecutive patients with ITP attending our hospital: 29 (72.5%) had primary ITP and 11 (27.5%) had secondary ITP. Rituximab was given either as four weekly injections (375 mg/m(2)) or two injections of 1,000 mg given 2 weeks apart in 30 and 10 patients, respectively. The primary objective was to evaluate overall (OR) and complete response (CR) to rituximab therapy for ITP. OR was excellent and rapid and similar when secondary ITP was excluded from the analysis: OR was achieved in 28 (71.8%) patients and CR in 22 (56.4%). But, at >6 months, of the 28 responders, only 10 of 22 of the evaluable responses (45.5%) were sustained. In addition, except for the nonsignificant occurrence of antinuclear antibodies, no clinical or biological factors were predictive for OR or CR after the rituximab therapy. Twelve patients received a second course of rituximab. Overall, rituximab therapy achieved a response in two thirds of the patients, but the responders exhibited a high rate of early relapses, with no obvious difference according to the regimen of administration or rituximab dose.
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Affiliation(s)
- Souleymane Brah
- Service de Médecine Interne, Hôpital Universitaire de la Conception, Centre de Compétence des Cytopénies Auto-immunes PACA Ouest, 147 Bd Baille, 13005, Marseille, France
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18
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Chiche L, Cournac JM, Mancini J, Bardin N, Thomas G, Jean R, Schleinitz N, Kaplanski G, Durand JM, Boucraut J, Harlé JR. Normalization of serum-free light chains in patients with systemic lupus erythematosus upon rituximab treatment and correlation with biological disease activity. Clin Rheumatol 2011; 30:685-9. [PMID: 21221683 DOI: 10.1007/s10067-010-1674-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 12/11/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
Abstract
Increased free light chain (FLC) levels have been reported as useful in various autoimmune conditions. We investigated how FLC concentrations change upon B cell targeted therapy in systemic lupus erythematosus (SLE) patients and if they correlate with disease activity. We retrospectively studied 11 SLE patients without renal failure, whom were treated with rituximab. Quantitative determination of IgG, IgA, IgM, and serum FLC was performed before and after rituximab. At baseline, 70% had abnormal serum FLC levels, including increased kappa and lambda levels, while the kappa/lambda ratio was normal for all. A strong correlation was observed between complement C3 fraction and kappa levels (r = -0.929, P < 0.001) or lambda levels (r = -0.854, P = 0.003), but not with IgG, IgA, or IgM levels. After rituximab treatment, kappa and lambda FLC concentrations decreased significantly whilst total concentrations of IgG, IgA, and IgM also decreased but remained within the normal range. There was a strong correlation only between kappa FLC levels and complement C3 fraction consumption (r = -0.543, P = 0.003). In SLE patients without renal failure, increased FLC levels (mainly kappa) with normal kappa/lambda ratios are a common feature, and in contrast to total IgG levels, FLC concentrations correlate with biological disease activity.
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Affiliation(s)
- L Chiche
- Department of Internal Medicine, Hôpital de la Conception, 147 Bd Baille, 13005, Marseille, France.
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Granel B, Argiro L, Hachulla E, Fajardy I, Weiller PJ, Durand JM, Frances Y, Dombey AM, Marquet S, Lesavre N, Disdier P, Bernard F, Hatron PY, Chevillard C. Association between a CTGF gene polymorphism and systemic sclerosis in a French population. J Rheumatol 2009; 37:351-8. [PMID: 20032097 DOI: 10.3899/jrheum.090290] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc) is a life-threatening autoimmune disease characterized by chronic fibrosis of the skin and internal organs. Connective tissue growth factor (CTGF) is believed to be a primary mediator of chronic fibrosis. We assessed the possible association between 7 single-nucleotide polymorphisms (SNP) in the CTGF gene and scleroderma in a French population (registration number 2006/0182). METHODS We conducted a case-control study with 241 scleroderma patients and 269 controls. Seven SNP were genotyped using the TaqMan system. Univariate and multivariate analyses were performed. In silico electrophoretic mobility shift assay (EMSA), and reverse transcriptase polymerase chain reaction analyses were done to assess the effect of the SNP on CTGF gene expression. RESULTS The frequency of the rs9399005TT genotype was significantly lower in SSc patients than in controls. This association remained significant after adjustment for gender. An association was detected between the rs9399005 and the diffuse and limited cutaneous forms. Multivariate analysis between SSc patients and controls taking into account all 7 SNP and sex revealed that only sex and the rs9399005 SNP were associated with disease. DNA analysis by EMSA indicated that the T allele bound nuclear factors that were also bound by the C allele. The binding affinity was higher for the T allele. Analysis of the human database and experiments with human hepatocyte cell line indicated the existence of an alternative transcript containing the rs9399005 polymorphism in its 3'UTR region. In silico analysis indicated that this polymorphism may alter the structure of CTGF messenger RNA. CONCLUSION These findings suggest that CTGF gene polymorphisms may contribute to susceptibility to scleroderma.
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Affiliation(s)
- Brigitte Granel
- INSERM, U906, (Institut Nationale de la Santé et de la Recherche Médicale), Laboratoire d'Immunologie et de Génétique des Maladies Parasitaires, Faculté de Médecine, Université de la Méditerranée (UM) Service de Médecine Interne, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille (AP-HM), UM, Marseille, France.
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Branger S, Daumas A, Hadamou A, Jean R, Chiche L, Durand JM, Crétel E. JAW CLAUDICATION AS AN ATYPICAL MANIFESTATION OF AORTIC THORACIC DISSECTION IN ELDERLY PEOPLE. J Am Geriatr Soc 2008; 56:1160-1. [DOI: 10.1111/j.1532-5415.2008.01697.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Borentain P, Grandval P, Ananian P, Meunier-Carpentier S, Gérolami R, Escoffier JM, Durand JM, Botta-Fridlund D, Bernardini D. [Pancreatic tuberculosis: an unusual cause of obstructive jaundice accessible to endoscopic management]. ACTA ACUST UNITED AC 2008; 31:1024-7. [PMID: 18166900 DOI: 10.1016/s0399-8320(07)78325-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Tuberculosis of the pancreas is unusual and often secondary to generalized tuberculosis. In most cases clinical presentation is obstructive jaundice due to pancreatic mass lesion. Although diagnosis is usually obtained after resection of the mass lesion, endoscopic procedures might avoid non-necessary surgical procedure. We report a clinical case of pancreatic tuberculosis diagnosed by endoscopic ultrasound guided fine needle aspiration biopsy and treated by biliary stenting.
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Affiliation(s)
- Patrick Borentain
- (1) Service d'hépatogastroentérologie, Hôpital de la Conception, Marseille.
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22
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Chiche L, Thomas G, Canavese S, Branger S, Jean R, Durand JM. Severe hemorrhagic syndrome due to similarity of drug names. Eur J Intern Med 2008; 19:135-6. [PMID: 18249310 DOI: 10.1016/j.ejim.2007.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Accepted: 03/09/2007] [Indexed: 11/16/2022]
Abstract
The names of many drugs look or sound like those of other drugs, which leads to confusion and potentially harmful medication errors. We report a nearly fatal permutation between two drugs including a vitamin K antagonist that resulted in a 68-year-old man being admitted to the emergency department with severe, spontaneous hemorrhagic syndrome. Such problems can be alleviated through actions by regulatory agencies, pharmaceutical manufacturers, health care professionals, and patients.
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Affiliation(s)
- L Chiche
- Service de Médecine Interne, Hôpital de la Conception, 147 bd Baille, 13005 Marseille, France.
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23
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Granel B, Allanore Y, Chevillard C, Arnaud V, Marquet S, Weiller PJ, Durand JM, Harlé JR, Grange C, Frances Y, Berbis P, Gaudart J, de Micco P, Kahan A, Dessein A. IL13RA2 gene polymorphisms are associated with systemic sclerosis. J Rheumatol 2006; 33:2015-9. [PMID: 16981293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To investigate the influence of genetic variability on the phenotypic expression of systemic sclerosis (SSc), by testing possible associations between single nucleotide polymorphisms (SNP) in IL13RA1 and IL13RA2 genes and SSc in a Caucasian population. METHODS As IL13RA1 and IL13RA2 are located on the X chromosome and SSc occurs far more frequently in women than in men, only women were genotyped. The study group comprised 97 women with SSc, 36 with diffuse (dcSSc) and 61 with limited (lcSSc) cutaneous forms of disease, and 109 healthy controls. Patients and controls were Caucasian. We investigated 4 SNP in IL13RA1 and 3 in IL13RA2 by polymerase chain reaction amplifications and enzymatic digestion or primer extension reactions and denaturing high-performance liquid chromatography. RESULTS We detected an association between IL13RA2 rs638376 and patients with SSc [p = 0.004, odds ratio (OR) = 1.85, confidence interval (CI) 1.22-2.74, p corr = 0.02], as well as with dcSSc in that subgroup of patients (p = 0.01, OR 2.22, 95% CI 1.27-3.89, p corr = 0.05). The IL13RA2 rs638376G allele frequency was higher in patients with SSc (51.6%) than in controls (36.4%, p = 0.003, OR 1.86, 95% CI 1.24-2.79, p corr = 0.015) and in the subgroup with dcSSc (57.6%) than in controls (36.4%, p = 0.003, OR 2.37, 95% CI 1.35-4.15, p corr = 0.015). One other IL13RA2 SNP was only associated with the dcSSc subgroup: the IL13RA2 rs5946040G allele was more common in patients with dcSSc (33.8%) than in controls (17%, p = 0.004, OR 2.5, 95% CI 1.36-4.60, p corr = 0.02). CONCLUSION Our data suggest that IL13RA2 gene polymorphisms may be involved in susceptibility to SSc. Further studies are under way to show that they contribute to disease.
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Affiliation(s)
- Brigitte Granel
- Laboratoire d'Immunologie et de Génétique des Maladies Parasitaires, Université de la Méditerranée - Faculté de Médecine de La Timone, 27 boulevard Jean Moulin, 13385 Marseille Cedex 05, France.
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Granel B, Chevillard C, Allanore Y, Arnaud V, Cabantous S, Marquet S, Weiller PJ, Durand JM, Harlé JR, Grange C, Frances Y, Berbis P, Gaudart J, de Micco P, Kahan A, Dessein A. Evaluation of interleukin 13 polymorphisms in systemic sclerosis. Immunogenetics 2006; 58:693-9. [PMID: 16832637 DOI: 10.1007/s00251-006-0135-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [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: 02/13/2006] [Accepted: 05/23/2006] [Indexed: 10/24/2022]
Abstract
Systemic sclerosis (SSc) is a multisystem disease of unknown etiology. It is characterized by excessive cutaneous and visceral fibrosis, damage to small blood vessels, and production of autoantibodies. Interleukin-13 (IL-13) has been shown to be involved in abnormal fibrosis in other diseases. Therefore, we have evaluated its possible involvement in SSc. We analyzed four IL13 gene polymorphisms, rs1800925 (IL13-1055), rs20541 (Arg130Gln), rs847, and rs2243204 in 107 unrelated SSc patients (40 patients having diffuse cutaneous form and 67 patients having limited cutaneous form) and in 170 controls. All subjects were Caucasians. In the total patient population and in the diffuse cutaneous subset, we observed an association between two IL13 polymorphisms, IL13 rs1800925 (IL13-1055), and IL13 rs2243204, and disease (p=0.03-0.04). The IL13 rs2243204T allele was more common in SSc patients (p=0.01, OR=2.3 CI 1.21-4.38) and in the diffuse cutaneous form (p=0.01, OR=2.95, CI 1.35-6.49) than in control subjects. Our result supports the suggestion that polymorphisms in IL13 are associated to SSc and skin fibrosis process. However, further studies on larger and independent population and functional analyses are needed to confirm these findings.
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Affiliation(s)
- Brigitte Granel
- Laboratoire d'Immunologie et de Génétique des Maladies Parasitaires, UMR 399 INSERM, Université de la Méditerranée, Faculté de Médecine, 13005, Marseille, France.
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Chandesris MO, Durand JM, Gamby T, Saadallah-Bouchemot N, Jean R, Figarella-Branger D, Crétel-Durand E. Dermatomyosite avec nécroses cutanées révélatrice d'un cancer de la trompe utérine. Rev Med Interne 2005; 26:508-10. [PMID: 15936479 DOI: 10.1016/j.revmed.2005.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2004] [Accepted: 01/05/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Adult dermatomyositis is a rare inflammatory myopathy associated with typical cutaneous lesions and an increased incidence of internal malignancies, notably cancers of the female genital tract. Nevertheless, fallopian tube carcinoma is exceptionally associated with dermatomyositis. EXEGESIS We report an unusual case of dermatomyositis because of cutaneous necrosis revealing a cancer of the fallopian tube. CONCLUSION Predictive factors of cancer can improve prognosis of dermatomyositis due to earlier diagnosis of associated cancer. In our observation as in literature review, cutaneous necrosis lesions are highly predictive of an associated neoplasia even as rare as a fallopian tube carcinoma.
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Affiliation(s)
- M-O Chandesris
- Service de médecine interne, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille cedex 08, France
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Jean R, Bastard E, Cretel E, Lefèvre P, Durand JM. Intravenous immunoglobulin and antiphospholipid syndrome: Comment on the article by Erkan et al. ACTA ACUST UNITED AC 2004; 50:2711; author reply 2711-3. [PMID: 15334491 DOI: 10.1002/art.20387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chotel F, Parot R, Durand JM, Garnier E, Hodgkinson I, Bérard J. [Initial management of congenital varus equinus clubfoot by Ponseti's method]. Rev Chir Orthop Reparatrice Appar Mot 2002; 88:710-7. [PMID: 12457118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The choice of first-line treatment for congenital varus equine clubfoot remains a controversial issue largely dependent on experience. In France, functional treatment predominates. In 1948, Ponseti proposed reducing the deformity with successive casts. Although cast treatment is a very old method, Ponseti's method is original because it is based on strict rules established from anatomic evidence. The goal is not to correct the apparent deformation, but on the contrary to impose a simultaneous supination and abduction of the foot. Once the calcaneopedal block has been derotated, percutaneous tenotomy of the Achilles tendon is performed. We relate our experience with this method and recall the precise technique used to make the casts. After the cast, derotation braces are worn at night but rehabilitation exercises are not required. We emphasize the quality of the clinical reduction achieved as well as the smaller number of patients who require surgery at walking age.
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Affiliation(s)
- F Chotel
- Service Chirurgie Pédiatrique, Hôpital Debrousse, 29, rue Soeur-Bouvier, 69322 Lyon Cedex 05, France.
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Kaplanski G, Marin V, Maisonobe T, Sbai A, Farnarier C, Ghillani P, Thirion X, Durand JM, Harlé JR, Bongrand P, Piette JC, Cacoub P. Increased soluble p55 and p75 tumour necrosis factor-alpha receptors in patients with hepatitis C-associated mixed cryoglobulinaemia. Clin Exp Immunol 2002; 127:123-30. [PMID: 11882042 PMCID: PMC1906273 DOI: 10.1046/j.1365-2249.2002.01728.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [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] [Indexed: 01/26/2023] Open
Abstract
To investigate whether tumour necrosis factor alpha (TNFalpha) plays a role in the pathogenesis of hepatitis C virus-associated mixed cryoglobulinaemia (HCV-MC), we measured soluble TNFalpha and its soluble p55 (sTNFR1) and p75 (sTNFR2) receptors in the serum of patients with HCV-MC. TNFalpha, sTNFR1 and sTNFR2 were measured in the serum of 32 patients with HCV-MC, 18 patients with hepatitis C without MC (HCV) and 18 healthy volunteers, using specific immunoassays. Correlations between clinical and biological parameters and the concentrations of TNFalpha and sTNFRs were established by studying detailed clinical records of the 32 HCV-MC patients. Although higher, TNFalpha levels were not significantly different in HCV-MC patients compared with healthy or HCV controls. sTNFR1 and sTNFR2, however, were significantly higher in HCV-MC compared with controls or with HCV patients, and higher concentrations of sTNFR1 and sTNFR2 were observed in patients with severe visceral vasculitis, compared with patients with limited purpura. sTNFR1 concentrations positively correlated with fibrinogen levels but TNFalpha, sTNFR1 and sTNFR2 did not correlate with other biological parameters such as rheumatoid factor concentrations, CH50 or C4 values. These data suggest a role for TNFalpha in the pathogenesis of the immune complex-mediated vasculitis associated with HCV-MC.
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MESH Headings
- Aged
- Aged, 80 and over
- Antigen-Antibody Complex
- Antigens, CD/blood
- Antigens, CD/immunology
- Cryoglobulinemia/blood
- Cryoglobulinemia/etiology
- Cryoglobulinemia/immunology
- Female
- Hepatitis C/blood
- Hepatitis C/complications
- Hepatitis C/immunology
- Humans
- Male
- Middle Aged
- Receptors, Tumor Necrosis Factor/blood
- Receptors, Tumor Necrosis Factor/immunology
- Receptors, Tumor Necrosis Factor, Type I
- Receptors, Tumor Necrosis Factor, Type II
- Vasculitis, Leukocytoclastic, Cutaneous/etiology
- Vasculitis, Leukocytoclastic, Cutaneous/immunology
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Affiliation(s)
- G Kaplanski
- INSERM U387, Hôpital Sainte-Marguerite, Marseille, France.
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Abstract
Silicone-induced connective tissue disease raises a controversial issue. We report a case of Still's disease associated with silicone and collagen implants that showed improvement on steroids, but remained steroid-dependent despite removal of the silicone implants. This observation complements four previous cases in the literature and questions the role of breast implants in the pathogenesis of Still's disease. The number of cases studied is insufficient for conclusions, but silicone-implant-associated syndrome may be confused with Still's disease. We consequently propose the use of ferritinemia and its serum glycosylated fraction level as discriminating factors. Collagen has been associated with some inflammatory diseases, but never previously with Still's disease. However, considering this observation and previous data in the literature, its role may be postulated as an exacerbating factor or a pathogenic agent.
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Affiliation(s)
- E Crétel
- Service de Médecine Interne, H pital Sainte-Marguerite, France
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Beguin L, Feugier P, Durand JM, Chalencon F, Gresta G, Fessy MH. [Vascular risk and total hip arthroplasty]. Rev Chir Orthop Reparatrice Appar Mot 2001; 87:489-98. [PMID: 11547236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
PURPOSE OF THE STUDY Though exceptional, there is a real risk of vascular complications during total hip arthroplasty procedures. The gravity of these iatrogenic accidents results from their high mortality (7%) and possible functional sequelae (19%). MATERIAL AND METHOD We report a retrospective multicenter study of 14 vascular complications, six of which occurred during revision surgery for total hip arthroplasty. We assessed risk factors and identified situations of major risk related to acetabular revision: intrapelvic dislocation, protrusion with no bony barrier, and presence of intrapelvic foreign bodies. We advocate the retroperitoneal approach for acetabular revision in case of intrapelvic dislocation or anomalous vessel size or trajectory on the preoperative arteriography. This approach allows ablation of the implants under visual control of the iliac vessels. RESULTS AND DISCUSSION A careful preoperative work-up is essential to avoid arterial or venous injury. A perfect knowledge of the vessel trajectories and their projection on the acetabulum is crucial. Indeed, such vascular complications are never expected and transform a well-programmed functional procedure into an emergency procedure with the inherent risks. We recall that such accidents may be expressed well after closing and the importance of careful surveillance before, during and after the surgical procedure.
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Affiliation(s)
- L Beguin
- Centre d'Orthopédie-Traumatologie, Pavillon 1-3, Hôpital Bellevue, CHRU de Saint-Etienne, 42055 Saint-Etienne Cedex 2
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Genty I, Jean R, Cretel E, Xeridat B, Astoul P, Poulain P, Lefevre P, Gastaut JA, Durand JM. [Thymoma and disseminated lupus erythematosus. Two new cases and review of the literature]. Rev Med Interne 2001; 22:475-84. [PMID: 11402520 DOI: 10.1016/s0248-8663(01)00374-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Thymoma is a tumour originating in the epithelial cells of the thymus, associated with several immunologic disorders. The association of thymoma with systemic lupus erythematosus has rarely been described. We report two cases of this association. EXEGESIS Description of two cases and a review of the literature. Mr T. was 41 years old when the diagnosis of thymoma and lupus was made. The thymectomy did not influence the evolution of his lupus. Mrs G. had been treated because of a lupus for 8 years prior to developing a thymoma. One year later she presented with erythroblastopenia, which was only sensitive to cyclosporin. CONCLUSION The association between lupus and thymoma has been reported in 36 cases in the literature. Thymoma is benign in 59% of the cases. The clinical presentation of lupus is nonspecific except for age, median 48 years, and sex ratio, 4:3. The clinical outcome of the lupus is not influenced by the thymectomy. Thymoma may precede lupus with a delay of several years or it may be diagnosed concurrently or several years later. This association is not accidental, though the pathogenic link between these conditions remains unknown. One could suppose that the decrease of the thymic function in the course of thymoma could enhance the expression of autoreactive T lymphocytes as well as the activation of B cells. Patients should be followed after thymectomy because autoimmune diseases, particularly lupus, may develop belatedly. On the other hand, thymoma may be suspected mainly when lupus occurs in patients around 50 years of age.
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Affiliation(s)
- I Genty
- Service de médecine interne, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille, France
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Retornaz F, Seux V, Arnoulet C, Durand JM, Sainty D, Soubeyrand J. Plasmodium falciparum malaria infection complicated by haemophagocytic syndrome in an old man. Acta Haematol 2001; 103:224-5. [PMID: 11014899 DOI: 10.1159/000041055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- F Retornaz
- Department of Internal Medicine, Centre Hospitalier Régional et Universitaire, Hôpital de Sainte-Marguerite, Marseille, France
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Jean R, Genty I, Crétel E, Durand JM. Acute tubulointerstitial nephritis associated with panuveitis. Nephron Clin Pract 2000; 86:381-2. [PMID: 11096314 DOI: 10.1159/000045812] [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: 11/19/2022] Open
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36
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Retornaz F, Durand JM, Poullin P, Lefèvre P, Soubeyrand J. [Idiopathic thrombotic thrombocytopenic purpura or Moschowitz syndrome: current physiopathologic and therapeutic perspectives]. Rev Med Interne 2000; 21:777-84. [PMID: 11039173 DOI: 10.1016/s0248-8663(00)00223-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The objective of this work was to review current data about the physiopathology, clinical features, and treatment of thrombotic thrombocytopenic purpura (Moschowitz's syndrome). CURRENT KNOWLEDGE AND KEY POINTS Thrombotic thrombocytopenic purpura is a rare disorder characterized by widespread thrombotic injuries of platelets in the microcirculation. Its physiopathology has been elucidated recently. Evidence of a deficiency of Von Willebrand's factor-cleaving protease would be due to either IgG antibodies in the acute form of the disease or constitutional deficiency in the chronic form of the disease. FUTURE PROSPECTS AND PROJECTS Plasma exchange is the current reference treatment. However, in the light of recent publications, either infusions of concentrates of purified enzyme or more intensive immunosuppressive therapy would be more specific.
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Affiliation(s)
- F Retornaz
- Service de médecine interne, hôpital de Sainte-Marguerite, CHRU, Marseille, France
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Graffin B, Genty I, Crétel E, Jean R, Drancourt M, Durand JM. [Erythema nodosum in cat scratch disease]. Presse Med 2000; 29:1125. [PMID: 10901791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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39
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Retornaz F, Jean-Pastor MJ, Monestier S, Durand JM, Soubeyrand J. Recurrent calcium oxalate nephrolithiasis induced by naftidrofuryl oxalate. Nephron Clin Pract 2000; 85:92. [PMID: 10773762 DOI: 10.1159/000045636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
INTRODUCTION Ovarian hemorrhage with hemoperitoneum is a rare but serious complication of ovulation related to rupture of either the corpus luteum or functional cyst. It is due to treatment using oral indirect anticoagulant and specifically affects young women. CURRENT KNOWLEDGE AND KEY POINTS We review cases that were reported since the initial description by Weseley in 1957. The main indications for oral indirect anticoagulant are thrombophlebitis and valvular cardiac prosthesis. Pelvic pain with peritoneal irritation is the most common symptom in more than one third of the patients. An initial collapse is reported in 22% of the cases. Surgery is the main treatment. Mortality is 3% and recurrences occur in nearly 25% of the patients. FUTURE PROSPECTS AND PROJECTS Potential ovarian hemorrhage should be investigated when a woman taking oral indirect anticoagulant develops acute abdominal pain. Surgery should be conservative and whenever possible, should include celioscopy. Systematic ovarian blockade should be discussed in women taking long-term oral indirect anticoagulant.
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Affiliation(s)
- E Crétel
- Service de médecine interne, hôpital de la Pitié-Salpêtrière, Paris, France
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41
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Durand JM, Jean R, Cretel E. Antiphospholipid antibody syndrome associated with hepatitis C infection. J Rheumatol 2000; 27:823-4. [PMID: 10743837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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42
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Graffin B, Chouquet D, Genty I, Crétel E, Retornaz F, Choux R, Durand JM. [Cryptogenic chronic cytolysis: think about celiac disease]. Rev Med Interne 2000; 21:206. [PMID: 10703085 DOI: 10.1016/s0248-8663(00)88258-2] [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: 10/18/2022]
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Durand JM, Dagberg B, Uhlin BE, Björk GR. Transfer RNA modification, temperature and DNA superhelicity have a common target in the regulatory network of the virulence of Shigella flexneri: the expression of the virF gene. Mol Microbiol 2000; 35:924-35. [PMID: 10692168 DOI: 10.1046/j.1365-2958.2000.01767.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Full expression of the virulence genes of Shigella flexneri requires the presence of two modified nucleosides in the tRNA [queuosine, Q34, present in the wobble position (position 34) and 2-methylthio-N6-isopentenyladenosine (ms2i6A37, adjacent to and 3' of the anticodon)]. The synthesis of these two nucleosides depends on the products of the tgt and miaA genes respectively. We have shown that the intracellular concentration of the virulence-related transcriptional regulator VirF is reduced in the absence of either of these modified nucleosides. The intracellular concentration of VirF is correlated with the expression of the virulence genes. Overproduction of VirF in the tgt and the miaA mutants suppressed the less virulent (tgt) or the avirulent (miaA) phenotypes respectively, caused by the tRNA modification deficiency. This suggests that the primary result of undermodification of the tRNA is a poor translation of virF mRNA and not of any other mRNA whose product acts downstream of the action of VirF. Shigella showed no virulence phenotypes at 30 degrees C, but forced synthesis of VirF at 30 degrees C induced the virulence phenotype at this low temperature. In addition, removal of the known gene silencer H-NS by a mutation in its structural gene hns increased the synthesis of VirF at low temperature and thus induced a virulent phenotype at 30 degrees C. Conversely, decreased expression of VirF at 37 degrees C induced by the addition of novobiocin, a known inhibitor of gyrase, led to an avirulent phenotype. We conclude that tRNA modification, temperature and superhelicity have the same target - the expression of VirF - to influence the expression of the central regulatory gene virB and thereby the virulence of Shigella. These results further strengthen the suggestion that the concentration of VirF is the critical factor in the regulation of virulence in Shigella. In addition, they emphasize the role of the bacterial translational machinery in the regulation of the expression of virulence genes which appears here quantitatively as important as the well-established regulation on the transcriptional level.
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Affiliation(s)
- J M Durand
- Department of Microbiology, Umeå University, S-90187 Umeå, Sweden
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Kaplanski G, Cacoub P, Farnarier C, Marin V, Grégoire R, Gatel A, Durand JM, Harlé JR, Bongrand P, Piette JC. Increased soluble vascular cell adhesion molecule 1 concentrations in patients with primary or systemic lupus erythematosus-related antiphospholipid syndrome: correlations with the severity of thrombosis. Arthritis Rheum 2000; 43:55-64. [PMID: 10643700 DOI: 10.1002/1529-0131(200001)43:1<55::aid-anr8>3.0.co;2-m] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Recent studies have shown that in vitro endothelial cells are activated by antiphospholipid antibodies and may support leukocyte adhesion. We studied levels of soluble intercellular adhesion molecule 1 (sICAM-1, sCD54), soluble vascular cell adhesion molecule 1 (sVCAM-1, sCD106), and soluble E-selectin (soluble endothelial leukocyte adhesion molecule 1 [sELAM-1, sCD62E]) in sera from patients with primary antiphospholipid syndrome (primary APS), and compared them with those from patients with systemic lupus erythematosus-associated APS (SLE-APS) or pure SLE, as well as with those from 2 control groups composed of healthy volunteers and patients with thrombosis unrelated to autoimmune diseases. METHODS Serum samples from 24 patients with primary APS, 15 patients with SLE-APS, 22 patients with pure SLE, 48 control patients with thrombosis, and 18 healthy volunteers were examined using enzyme-linked immunosorbent assays specific for sICAM-1, sVCAM-1, and sELAM-1. RESULTS Serum levels of sVCAM-1, but not sICAM-1 or sELAM-1, were significantly increased in all patient study groups compared with thrombosis control patients and healthy volunteers, but did not differ between the groups of patients with primary APS, SLE-APS, or pure SLE. Concentrations of sVCAM-1 were significantly higher in primary APS or SLE-APS patients with severe, recurrent thrombosis and were negatively correlated with platelet counts in primary APS patients. In patients with primary APS, sVCAM-1 levels were higher if there was thrombotic kidney involvement and correlated with creatinemia. CONCLUSION Serum sVCAM-1 concentrations are increased in patients with primary APS, especially those with repeated thrombotic events or kidney involvement. These findings suggest that endothelial/ monocyte interaction may be important in the pathogenesis of primary APS.
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Affiliation(s)
- G Kaplanski
- Hôpital Sainte-Marguerite and Hôpital de la Conception, Marseille, France
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Durand JM, Crétel E, Jean R, Genty I. [Neurologic complications of Gougerot-Sjögren syndrome]. Presse Med 1999; 28:1820. [PMID: 10584115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
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Retornaz F, Niamkey E, Kadjo K, Durand JM, Soubeyrand J. Acute tubulointerstitial nephritis and uveitis with angiotensin-converting enzyme increase. Nephron Clin Pract 1999; 83:284. [PMID: 10529642 DOI: 10.1159/000045528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
INTRODUCTION Microscopic colitis describes a subset of patients with chronic watery diarrhea of unknown origin, and normal endoscopic findings and microscopic evidence of an inflammatory infiltrate in the colonic mucosa. We report two cases associated with sicca syndrome. EXEGESIS A 56-year-old woman and a 76-year-old man presented with a history of lymphocytic colitis associated with sicca syndrome. Drugs or infectious agents were not implicated in the cause of lymphocytic colitis, suggesting that sicca syndrome may be involved in the pathogenesis of microscopic colitis. CONCLUSION These cases suggest that sicca syndrome should be detected in patients with lymphocytic colitis.
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Affiliation(s)
- R Jean
- Service de médecine interne, hôpital Sainte-Marguerite, Marseille, France
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Durand JM, Salas S, Gauthier C, Crétel E, Jean R, Lacroze V, D'Ercole C, Retornaz F, Soubeyrand J. [Danger of anti-erythrocyte antibodies during pregnancy]. Rev Med Interne 1999; 20:693-5. [PMID: 10480172 DOI: 10.1016/s0248-8663(99)80489-5] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Red cell autoantibodies are very rarely observed in pregnant women. We report one case related to the presence of a lupus anticoagulant. EXEGESIS A 32-year-old woman had a history of two intrauterine deaths that had occurred at weeks 32 and 33, respectively. Due to the presence of a lupus anticoagulant, prednisone (20 mg/day) and subcutaneous calcium heparin were administered during her third pregnancy. The direct antiglobulin test remained positive throughout the pregnancy; however, hemolysis could not be detected. Caesarean section was done in emergency at week 29, due to fetal bradycardia related to severe fetal hemolysis. CONCLUSION When autoimmune hemolysis occurs during pregnancy, risks for the fetus increase with the severity of hemolysis in the mother. It is thought that child mortality reflects the existence of anemia, rather than the existence of hemolysis. Our observation suggests that severe fetal hemolysis may occur, despite the absence of hemolysis in the mother.
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Affiliation(s)
- J M Durand
- Service de médecine interne, hôpital Sainte-Marguerite, Marseille
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