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Rohmer J, Couteau‐Chardon A, Trichereau J, Panel K, Gesquiere C, Ben Abdelali R, Bidet A, Bladé J, Cayuela J, Cony‐Makhoul P, Cottin V, Delabesse E, Ebbo M, Fain O, Flandrin P, Galicier L, Godon C, Grardel N, Guffroy A, Hamidou M, Hunault M, Lengline E, Lhomme F, Lhermitte L, Machelart I, Mauvieux L, Mohr C, Mozicconacci M, Naguib D, Nicolini FE, Rey J, Rousselot P, Tavitian S, Terriou L, Lefèvre G, Preudhomme C, Kahn J, Groh M, Ackermann F, Adiko D, Ahwij N, Baruchel A, Beal C, Bemba M, Beylot Barry M, Beyne Rauzy O, Bielefeld P, Boisseau M, Bonmati C, Bonnote B, Borel C, Bouredji D, Brignier A, Brouillard M, Campos F, Carre M, Chalayer E, Chomel JC, Coiteux V, Contejean A, Corby A, Darre S, Dubruille V, Durel CA, El Yamani A, Etancelin P, Etienne N, Evon P, Gyan E, Hachulla E, Hermet M, Huguet F, Ianotto JC, Inchiappa L, Jdid I, Jondeau K, Joubert M, Legrand F, Lejeune C, Le Pendu C, Lidove O, Lemal R, Limal N, Lopinet E, Maloisel F, Marfaing A, Marroun I, Maurier F, Muller E, Muron T, Ojeda M, Paule R, Pignon JM, Rossi C, Roumier M, Sene D, Sene T, Simon L, Slama B, Suarez F, Tcherakian C, Torregrosa JM, Toussaint E, Vatan R, Visanica S, Voilat L, Zini JM. Epidemiology, clinical picture and long-term outcomes of FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia: Data from 151 patients. Am J Hematol 2020; 95:1314-1323. [PMID: 32720700 DOI: 10.1002/ajh.25945] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022]
Abstract
FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia (F/P+ MN-eo) is a rare disease: robust epidemiological data are lacking and reported issues are scarce, of low sample-size and limited follow-up. Imatinib mesylate (IM) is highly efficient but no predictive factor of relapse after discontinuation has yet been identified. One hundred and fifty-one patients with F/P+ MN-eo (143 males; mean age at diagnosis 49 years; mean annual incidence: 0.18 case per million population) were included in this retrospective nationwide study involving all French laboratories who perform the search of F/P fusion gene (study period: 2003-2019). The main organs involved included the spleen (44%), skin (32%), lungs (30%), heart (19%) and central nervous system (9%). Serum vitamin B12 and tryptase levels were elevated in 74/79 (94%) and 45/57 (79%) patients, respectively, and none of the 31 patients initially treated with corticosteroids achieved complete hematologic remission. All 148 (98%) IM-treated patients achieved complete hematologic and molecular (when tested, n = 84) responses. Forty-six patients eventually discontinued IM, among whom 20 (57%) relapsed. In multivariate analysis, time to IM initiation (continuous HR: 1,01 [0.99-1,03]; P = .05) and duration of IM treatment (continuous HR: 0,97 [0,95-0,99]; P = .004) were independent factors of relapse after discontinuation of IM. After a mean follow-up of 80 (56) months, the 1, 5- and 10-year overall survival rates in IM-treated patients were 99%, 95% and 84% respectively. In F/P+ MN-eo, prompt initiation of IM and longer treatment durations may prevent relapses after discontinuation of IM.
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Affiliation(s)
- Julien Rohmer
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine Hôpital Foch Suresnes France
| | - Amélie Couteau‐Chardon
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Intensive Care medicine Centre Hospitalier Annecy Genevois Saint‐Julien‐en‐Genevois France
| | - Julie Trichereau
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Clinical Research Department Hôpital Foch Suresnes France
| | - Kewin Panel
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Clinical Research Department Hôpital Foch Suresnes France
| | - Cyrielle Gesquiere
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
| | - Raouf Ben Abdelali
- Pole Hématologie et Oncologie Laboratoire CERBA Saint‐Ouen‐l'Aumône France
| | - Audrey Bidet
- Laboratory of Hematology CHU de Bordeaux Pessac France
| | | | - Jean‐Michel Cayuela
- Laboratory of Hematology Saint‐Louis Hospital, University of Paris Paris France
| | - Pascale Cony‐Makhoul
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Hematology Department CH Annecy Genevois Annecy France
| | - Vincent Cottin
- National Coordinating Reference Center for Rare Pulmonary Diseases Louis Pradel Hospital Lyon France
- Hospices Civils de Lyon, UMR754, University Claude Bernard Lyon 1 Lyon France
| | - Eric Delabesse
- Laboratory of Hematology Institut Universitaire du Cancer de Toulouse Oncopole, CHU de Toulouse Toulouse France
| | - Mikaël Ebbo
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Aix Marseille University, Department of Internal Medicine Hôpital de la Timone, AP‐HM, CNRS, INSERM, CIML Marseille France
| | - Olivier Fain
- Department of Internal Medicine CHU Saint Antoine Paris France
| | - Pascale Flandrin
- Laboratory of Hematology Hôpital Nord, CHU de Saint‐Étienne Saint‐Étienne France
| | - Lionel Galicier
- Department of Clinical Immunology Saint Louis hospital Paris France
| | - Catherine Godon
- Laboratoire de cytogénétique hématologique CHU de Nantes Nantes France
| | | | - Aurélien Guffroy
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (RESO), Tertiary Center for Primary Immunodeficiency Strasbourg University Hospital Strasbourg France
| | - Mohamed Hamidou
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine CHU de Nantes Nantes France
| | | | | | | | - Ludovic Lhermitte
- University of Paris, Institut National de Recherche Médicale U1151 Laboratory of Onco‐Hematology, Hôpital Necker Enfants‐Malades Paris France
| | - Irène Machelart
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine CHU de Bordeaux Bordeaux France
| | - Laurent Mauvieux
- Université de Strasbourg, INSERM U1113 Interface de Recherche Fondamentale et Appliquée en Cancérologie, Laboratoire d'hématologie du CHRU Strasbourg, Faculté de Médecine de Strasbourg Strasbourg France
| | - Catherine Mohr
- Service d'Hématologie Oncologie, CHU Groupe Hospitalier Sud Réunion Saint Pierre, Reunion France
| | - Marie‐Joelle Mozicconacci
- Institut Paoli‐Calmettes, Centre de Recherche en Cancérologie de Marseille, Biopathologie Marseille France
| | - Dina Naguib
- Laboratory of Hematology CHU Caen Caen France
| | - Franck E. Nicolini
- Department of Hematology INSERM U 1052, CRCL, Centre Léon Bérard Lyon France
| | - Jerome Rey
- Department of Hematology Institut Paoli‐Calmettes Marseille France
| | - Philippe Rousselot
- Hematology Department Versailles André Mignot Hospital, University Paris‐Saclay Le Chesnay France
| | - Suzanne Tavitian
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse‐Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Louis Terriou
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto‐immunes Systémiques Rares du Nord et Nord‐Ouest de France (CeRAINO) Lille France
| | - Guillaume Lefèvre
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto‐immunes Systémiques Rares du Nord et Nord‐Ouest de France (CeRAINO) Lille France
| | | | - Jean‐Emmanuel Kahn
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université Paris‐Saclay, Department of Internal Medicine Ambroise Paré hospital, Boulogne Billancourt Cedex France
| | - Matthieu Groh
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine Hôpital Foch Suresnes France
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Durel CA, Aouba A, Bienvenu B, Deshayes S, Coppéré B, Gombert B, Acquaviva-Bourdain C, Hachulla E, Lecomte F, Touitou I, Ninet J, Philit JB, Messer L, Brouillard M, Girard-Madoux MH, Moutschen M, Raison-Peyron N, Hutin P, Duffau P, Trolliet P, Hatron PY, Heudier P, Cevallos R, Lequerré T, Brousse V, Lesire V, Audia S, Maucort-Boulch D, Cuisset L, Hot A. Observational Study of a French and Belgian Multicenter Cohort of 23 Patients Diagnosed in Adulthood With Mevalonate Kinase Deficiency. Medicine (Baltimore) 2016; 95:e3027. [PMID: 26986117 PMCID: PMC4839898 DOI: 10.1097/md.0000000000003027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to describe the clinical and biological features of Mevalonate kinase deficiency (MKD) in patients diagnosed in adulthood. This is a French and Belgian observational retrospective study from 2000 to 2014. To constitute the cohort, we cross-check the genetic and biochemical databases. The clinical, enzymatic, and genetic data were gathered from medical records. Twenty-three patients were analyzed. The mean age at diagnosis was 40 years, with a mean age at onset of symptoms of 3 years. All symptomatic patients had fever. Febrile attacks were mostly associated with arthralgia (90.9%); lymphadenopathy, abdominal pain, and skin lesions (86.4%); pharyngitis (63.6%); cough (59.1%); diarrhea, and hepatosplenomegaly (50.0%). Seven patients had psychiatric symptoms (31.8%). One patient developed recurrent seizures. Three patients experienced renal involvement (13.6%). Two patients had angiomyolipoma (9.1%). All but one tested patients had elevated serum immunoglobulin (Ig) D level. Twenty-one patients had genetic diagnosis; most of them were compound heterozygote (76.2%). p.Val377Ile was the most prevalent mutation. Structural articular damages and systemic AA amyloidosis were the 2 most serious complications. More than 65% of patients displayed decrease in severity and frequency of attacks with increasing age, but only 35% achieved remission. MKD diagnosed in adulthood shared clinical and genetic features with classical pediatric disease. An elevated IgD concentration is a good marker for MKD in adults. Despite a decrease of severity and frequency of attacks with age, only one-third of patients achieved spontaneous remission.
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Affiliation(s)
- Cécile-Audrey Durel
- From the Internal Medicine Department, Edouard Herriot Hospital, Lyon (C-AD, BC, JN, M-HG-M, AH); Internal Medicine Department, Côte de Nacre Hospital, Caen (AA, BB, SD); Medicine and Rheumatology Department, Saint-Louis Hospital, La Rochelle (BG); Inborn Errors of Metabolism Laboratory, Civil Hospital of Lyon, Bron (CA-B); Internal Medicine Department, Claude Huriez Hospital, Lille (EH, P-YH); Polyvalent Medicine Department, Cornouaille Hospital Center, Quimper (FL, PH); Autoinflammatory Diseases Medical Unit, Arnaud Villeuneuve Hospital, Montpellier (IT); Nephrology Department, Metropole Savoie Hospital Center, Chambéry (J-BP); Rheumatology Department, Louis Pasteur Hospital, Colmar (LM); Hematology Department, Arras Hospital Center, Arras, France (MB); Internal Medicine Department, Sart Tilman, Liège, Belgique (MM); Dermatology and Allergology Department, Saint-Eloi Hospital, Montpellier (NR-P); Internal Medicine Department, Saint-André Hospital, Bordeaux (PD); Nephrology Department, Lyon Sud Hospital Center, Pierre-Bénite (PT); Hematology Department, Princesse Grace Hospital Center, Monaco (PH); Internal Medicine Department, Saint-Vincent Hospital Center, Strasbourg (RC); Rheumatology Department, Charles Nicole Hospital, Rouen (TL); Department of Pediatrics, Necker-Enfants Malades Hospital, Paris (VB); Diabetology and Internal Medicine Department, Blois Hospital Center, Blois (VL); Internal Medicine Department, Bocage Central, Dijon (SA); Service de Biostatistique, Hospices civiles de Lyon, Université de Lyon 1, Villeurbanne; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne (DM-B); and Department of Biochemical Genetics, Hospital and Institut Cochin, Paris (LC), France
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Bourgeois E, Caulier MT, Delarozee C, Brouillard M, Bauters F, Fenaux P. Long-term follow-up of chronic autoimmune thrombocytopenic purpura refractory to splenectomy: a prospective analysis. Br J Haematol 2003; 120:1079-88. [PMID: 12648082 DOI: 10.1046/j.1365-2141.2003.04211.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Splenectomy remains the most effective treatment of chronic autoimmune idiopathic thrombocytopenia (ITP) (i.e. of > 6 months duration). Treatment of patients refractory to splenectomy (with absence of response or relapse after initial response) is difficult, and their long-term outcome is not well known. Over a 10-year period, 183 patients with chronic ITP were splenectomized including 158 adults and 25 children (</= 15 years). Forty-seven of them, who were refractory to this treatment, were prospectively followed up for 5-15 years (median 7.5 years). Twelve of them, with moderate thrombocytopenia, remained untreated, and 35 were treated by a median of two regimens (range 1--6), to which 27 responded. Thirty-six (77%) of the refractory cases reached platelet counts durably > 100 x 10(9)/l, nine of them without treatment and 27 of them with low-dose steroids or azathioprine; six (13%) remained moderately thrombocytopenic (35 x 10(9)/l to 100 x 10(9)/l platelets); the last five patients, without response to any treatment (up to six regimens), remained severely thrombocytopenic (platelets < 20 x 10(9)/l), and three of them died from bleeding. Twenty-seven (57%) of the 47 refractory cases required at least one hospitalization, in the majority of cases for intravenous immunoglobulin (IVIg) infusions. Seven of the refractory cases occurred in children. Six of them subsequently reached platelet counts > 100 x 10(9)/l, but one died from bleeding. Our findings confirm the overall favourable long-term prognosis of chronic ITP refractory to splenectomy.
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Bonnel C, Wibaux F, Caulier M, Brouillard M, Delarozee C, Bauters F, Fenaux P. Devenir à long terme des échecs de la splénectomie dans le purpura thrombopénique auto-immun chronique. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)83356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wibaux F, Bonnel C, Hallez-Wassouf I, Loche V, Visticot F, Chevalier D, Hatron P, Wallaert B, Brouillard M. Manifestations ORL de la sarcoïdose : à propos de dix cas. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)83413-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Brouillard M, Gheerbrant JD, Gheysens Y, Fleury D, Devred M, Hazzan M, Colombel JF. [Chronic interstitial nephritis and mesalazine: 3 new cases?]. Gastroenterol Clin Biol 1998; 22:724-6. [PMID: 9823562] [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: 02/09/2023]
Abstract
We report three new cases of chronic interstitial nephritis occurring in two patients with Crohn's disease and one patient with ulcerative colitis treated with mesalazine. In the three cases asymptomatic renal disease was revealed by an increase in serum creatinine which was normal before treatment. Renal biopsy showed features of severe chronic interstitial nephritis. Mesalazine withdrawal and administration of steroids in two cases led to partial improvement of renal function. Mechanism of renal toxicity of mesalazine is unknown. These observations stress the need for monitoring renal function in patients with inflammatory bowel disease treated with mesalazine.
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Affiliation(s)
- M Brouillard
- Service de Médecine C, Centre Hospitalier, Arras
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Durand F, Gheerbrant JD, Reumaux D, Duthilleul P, Brouillard M. Micropolyangéite avec p-ANCA de type antimyéloperoxydase chez un patient silicosé. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80221-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brouillard M, Hatron PY, Gheerbrant JD, Derrien G, Hachulla E, Devulder B. Cystite interstitielle et connectivites: quatre cas dont deux associations inédites. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80243-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tillie-Leblond I, Wallaert B, Leblond D, Salez F, Perez T, Remy-Jardin M, Vanhille P, Brouillard M, Marquette C, Tonnel AB. Respiratory involvement in relapsing polychondritis. Clinical, functional, endoscopic, and radiographic evaluations. Medicine (Baltimore) 1998; 77:168-76. [PMID: 9653428 DOI: 10.1097/00005792-199805000-00002] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Although respiratory involvement occurs in 50% of patients with relapsing polychondritis (RP) and augurs a poor prognosis, few previous studies have provided complete descriptions of respiratory tract involvement. For this reason, we investigated the respective role of clinical, functional, endoscopic, and radiographic (computed tomography [CT]) examinations in 9 consecutive patients with RP and lower respiratory tract localization. All exhibited cough, dyspnea, and wheezing. Eight had a nonreversible obstructive pattern with a marked decrease of the maximal flow ratio at 75% and 25% of vital capacity. Rotman functional criteria were evaluated to differentiate upper from lower respiratory tract involvement; they were consistent with the results of other examinations in 4/9 cases. Endoscopic examination showed moderate to severe inflammation in 8/9 patients; tracheal stenosis was present in 6/9 patients, bronchial stenosis in 4/9 patients, and tracheal collapse in 7 cases. CT showed tracheal stenosis in 8/9 patients (diffuse, 7; localized, 1) and bronchial stenosis in 6/9 patients. Tracheobronchial wall thickening and/or calcifications were observed in 7 cases. Clinical symptoms are of poor specificity for defining respiratory involvement precisely, although degree of dyspnea is correlated to the decrease in forced expiratory volume in 1 second (FEV1). Functional criteria were helpful in evaluating the obstructive ventilatory defect but did not differentiate, in most cases, the respective part of lower and upper respiratory involvement when using Rotman criteria. Compared to CT findings, endoscopic examination failed to identify tracheal and bronchial stenosis and tracheal wall alterations at an early stage of the disease. In our series CT appears to be a reliable method to identify tracheal and bronchial involvement and can be repeated safely during the course of the disease.
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Affiliation(s)
- I Tillie-Leblond
- Clinique des Maladies Respiratoires, Hôpital Calmette, CHRU, Lille, France
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Gheerbrant JD, Brouillard M, Gheyssens Y, Leroy C, Marie A, Makdassi R, Andrejak M. Insuffisance rénale au cours d'une maladie inflammatoire du tube digestif savoir évoquer une néphrite interstitielle au 5 ASA. Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Parent-Woillez K, Hachulla E, Bauters C, Hatron PY, Brouillard M, Rifai A, Devulder B. [Primary pulmonary hypertension: a rare but often fatal complication of Crest syndrome]. Rev Med Interne 1997; 18:109-13. [PMID: 9092028 DOI: 10.1016/s0248-8663(97)84675-9] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In a retrospective study of 194 systemic sclerosis, we selected 37 Crest syndrome patients. Among these 37 patients, five presented a primary pulmonary hypertension. For three of these patients, the evolution of this primary pulmonary hypertension was rapidly fatal, one died of another cause. One died without certitude that death is imputable to HTAP. Diagnosis and management of the evolution of primary pulmonary hypertension may be easily assessed by doppler-echocardiography.
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Affiliation(s)
- K Parent-Woillez
- Service de médecine interne, hôpital Claude-Huriez, CHU, Lille, France
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Brouillard M, Reade R, Boulanger E, Cardon G, Dracon M, Dequiedt P, Pagniez D. Erythrocyte sedimentation rate, an underestimated tool in chronic renal failure. Nephrol Dial Transplant 1996; 11:2244-7. [PMID: 8941585 DOI: 10.1093/oxfordjournals.ndt.a027143] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 02/06/2023] Open
Abstract
BACKGROUND Erythrocyte sedimentation rate is widely used in the general population. It has seldom been studied in patients with chronic renal failure. The purpose of this study was to assess its usefulness in haemodialysis patients. METHODS Forty-five haemodialysis patients with no evidence of acute or chronic inflammatory illness were studied. Nine were diabetic, and 12 used a non-biocompatible membrane. Erythrocyte sedimentation rate was determined, using a modified Westergren method. Plasma fibrinogen concentration, complete blood count, and serum chemistries were also studied. RESULTS Erythrocyte sedimentation rate was normal or mildly elevated in most of our patients, with a median of 30 mm/h. Linear analysis found positive correlation between erythrocyte sedimentation rate and fibrinogen concentration, globulin level, platelet, and white cell counts, and negative correlation with haematocrit. Fibrinogen concentration was normal in 22 patients, and moderately elevated in 14. It was significantly higher in diabetic patients, or those using a non-biocompatible membrane. The same positive correlations were found for fibrinogen concentration as for erythrocyte sedimentation rate. CONCLUSIONS We conclude that erythrocyte sedimentation rate can be used in haemodialysis patients much in the same way as in the general population, as it is influenced by the same factors, and its baseline value is lower than previously reported. The lower concentration of fibrinogen, an independent predictor of cardiovascular risk, in patients treated with biocompatible membranes may be of clinical relevance.
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Affiliation(s)
- M Brouillard
- Clinique Néphrologique, Centre Hospitalier Universitaire, Lille, France
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Brouillard M, Louville A, Gillot JM, Tillie I, Delaporte E, Houvenagel E, Hatron PY, Decoulx M, Hachulla E, Piette F, Tonnel AB, Devulder B. [Initial manifestations and late diagnosis in chronic atrophic polychondritis: apropos of a series of 15 patients]. Rev Med Interne 1996; 17:541-4. [PMID: 8881378 DOI: 10.1016/0248-8663(96)83089-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: 02/02/2023]
Abstract
An auricular or nasal chondritis or a saddle nose deformity are the initial manifestation in half of cases of relapsing polychondritis; the other initial manifestations are various and less evocative; polyarthritis, laryngo-tracheal symptoms, episcleritis which delay the diagnosis. From 15 cases of relapsing polychondritis, the diagnosis time from the first symptom are studied; this one is long, about 3 years and 6 months (from 3 months to 17 years) in 13/15 of the cases even if the first manifestation is typical (external chondritis). In two cases only, the diagnosis was established after the first attack. This late of diagnosis had socioeconomical impact and exposed to severe complications like tracheal chondritis.
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Affiliation(s)
- M Brouillard
- Service de médecine interne, hôpital Claude-Huriez, CHRU, Lille, France
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Gillot JM, Brouillard M, Hatron PY, Devulder B. [Testicular localization of systemic diseases]. Presse Med 1995; 24:691-4. [PMID: 7770418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Acute orchitis or a mass in testis usually evokes a neoplasm, a torsion or infectious disease for the clinician. Rarely, a systemic disease is involved. Nevertheless, testicular involvement occurs during vasculitis, Behçet or granulomatous diseases, but is uncommonly the first manifestation. Histologic changes after biopsy or orchiectomy usually give the diagnosis. Testicular localization of systemic disease does not change the general treatment.
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Affiliation(s)
- J M Gillot
- Service de Médecine interne A, Hôpital Claude Huriez, CHRU de Lille
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Hebbar M, Brouillard M, Wattel E, Decoulx M, Hatron PY, Devulder B, Fenaux P. Association of myelodysplastic syndrome and relapsing polychondritis: further evidence. Leukemia 1995; 9:731-3. [PMID: 7723411] [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: 01/26/2023]
Abstract
We report five patients with both a myelodysplastic syndrome (MDS) and relapsing polychondritis (RP), that represented 0.6% of all MDS and 28% of all RP diagnosed over a period of 14 years. Ten other cases had previously been reported (four in detail), supporting a non-fortuitous association between the two disorders, already suggested for MDS and some other immunological disorders.
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Affiliation(s)
- M Hebbar
- Department of Internal Medicine, CHU, Lille, France
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16
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Feutrie ML, Hachulla E, Hatron PY, Flipo RM, Brouillard M, Labalette P, Delaporte E, Wallaert B, Gosset D, Devulder B. [Behçet disease. Comparative aspect of diagnostic criteria]. Presse Med 1994; 23:1809-12. [PMID: 7899302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Different diagnostic criteria for Behçet's disease are proposed in the literature. We compared the criteria proposed by Mason and Barnes with those proposed by the International Study Group and with those proposed by the Japanese committee. METHODS This retrospective study included 41 patients with Behçet's disease according to the criteria set by Mason and Barnes. There were 16 patients of French origin and 25 patients of North African origin. RESULTS Genital ulcerations were more frequent in the North African population (p < 0.007) and typical Behçet skin lesions were more frequent in the French population (p < 0.021). Comparing the clinical data among the 41 patients with Behçet's disease according to the Mason-Barnes criteria revealed that only 83% met the criteria set by the International Study Group and only 54% the criteria of the Japanese committee. For the International Study Group criteria, the requirement for recurrent buccal ulcerations with at least 3 episodes over a 12 month period (a major criteria) was the most limiting element. Likewise, genital ulcerations were not always recurrent. CONCLUSION These findings confirm the variability of clinical manifestations of Behçet's disease with ethnic origin. Proposed diagnostic criteria vary depending on the study committee and should be used as diagnostic guidelines rather than as criteria required for positive diagnosis.
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Affiliation(s)
- M L Feutrie
- Service de Médecine interne, Hôpital Claude Huriez, Lille
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17
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Hachulla E, Hatron PY, Brouillard M, Cesbron JY, Reumaux D, Devulder B. [Sensitivity and specificity of antineutrophil cytoplasmic antibodies in systemic vasculitis]. Rev Med Interne 1994; 15:381-6. [PMID: 7914710 DOI: 10.1016/s0248-8663(05)81452-3] [Citation(s) in RCA: 4] [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: 01/27/2023]
Abstract
The diagnostic value of c-ANCA as a specific marker of systemic vasculitis (particularly Wegener's granulomatosis) is well established. The prognostic value of c-ANCA for determining disease activity is controversial. We have prospectively studied in ten patients with systemic vasculitis over a mean period of 34 months (extreme 2-61 months). All patients had c-ANCA at the moment of the diagnosis: four patients had high titer of c-ANCA all over the period study; three clinical and biological exacerbations of the disease was observed without variation of the c-ANCA titer. In four patients c-ANCA disappeared within 6 months after the beginning of the treatment correlated with disease activity. Sometimes a rise of c-ANCA titer was observed with or without disease activity. In one case c-ANCA titer had a serrated evolution. The sensitivity and the specificity of the c-ANCA for disease activity in the ten studied patients were respectively 1 and 0.28. In patients with systemic vasculitis and c-ANCA at the time of the diagnosis, variation in c-ANCA titer alone is of limited prognostic value for predicting disease course.
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Affiliation(s)
- E Hachulla
- Service de médecine interne, Hôpital Claude-Huriez, CHRU de Lille, France
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18
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Brouillard M, Laccourreye L, Jabbour W, Emile J, Pouplard-Barthelaix A. [Ultrastructural and immunohistochemical study of the olfactory mucosa in Alzheimer's disease]. Bull Assoc Anat (Nancy) 1994; 78:25-8. [PMID: 8054692] [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: 01/28/2023]
Abstract
The discovery of reliable peripheral markers would be of great interest for the diagnosis of Alzheimer's disease. Interestingly specific lesions of Alzheimer's disease were found in the olfactory areas of the brain. The loss of the detection and the identification capabilities in olfaction suggest a defect in the olfactory mucosa. The ultrastructural study of biopsy of olfactory mucosa from patients suspected to suffer of Alzheimer's disease revealed a degeneration of sustentacullar and olfactory cells as well as an architectural disorganization. No neuropathological characteristic lesion such as Paired Helicoidal Filaments or amyloid fibrils could be evidenced. Immunohistochemical analysis achieved with a polyclonal antiserum raised against A4 protein (fragment 1-28) showed a specific staining in the sustencellular and of the outer part of the olfactory epithelium corresponding to the mucus area, whereas appropriate controls were negative. Our study raised the question of the amyloid protein origin in the olfactory mucosa. Analysis of some more patients will enable us to determine the diagnostic value of this study in Alzheimer's disease.
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Affiliation(s)
- M Brouillard
- Laboratoire de biologie cellulaire, INSERM U 298, Centre Hospitalier Universitaire, ANGERS, France
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19
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Rose C, Hatron PY, Brouillard M, Hachulla E, Gosset D, Marlier C, Piette F, Devulder B. [Predictive signs of cancers in dermatomyositis. Study of 29 cases]. Rev Med Interne 1994; 15:19-24. [PMID: 8052749 DOI: 10.1016/s0248-8663(05)82125-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [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: 01/28/2023]
Abstract
Dermatomyositis (DM) is characterized by an inflammatory myopathy and typical cutaneous lesions. In a retrospective study, 29 adult cases without overlap syndrome were reviewed. Our aim was to define predictive signs of cancer. Ten (four women, six men) of the 29 patients (35%) had DM associated with malignancy. The diagnosis of cancer was made concomitantly in six cases, more than year after (two cases), more than year prior to (two cases) the occurrence of DM. No extensive diagnosis procedures were necessary for identifying the tumors. A paraneoplasic evolution was certain for any patient, probable for six, improbable for fourth. For the group with malignancy: age was higher (P = 0.01), albumin lower (P = 0.04), C reactive protein higher (P = 0.0061). These parameters seem to have predictive value for the presence of malignancy.
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Affiliation(s)
- C Rose
- Service de médecine interne, hôpital Claude-Huriez, CHRU Lille, France
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20
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Leteurtre E, Hachulla E, Janin A, Hatron PY, Brouillard M, Devulder B. [Vascular manifestations of dermatomyositis and polymyositis. Clinical, capillaroscopic and histological aspects]. Rev Med Interne 1994; 15:800-7. [PMID: 7863114 DOI: 10.1016/s0248-8663(05)82836-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [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: 01/27/2023]
Abstract
Polymyositis is characterized by a T-cell-mediated and MHC-I-restricted cytotoxic process, whereas dermatomyositis is a primitively vascular disease with microangiopathy mediated by the complement C5b-9 membranolytic attack complex. We have tried to estimate the frequency of vascular abnormalities in polymyositis as defined by Bohan and Peter. We have retrospectively studied 17 patients with dermatomyositis and 15 patients with polymyositis. Vascular abnormalities have been defined by clinical, capillaroscopic and histologic (muscle biopsy and minor salivary glands biopsy) features. After clinical features, 5/17 dermatomyositis had a Raynaud's phenomenon, against 6/15 polymyositis. Digital necrosis has been observed for 2/17 dermatomyositis and 2/15 polymyositis. In capillaroscopy, 14/17 dermatomyositis had a microangiopathy with or no enlarged capillary loops, against 7/15 polymyositis. None of these polymyositis had enlarged capillary loops. The muscle biopsy showed a predominantly perivascular or perimysial inflammatory infiltrate (vascular process) for 10/16 dermatomyositis against 4/13 polymyositis; a perifascicular atrophy for 3/16 dermatomyositis against 2/13 polymyositis. The histological study of minor salivary glands, showed vascular lesions for 2/11 dermatomyositis and for 1/8 polymyositis. Finally, Bohan and Peter's classification is now inadequate to distinguish between dermatomyositis and polymyositis. Indeed, some dermatomyositis sine dermatitis, may exist and be recognized by their vascular features. To distinguish between dermatomyositis and polymyositis is important, to evaluate the risk of cancer which is more frequent in dermatomyositis.
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Affiliation(s)
- E Leteurtre
- Service de médecine interne, CHRU, hôpital Claude-Huriez, Lille
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21
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Grard C, Perez-Cousin M, Desmyttère J, Alsberghe MC, Hachulla E, Copin D, Roux JP, Brouillard M, Hatron PY, Warembourg H. [Follow-up study, using dynamic transcutaneous oximetry in 17 patients with stage II Leriche and Fontaine occlusive arterial disease of the lower limbs]. Rev Med Interne 1994; 15:510-4. [PMID: 7938965 DOI: 10.1016/s0248-8663(05)81480-8] [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] [Indexed: 01/28/2023]
Abstract
We evaluated the value of dynamic transcutaneous oxygen pressure measurement (TcPO2) in 17 patients with stage II occlusive arterial disease of the lower limbs treated with exercise only. We studied 17 patients (15 men, two women) with an average age of 63 years (range 39-80 years). Claudication perimeter and dynamic TcPO2 were evaluated before and after 6 month walking exercise and tabac stopping. Four different sites of TcPO2 were studied: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot TcPO2/precordial TcPO2 x 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. Claudication perimeter was 255 m +/- 221 before 6 months exercise and 835 m +/- 539 after (P < 0.01). The duration of significative ischemia was significantly reduced after 6 months exercise (P = 0.02 calf, P < 0.01 foot). Dynamic transcutaneous oxymetry would therefore seem to be a useful method of assessing stage II occlusive peripheral arterial disease and the topography of tissue hypoxia. It could be valuable in orientating treatment and the first method to provide and objective evaluation of the efficacy of medical or surgical treatment.
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Affiliation(s)
- C Grard
- Service de médecine interne, CHRU, hôpital Claude-Huriez, Lille
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22
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Abstract
We report three cases of primary Sjögren's syndrome in silicotic coal miners. All patients fulfilled the diagnostic criteria for Sjögren's syndrome recently established by the European Community study group. One patient had cryoglobulinemia and polynevritis. Another had Raynaud's phenomenon, arthralgia, purpura and polynevritis. Capillary microscopy was normal in all the three patients. Antinuclear antibodies were detected only in one patient, who had also anti-SSa and anti-SSb antibodies. The prevalence of systemic sclerosis, rheumatoid arthritis and probably systemic lupus erythematosus is significantly higher after longstanding occupational exposure to silica. On the contrary, any case of Sjögren's syndrome was till now described in the course of pulmonary silicosis. The physiopathological mechanisms of these associations are misunderstood.
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Affiliation(s)
- F Puisieux
- Service de médecine interne, hôpital Claude-Huriez, CHRU, Lille, France
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23
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Fajardy I, Feutry ML, Hachulla E, Labalette P, Flipo RM, Hatron PY, Brouillard M, Devulder B, Danzé PM. Haplotype HLA de classe II et maladie de Behçet avec panuvéite sévère. Rev Med Interne 1994. [DOI: 10.1016/s0248-8663(05)82588-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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24
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Facon T, Brouillard M, Duhamel A, Morel P, Simon M, Jouet JP, Bauters F, Fenaux P. Prognostic factors in Waldenström's macroglobulinemia: a report of 167 cases. J Clin Oncol 1993; 11:1553-8. [PMID: 8336194 DOI: 10.1200/jco.1993.11.8.1553] [Citation(s) in RCA: 123] [Impact Index Per Article: 4.0] [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: 01/30/2023] Open
Abstract
PURPOSE A single-center retrospective analysis was conducted in 167 patients with Waldenström's macroglobulinemia (WM) to delineate prognostic factors. PATIENTS AND METHODS One hundred sixty-seven patients diagnosed between January 1969 and December 1988, fulfilling diagnostic criteria of WM, were entered onto this study. One hundred twenty-eight patients were treated with chlorambucil (0.1 mg/kg/d): 117 at diagnosis and 11 during the disease course. Seventeen variables were analyzed in all patients and in treated patients for their prognostic value on survival using the Kaplan-Meier method and a Cox multivariate regression analysis. RESULTS Median survival duration for all patients was 60 months. Pretreatment factors associated with shorter survival in the entire population were age > or = 60 years (P = .006), male sex (P = .0001), general symptoms (P = .01), hemoglobin less than 10 g/dL (P = .008), leukocytes less than 4 X 10(9)/L (P = .02), neutrophils less than 1.7 X 10(9)/L (P = .02), and platelets less than 150 X 10(9)/L (P = .0006). Organomegaly, signs of hyperviscosity, renal failure, monoclonal immunoglobulin M (M IgM) level, blood lymphocytosis, and percentage of marrow lymphoid cells were not significantly correlated with survival. In a Cox multivariate regression analysis, the combination of factors that gave the best prognostic value was the association of sex (P = .0002), neutrophils (P = .002), age (P = .008), and hemoglobin (P = .02). CONCLUSION Our findings suggest that some pretreatment parameters, including older age, male sex, general symptoms, and cytopenias, carry a poor prognosis in WM. By contrast, high initial tumor burden (indicated by organomegaly, high IgM level, and high percentage of marrow lymphoid cells) does not seem to be significantly associated with short survival. Our results help define a high-risk population that could perhaps benefit from newer therapeutic approaches.
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Affiliation(s)
- T Facon
- Service des Maladies du Sang, Lille, France
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25
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Brouillard M, Rose C, Hachulla E, Catteau M, Bataille D, Gosset D, Hatron P, Devulder B. Artérite distale symptomatique des membres supérieurs: 60 observations. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Feutry M, Hachulla E, Hatron P, Brouillard M, Flipo R, Labalette P, Gosset D, Devulder B. Aspects comparatifs des critères diagnostiques de la maladie de behçet autochtone et non autochtone. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Hachulla E, Hatron P, Bataille D, Brouillard M, Cesbron J, Remeaux D, Devulder B. Valeur pronostique des anticorps anticytoplasme des neutrophiles (c-ANCA) au cours des vascularites systémiques. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Bataille D, Hatron P, Brouillard M, Hachulla E, Millaire A, Chambon J, Devulder B. Thrombose artérielle périphérique et syndrome des antiphospholipides: 6 observations. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80381-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Rose C, Marlier C, Brouillard M, Hachulla E, Bataille D, Gosset D, Piette F, Hatron P, Devulder B. Dermatomyosite et cancers. 10 observations parmi 41 myopathies inflammatoires. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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30
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Menei P, Daniel V, Montero-Menei C, Brouillard M, Pouplard-Barthelaix A, Benoit JP. Biodegradation and brain tissue reaction to poly(D,L-lactide-co-glycolide) microspheres. Biomaterials 1993; 14:470-8. [PMID: 8507795 DOI: 10.1016/0142-9612(93)90151-q] [Citation(s) in RCA: 157] [Impact Index Per Article: 5.1] [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: 01/31/2023]
Abstract
The therapeutic application of neuroactive molecules in neuroscience is limited, due to the problems posed by the administration of these drugs (peripheral metabolism, systemic effect and passage of the blood-brain barrier). One solution is the implantation in the brain of biodegradable polymer devices with controlled release of a neuroactive drug. The biodegradation and tissue reaction of the copolymer poly(D,L-lactide-co-glycolide) microspheres prepared by the solvent evaporation method, radiosterilized and stereotactically implanted in the rat brain were studied by routine staining, immunohistochemistry and transmission electronic microscopy. The brain tissue reaction observed was a non-specific astrocytic proliferation and a macrophagous-microglial cell reaction, typically found following damage to the central nervous system. Some foreign-body giant cells were observed and the inflammatory and macrophagous reaction decreased dramatically after 1 month and almost ended after 2 months when the microspheres were totally biodegraded. The copolymer poly(D,L-lactide-co-glycolide) microspheres may be considered biocompatible to the brain tissue.
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Affiliation(s)
- P Menei
- Service de Neurochirurgie, CHU d'Angers, France
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31
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Brouillard M. [Inhalation corticotherapy in asthma]. Rev Med Interne 1993; 14:199-200. [PMID: 8378648 DOI: 10.1016/s0248-8663(05)81174-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- M Brouillard
- Service de Médecine Interne A, Hôpital Claude Huriez, CHRU de Lille
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32
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Hachulla E, Brouillard M, Hatron PY, Devulder B. [Role of high-dose polyvalent immunoglobulins in the treatment of dermatopolymyositis: treatment of first intention or of salvage?]. Rev Med Interne 1993; 14:977. [PMID: 8009070 DOI: 10.1016/s0248-8663(05)80095-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- E Hachulla
- Service de médecine interne A, CHRU Lille
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33
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Brouillard M, Houvenagel É, Deprez X, Cortet B, Vincent G, Duquesnoy B, Delcambre B. Fasciite palmaire et polyarthrite: rechercher le cancer ! Rev Med Interne 1992. [DOI: 10.1016/s0248-8663(05)81058-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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34
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Senneville E, Chidiac C, Brouillard M, Beuscart C, Leroy O, Sivery B, Beaucaire G, Mouton Y. [Acyclovir and specific anti-varicella-herpes zoster immunoglobulins in the treatment of varicella-zoster virus infection in 113 adults]. Pathol Biol (Paris) 1990; 38:568-71. [PMID: 2166935] [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: 12/30/2022]
Abstract
From January 1978 to December 1988, 54 males and 59 females were treated for varicella, zoster and disseminated zoster by varicella-zoster immunoglobulin (group I) or acyclovir (group II). 67 patients had immune deficiency disease. Treatment was successful for 92/100 patients in group I and for 100/100 patients in group II. Thrombophlebitis and renal failure were observed in group II and regressed when acyclovir was stopped. Varicella-zoster immunoglobulin and acyclovir are two effective therapeutics in the treatment of varicella and zoster in adults including immunocompromised patients. The use of acyclovir could not reduce the duration of hospitalization.
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Affiliation(s)
- E Senneville
- Service Régional des Maladies Infectieuses, Centre Hospitalier, Tourcoing
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35
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Zucker D, Taylor CB, Brouillard M, Ehlers A, Margraf J, Telch M, Roth WT, Agras WS. Cognitive aspects of panic attacks. Content, course and relationship to laboratory stressors. Br J Psychiatry 1989; 155:86-91. [PMID: 2605437 DOI: 10.1192/bjp.155.1.86] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Twenty patients with panic attacks and ten controls were given a standardised interview about thoughts occurring during times of anxiety or panic attacks. The interviewer was blind to the subject's diagnosis. The 20 panic patients underwent a psychophysiological test battery which included a cold pressor test, mental arithmetic task, and 5.5% CO2 inhalation. More patients than controls reported thoughts centered on fears of losing control and shame when anxious. Panic patients rated their thoughts as stronger and clearer than did controls and they had more difficulty excluding them from their minds. A feeling of anxiety preceded anxious thoughts in patients. This suggests that 'faulty cognitions' are not the initial event in a panic attack, although anxious thoughts may exacerbate or maintain them. Significant correlations were found between the intensity of anxiety-related thoughts in anticipation of mental arithmetic and changes in diastolic blood pressure and heart rate during mental arithmetic.
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Affiliation(s)
- D Zucker
- Psychiatry Department, Stanford University School of Medicine, CA 94305-5490
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36
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Abstract
The present study examined several dimensions of panic cognitions to test whether panic appraisals predict phobicity among panic sufferers. Thirty-five patients meeting DSM-III-R criteria for panic disorder with minimal or no phobic avoidance were compared to 40 patients meeting DSM-III-R criteria for panic disorder with agoraphobia (severe). The two groups looked strikingly similar on measures of panic symptoms, panic frequency and panic severity. As expected, patients diagnosed as having panic disorder with agoraphobia reported significantly more depression and phobic avoidance than patients with PD. Striking differences emerged on each of the following panic appraisal dimensions: (a) anticipated panic, (b) perceived consequences of panic, and (c) perceived self-efficacy in coping with panic. In each case, patients with panic disorder and agoraphobia reported significantly more dysfunctional panic appraisals than patients with panic disorder and no avoidance. Of those panic appraisal dimensions studied, anticipated panic emerged as the most potent correlate of agoraphobic avoidance. These findings support the hypothesis that cognitive appraisal factors may play an important role in the genesis or maintenance of phobic avoidance among panic patients.
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