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Laguillier-Morizot C, Bonnet-Serrano F, Leguy MC, Simeonovic M, Sée C, Zientek C, Soussan M, Bouys L, Bertherat J, Guibourdenche J. Diagnostic performance of an automated immunoassay for salivary cortisol. Ann Endocrinol (Paris) 2024; 85:20-26. [PMID: 37926277 DOI: 10.1016/j.ando.2023.10.007] [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] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
Automated immunoanalysis (AI) is an interesting alternative for measuring salivary cortisol, as the gold standard HPLC-MS/MS method is not yet readily available. The aim of this study was to evaluate the diagnostic performance of salivary cortisol immunoassay on the iSYS immunoanalyzer in adrenal dynamic tests. Cortisol was measured on iSYS and on HPLC-MS/MS in saliva samples collected after 1mg-dexamethasone suppression test (DST) in 115 patients suspected of Cushing syndrome, and during Synacthen® stimulation test (SST) in 108 patients suspected of adrenal insufficiency. Concentrations on AI correlated well with HPLC-MS/MS (Spearman r=0.9496; P<0.0001), but with a significant positive bias. ROC analysis of salivary cortisol identified optimal cut-off values on AI and HPLC-MS/MS of respectively 3.5 and 0.77nmol/L for DST and 32.6 and 13.8nmol/L at T60 after SST. Automated immunoassays for salivary cortisol are suitable in daily practice but require determination of specific cut-off and reference values.
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Affiliation(s)
- Christelle Laguillier-Morizot
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France; Faculté de santé, université Paris Cité, 2, rue Valette, 75005 Paris, France.
| | - Fidéline Bonnet-Serrano
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France; Faculté de santé, université Paris Cité, 2, rue Valette, 75005 Paris, France
| | - Marie-Clémence Leguy
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France
| | - Miliça Simeonovic
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France; Université Paris-Est Créteil Val-de-Marne, 61, avenue du Général-de-Gaulle, 94010 Créteil cedex, France
| | - Catherine Sée
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France
| | - Corinne Zientek
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France
| | - Mickael Soussan
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France; Faculté de santé, université Paris Cité, 2, rue Valette, 75005 Paris, France
| | - Lucas Bouys
- Faculté de santé, université Paris Cité, 2, rue Valette, 75005 Paris, France; Department of Endocrinology, CHU Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Reference Center for Rare Adrenal Diseases, CHU Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Jérôme Bertherat
- Faculté de santé, université Paris Cité, 2, rue Valette, 75005 Paris, France; Department of Endocrinology, CHU Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Reference Center for Rare Adrenal Diseases, CHU Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Jean Guibourdenche
- Department of Hormonology, bâtiment J. Dausset, 2(e) étage, CHU Cochin, 27, rue du Fg-St-Jacques, 75014 Paris, France; Faculté de santé, université Paris Cité, 2, rue Valette, 75005 Paris, France
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Bouchut A, Lhote R, Maksud P, Ben Salem T, Fustier A, Moyon Q, Taieb D, Soussan M, Mathian A, Hie M, Haroche J, Amoura Z, Cohen Aubart F. Pronostic associé à l’atteinte osseuse en 18FDG-TEP-TDM au cours de la sarcoïdose. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.281] [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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Bouchut A, Lhote R, Maksud P, Ben Salem T, Fustier A, Moyon Q, Haroche J, Soussan M, Mathian A, Hié M, Amoura Z, Cohen F. POS1379 HYPERMETABOLIC BONE SARCOIDOSIS ON 18F-FDG PET-CT: IMPACT ON TREATMENT AND DISEASE RELAPSE IN A COHORT OF 165 PATIENTS FROM A SINGLE UNIVERSITY HOSPITAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSarcoidosis is a multisystemic granulomatosis of unknown cause. Prevalence of bone sarcoidosis is estimated between 3 and 30%. Bone sarcoidosis is symptomatic in about half of the cases. 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is a useful imaging modality in sarcoidosis, to search for a biopsiable site, evaluate organ involvement or assess disease activity. It is a sensitive imaging modality to detect bone involvement. However, clinical and prognostic significance of hypermetabolic bone involvement of sarcoidosis is not well known.ObjectivesThe aim of this study was to compare the characteristics of patients with and without hypermetabolic bone involvement of sarcoidosis and to evaluate the impact of metabolic bone involvement on treatments and outcomes.MethodsThis was an observational, comparative, retrospective monocentric study of prospectively collected data. Inclusion criteria were a diagnosis of sarcoidosis according to the World Association of Sarcoidosis and Other Granulomatous diseases (WASOG) criteria and at least one 18F-FDG PET-CT during follow-up. Metabolic bone involvement of sarcoidosis was defined as bone hypermetabolism for which alternative causes had been reasonably excluded, following the WASOG criteria of « at least probable » bone sarcoidosis. Characteristics of patients with and without bone involvement were compared using bilateral Fisher or Mann-Whitney tests. Relapse-free survival curves were constructed following the Kaplan-Meier method and compared using a log-rank test. A p-value < 0.05 was considered significant.ResultsAmong 503 patients with sarcoidosis, 165 with definite sarcoidosis who had undergone at least one 18F-FDG PET-CT were included. Fourteen patients had positive bone PET-CT findings which were attributed to other cause than sarcoidosis. Metabolic bone involvement of sarcoidosis was found in 29 patients (18%), among which 9 (31%) had structural bone lesions on CT. Metabolic bone involvement of sarcoidosis was associated with more frequent intrathoracic lymph node involvement (28 [96%] and 107 [79%], p < 0.001), extrathoracic lymph node involvement (15 [52%] and 40 [30%], p = 0.03) and a higher number of organ involvements (median [interquartile range], 6 [4-7] and 4 [2-5], p < 0.001). Patients with metabolic bone involvement received more frequently corticosteroids (29 [100%] and 99 [73%], p < 0.001), methotrexate (26 [90%] and 66 [48%], p < 0.001), tumor necrosis factor (TNF) alpha inhibitors (22 [76%] and 41 [30%], p < 0.001), and a higher number of treatments (3 [3-4] and 2 [1-3], p < 0.001). Despite more intensive treatments, disease relapse occurred significantly sooner in patients with metabolic bone involvement of sarcoidosis (median time to the first relapse, 63 [44-84] months and 96 [72-156] months respectively, p = 0.01).ConclusionMetabolic bone involvement on PET-CT was present in 18% of patients with sarcoidosis. It was predominantly axial and without structural lesions. In this comparative study, patients with metabolic bone involvement received significantly more treatments and had a shorter time to relapse. It could therefore reflect a more severe multisystemic involvement and chronic evolution of the disease. This could help adjust individual therapeutic strategy for patients with sarcoidosis.References[1]Challenges of Sarcoidosis and Its Management. Drent M, Crouser ED, Grunewald J. N Engl J Med. 2021 Sep 9;385(11):1018-1032.[2]Clinical Presentation and Treatment of High-Risk Sarcoidosis. Perlman DM, Sudheendra MT, Furuya Y, Shenoy C, Kalra R, Roukoz H, Markowitz J, Maier LA, Bhargava M. Ann Am Thorac Soc. 2021 Sep 15. doi: 10.1513/AnnalsATS.202102- 212CMEFigure 1.Disclosure of InterestsNone declared
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Laurent C, Marjanovic Z, Ricard L, Farge D, Soussan M, Mohty M, Fain O, Mekinian A. Autogreffe de cellules souches hématopoïétiques dans la maladie de Takayasu réfractaire, une série rétrospective du groupe de travail des maladies auto-immunes de la société européenne de greffe de moelle (EBMT). Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Laban T, Comparon C, Soussan M, Uzunhan Y, Delettre C, Dhôte R. Bénéfices du TEP-scanner dans la documentation et le suivi des atteintes graves au cours de la polychondrite chronique atrophiante. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.362] [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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Créhange G, Soussan M, Gensanne D, Decazes P, Thariat J, Thureau S. Interest of positron-emission tomography and magnetic resonance imaging for radiotherapy planning and control. Cancer Radiother 2020; 24:398-402. [PMID: 32247688 DOI: 10.1016/j.canrad.2020.02.010] [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: 01/23/2020] [Accepted: 02/07/2020] [Indexed: 12/24/2022]
Abstract
Computed tomography (CT) in the treatment position is currently indispensable for planning radiation therapy. Other imaging modalities, such as magnetic resonance imaging (MRI) and positron emission-tomography (PET), can be used to improve the definition of the tumour and/or healthy tissue but also to provide functional data of the target volume. Accurate image registration is essential for treatment planning, so MRI and PET scans should be registered at the planning CT scan. Hybrid PET/MRI scans with a hard plane can be used but pose the problem of the absence of CT scans. Finally, techniques for moving the patient on a rigid air-cushioned table allow PET/CT/MRI scans to be performed in the treatment position while limiting the patient's movements exist. At the same time, the advent of MRI-linear accelerator systems allows to redefine image-guided radiotherapy and to propose treatments with daily recalculation of the dose. The place of PET during treatment remains more confidential and currently only in research and prototype status. The same development of imaging during radiotherapy is underway in proton therapy.
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Affiliation(s)
- G Créhange
- Département de radiothérapie oncologique, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - M Soussan
- Service de médecine nucléaire, hôpital Avicenne, AP-HP, hôpitaux universitaires, 125, rue de Stalingrad, 93000 Bobigny, France
| | - D Gensanne
- Département de radiothérapie et de physique médicale, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; Quantif-Litis EA4108, université de Rouen Normandie, rue d'Amiens, 76000 Rouen, France
| | - P Decazes
- Quantif-Litis EA4108, université de Rouen Normandie, rue d'Amiens, 76000 Rouen, France; Département d'imagerie-médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
| | - J Thariat
- Département d'onco-radiothérapie, centre François-Baclesse, 3, avenue General-Harris, 14000 Caen, France; Association Advance Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue General-Harris, 14000 Caen, France; Université de Caen Normandie (Unicaen), 3, avenue General-Harris, 14000 Caen, France; Laboratoire de physique corpusculaire, Institut national de physique nucléaire et de physique des particules (IN2P3), 6, boulevard Maréchal-Juin, 14000 Caen, France
| | - S Thureau
- Département de radiothérapie et de physique médicale, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; Quantif-Litis EA4108, université de Rouen Normandie, rue d'Amiens, 76000 Rouen, France; Département d'imagerie-médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; Laboratoire de physique corpusculaire, Institut national de physique nucléaire et de physique des particules (IN2P3), 6, boulevard Maréchal-Juin, 14000 Caen, France.
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Barny I, Perrault I, Michel C, Soussan M, Goudin N, Rio M, Thomas S, Attié-Bitach T, Hamel C, Dollfus H, Kaplan J, Rozet JM, Gerard X. Basal exon skipping and nonsense-associated altered splicing allows bypassing complete CEP290 loss-of-function in individuals with unusually mild retinal disease. Hum Mol Genet 2019; 27:2689-2702. [PMID: 29771326 DOI: 10.1093/hmg/ddy179] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/02/2018] [Accepted: 05/06/2018] [Indexed: 12/18/2022] Open
Abstract
CEP290 mutations cause a spectrum of ciliopathies from Leber congenital amaurosis type 10 (LCA10) to embryo-lethal Meckel syndrome (MKS). Using panel-based molecular diagnosis testing for inherited retinal diseases, we identified two individuals with some preserved vision despite biallelism for presumably truncating CEP290 mutations. The first one carried a homozygous 1 base pair deletion in Exon 17, introducing a premature termination codon (PTC) in Exon 18 (c.1666del; p.Ile556Phefs*17). mRNA analysis revealed a basal exon skipping (BES) of Exon 18, providing mutant cells with the ability to escape protein truncation, while disrupting the reading frame in controls. The second individual harbored compound heterozygous nonsense mutations in Exon 8 (c.508A>T, p.Lys170*) and Exon 32 (c.4090G>T, p.Glu1364*), respectively. Some CEP290 lacking Exon 8 were detected in mutant fibroblasts but not in controls whereas some skipping of Exon 32 occurred in both lines, but with higher amplitude in the mutant. Considering that the deletion of either exon maintains the reading frame in either line, skipping in mutant cells likely involves nonsense-associated altered splicing alone (Exon 8), or with BES (Exon 32). Skipping of PTC-containing exons in mutant cells allowed production of CEP290 isoforms with preserved ability to assemble into a high molecular weight complex and to interact efficiently with proteins important for cilia formation and intraflagellar trafficking. In contrast, studying LCA10 and MKS fibroblasts we show moderate to severe cilia alterations, providing support for a correlation between disease severity and the ability of cells to express shortened, yet functional, CEP290 isoforms.
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Affiliation(s)
- Iris Barny
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
| | - Isabelle Perrault
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
| | - Christel Michel
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
| | - Mickael Soussan
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
| | - Nicolas Goudin
- Cell Imaging Core Facility of the Structure Fédérative de Recherche Necker, INSERM US24/CNRS UMS3633, Imagine and Paris Descartes University, Paris, France
| | - Marlène Rio
- Department of Genetics, IHU Necker-Enfants Malades, University Paris Descartes, Paris, France
| | - Sophie Thomas
- Laboratory of Embryology and Genetics of Human Malformation, INSERM UMR1163, Institute of Genetics Diseases, Imagine and Paris Descartes University, Paris, France
| | - Tania Attié-Bitach
- Laboratory of Embryology and Genetics of Human Malformation, INSERM UMR1163, Institute of Genetics Diseases, Imagine and Paris Descartes University, Paris, France
| | - Christian Hamel
- Centre de Référence des Affections Sensorielles Génétiques, Institut des Neurosciences de Montpellier, CHU-Saint Eloi Montpellier, Montpellier, France
| | - Hélène Dollfus
- Centre de Référence pour les Affections Génétiques Ophtalmologiques CARGO, CHRU Strasbourg, INSERM 1112, Université de Strasbourg, Strasbourg, France
| | - Josseline Kaplan
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
| | - Jean-Michel Rozet
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
| | - Xavier Gerard
- Laboratory of Genetics in Ophthalmology (LGO), INSERM UMR1163, Institute of Genetics Diseases
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Chauveau S, Goudot F, Brillet P, Soussan M, Freynet O, Meune C, Valeyre D, Nunes H, Bouvry D. Apport de la discussion multidisciplinaire pour le diagnostic de sarcoïdose cardiaque. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.105] [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: 10/27/2022]
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Sgard B, Brillet PY, Bouvry D, Djelbani S, Nunes H, Meune C, Valeyre D, Soussan M. Evaluation of FDG PET combined with cardiac MRI for the diagnosis and therapeutic monitoring of cardiac sarcoidosis. Clin Radiol 2018; 74:81.e9-81.e18. [PMID: 30482560 DOI: 10.1016/j.crad.2018.09.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 09/26/2018] [Indexed: 02/07/2023]
Abstract
AIM To compare combined 2-[18F]-fluoro-2-deoxy-d-glucose (FDG)-positron-emission tomography (PET) and cardiac magnetic resonance imaging (CMR) for the diagnosis and therapy monitoring of cardiac sarcoidosis (CS). MATERIALS AND METHODS Eighty patients with sarcoidosis and a suspicion of CS who underwent PET and CMR were included retrospectively. PET was undertaken after a low-carbohydrate-high-fat diet in all patients using a combined 16-section PET/computed tomography (CT) camera. PET was considered positive (PET+) in cases of focal or multifocal FDG uptake. CMR was considered positive (CMR+) in cases of subepicardial late gadolinium enhancement (LGE). A subgroup of 50 patients (50/80) was monitored during therapy and classified as responders or non-responders. RESULTS Eighty-two percent of patients with PET+ (9/11) also had CMR+ imaging, with good spatial agreement (kappa=0,79; 95% confidence interval [CI]: 0.65-0.94). Twenty-seven percent (22/80) had residual physiological FDG uptake, with a standardised uptake value (SUV) not significantly different compared to the SUV from pathological uptake (6.4 versus 6 respectively, p=0,92). The clinical response was more frequent in patients with baseline PET+ compared to baseline PET- (80% versus 45%, p=0.07). PET findings improved in all cases under treatment (7/7), whereas LGE improved in only 33% of patients (3/9). CONCLUSION Due to high risk of false-positive or undetermined findings, PET might be performed as a second-line study in cases of LGE, to assess inflammatory load. In addition, PET seems suitable to predict and assess response under therapy.
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Affiliation(s)
- B Sgard
- Department of Nuclear Medicine, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - P-Y Brillet
- Department of Radiology, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - D Bouvry
- Department of Pneumology, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - S Djelbani
- Department of Nuclear Medicine, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - H Nunes
- Department of Pneumology, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - C Meune
- Department of Cardiology, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - D Valeyre
- Department of Pneumology, Hôpital Avicenne, Paris 13 University, Bobigny, France
| | - M Soussan
- Department of Nuclear Medicine, Hôpital Avicenne, Paris 13 University, Bobigny, France.
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Laurent C, Mekinian A, Djelbani S, Gatfosse M, Cluzel P, Soussan M, Buob D, Fain O. Premier cas d’amylose AA compliquant une infection chronique de prothèse aortique. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.075] [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: 11/16/2022]
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Laurent C, Fain O, Mekinian A, Soussan M. Évaluation du TEP/IRM dans les vascularites des gros vaisseaux : étude monocentrique prospective. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rodrigues F, Elourimi G, Le Jeune S, Abad S, Larroche C, Saidenberg N, Soussan M, Warzocha U, Brillet P, Boissier M, Mourad J, Dhôte R. Atteinte aortique thoracique au cours de l’artérite temporale. Analyse cas-témoins des données morphologiques au diagnostic. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Soussan M, Hommada M, Abad S, Larroche C, Dhôte R, Fain O, Mekinian A. Comparaison du TEP au FDG et de l’angioscanner aortique pour la détection d’aortite au cours de l’artérite à cellules géantes. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.024] [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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Cohen Aubart F, Nunes H, Mathian A, Haroche J, Hié M, Le-Thi Huong Boutin D, Cluzel P, Soussan M, Waintraub X, Fouret P, Valeyre D, Amoura Z. [Cardiac sarcoidosis: Diagnosis and therapeutic challenges]. Rev Med Interne 2016; 38:28-35. [PMID: 27211064 DOI: 10.1016/j.revmed.2016.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 03/06/2016] [Accepted: 03/14/2016] [Indexed: 12/16/2022]
Abstract
Sarcoidosis is a granulomatous disorder of unknown cause characterized by non-caseating granuloma in young adults. Cardiac involvement is rare and range from 2 to 75% depending on diagnostic criteria. Cardiac involvement in sarcoidosis may be asymptomatic or may manifest as rhythm/conduction troubles or congestive heart failure. The diagnosis and treatment of cardiac sarcoidosis may be challenging. However, advances have come in recent years from the use of cardiac MRI and 18FDG-TEP scanner, as well as from the stratification of the risk of ventricular tachycardia/fibrillation. Due to the rarity of the disease, there is no reliable prospective large study to guide therapeutic strategy for cardiac sarcoidosis. Corticosteroids are probably efficacious, in particular in case of atrio-ventricular block or moderate heart failure. Immunosuppressive drugs have not been largely studied but methotrexate could be helpful. In refractory forms, TNF-α antagonists have been used with success.
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Affiliation(s)
- F Cohen Aubart
- Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France.
| | - H Nunes
- Service de pneumologie, hôpital Avicenne, AP-HP, université Paris XIII, 93000 Bobigny, France
| | - A Mathian
- Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France
| | - J Haroche
- Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France
| | - M Hié
- Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
| | - D Le-Thi Huong Boutin
- Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France
| | - P Cluzel
- Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France; Service de radiologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75651 Paris cedex 13, France
| | - M Soussan
- Service de médecine nucléaire, hôpital Avicenne, AP-HP, 93000 Bobigny, France
| | - X Waintraub
- Service de cardiologie, unité de rythmologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75651 Paris cedex 13, France
| | - P Fouret
- Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France; Service d'anatomo-pathologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75651 Paris cedex 13, France
| | - D Valeyre
- Service de pneumologie, hôpital Avicenne, AP-HP, université Paris XIII, 93000 Bobigny, France
| | - Z Amoura
- Service de médecine interne, institut E3M, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France; Université Paris VI Pierre-et-Marie-Curie, Sorbonne universités, 75013 Paris, France
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Mekinian A, Djelbani S, Viry F, Fain O, Soussan M. Place de l’imagerie dans l’évaluation des vascularites de gros vaisseaux. Rev Med Interne 2016; 37:245-55. [DOI: 10.1016/j.revmed.2015.10.353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 09/08/2015] [Accepted: 10/27/2015] [Indexed: 12/13/2022]
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Monnier J, Georgin-Lavialle S, Canioni D, Soussan M, Lhermitte L, Bruneau J, Dubreuil P, Chandesris MO, Bodemer C, Gandhi D, Hermine O. Sarcomes mastocytaires : série de cas français et revue de la littérature. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.063] [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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Boussouar S, Medjhoul A, Bernaudin JF, Tayebjee O, Soussan M, Uzunhan Y, Nunes H, Kambouchner M, Martin A, Valeyre D, Brillet PY. Diagnostic efficacy of ultrasound-guided core-needle biopsy of peripheral lymph nodes in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2015; 32:188-193. [PMID: 26422562] [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] [Received: 07/08/2014] [Accepted: 10/29/2014] [Indexed: 06/05/2023]
Abstract
BACKGROUND Core-needle biopsy guided by ultrasound can be performed for investigating peripheral lymph node (PLN). The aim of this study was to determine the efficacy of this technique in sarcoidosis. METHODS Retrospective review of files of all patients in the database of the radiology department of Avicenne university hospital who underwent PLN biopsies guided by ultrasound from January 2008 to June 2011 (n=292). Cases with either granulomas at histology with the procedure or with a final diagnosis of sarcoidosis were included in the study. RESULTS The histological specimens were adequate in 282 out of 292 cases (96%) showing non-caseating granulomas in 22 cases (n=20 patients with a final diagnosis of sarcoidosis and n=2 patients with tuberculosis). After reviewing clinical files of the 282 patient, 22 were confirmed to have sarcoidosis, at initial presentation (n=19) or later during flare-up or relapse (n=3) with only 2 patients having no granuloma on PLN biopsy. PLN were palpable in 18 cases and only detected by (18F)FDG-PET/CT showing increased PLN uptake in 4 cases. The sensitivity and specificity of adequate biopsy were 91 and 99% and the positive and negative predictive values were 91 and 99%, respectively. CONCLUSION Core-needle biopsy guided by ultrasound has a high efficacy for evidencing granulomas in sarcoidosis patients with PLN involvement either clinically palpable or in the presence of (18F)FDG-PET/CT uptake.
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Djelbani-Ahmed S, Chandesris MO, Mekinian A, Canioni D, Brouzes C, Hanssens K, Pop G, Durieu I, Durupt S, Grosbois B, Besnard S, Tournilhac O, Beyne-Rauzy O, Agapé P, Delmer A, Ranta D, Jeandel PY, Georgin-Lavialle S, Frenzel L, Damaj G, Eder V, Lortholary O, Hermine O, Fain O, Soussan M. FDG-PET/CT findings in systemic mastocytosis: a French multicentre study. Eur J Nucl Med Mol Imaging 2015; 42:2013-20. [PMID: 26140850 DOI: 10.1007/s00259-015-3117-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 04/02/2015] [Accepted: 06/10/2015] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Mastocytosis is a clonal haematological disease characterized by uncontrolled proliferation and the activation of mast cells. The value of FDG-PET/CT (FDG-PET) in mastocytosis has yet to be determined. METHODS We retrospectively identified patients with an established diagnosis of systemic mastocytosis (SM), according to the WHO criteria, who underwent PET using the French Reference Centre for Mastocytosis database. Semi-quantitative and visual analysis of FDG-PET was performed and compared to the clinico-biological data. RESULTS Our cohort included 19 adult patients, median age 65 years [range 58-74], including three with smouldering SM (SSM), three with aggressive SM (ASM), 10 with an associated clonal haematological non-mast-cell lineage disease (SM-AHNMD), and three with mast cell sarcoma (MCS). FDG-PET was performed at the time of the SM diagnosis (15/19), to evaluate lymph node (LN) activity (3/19) or the efficacy of therapy (1/19). FDG uptake was observed in the bone marrow (BM) (9/19, 47%), LN (6/19, 32%), spleen (12/19, 63%), or liver (1/19, 5%). No significant FDG uptake was observed in the SSM and ASM patients. A pathological FDG uptake was observed in the BM of 6/10 patients with SM-AHNMD, appearing as diffuse and homogeneous, and in the LN of 5/10 patients. All 3 MCS patients showed intense and multifocal BM pathological uptake, mimicking metastasis. No correlation was found between the FDG-PET findings and serum tryptase levels, BM mast cell infiltration percentage, and CD30 and CD2 expression by mast cells. CONCLUSIONS FDG uptake does not appear to be a sensitive marker of mast cell activation or proliferation because no significant FDG uptake was observed in most common forms of mastocytosis (notably purely aggressive SM). However, pathological FDG uptake was observed in the SM-AHNMD and in MCS cases, suggesting a role of FDG-PET in their early identification and as a tool of therapeutic assessment in this subgroup of patients.
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Affiliation(s)
- S Djelbani-Ahmed
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France
- Sorbonne Paris Cité, Paris 13 University, Bobigny, France
| | - M O Chandesris
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - A Mekinian
- Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Saint Antoine Hospital, Paris, France
| | - D Canioni
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
- Department of Pathology, Necker Children's Hospital, APHP, Paris, France
| | - C Brouzes
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
- Laboratory of Haematology, Necker Children's Hospital, APHP, Paris, France
| | - K Hanssens
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- INSERM U1068, Centre de Recherche en Cancérologie de Marseille (Signaling, Hematopoiesis and Mechanism of Oncogenesis), Paoli Calmettes Institute, Aix-Marseille University, Marseille, France
| | - G Pop
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France
| | - I Durieu
- Department of Internal and Vascular Medicine, Hospices Civils de Lyon, Groupe Hopitalier Sud, Université de Lyon, Pierre-Bénite, France
| | - S Durupt
- Department of Internal and Vascular Medicine, Hospices Civils de Lyon, Groupe Hopitalier Sud, Université de Lyon, Pierre-Bénite, France
| | - B Grosbois
- Department of Internal Medicine, Rennes University Hospital, Rennes, France
| | - S Besnard
- Department of Internal Medicine, Rennes University Hospital, Rennes, France
| | - O Tournilhac
- Department of Internal Medicine, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - O Beyne-Rauzy
- Department of Internal Medicine, Purpan University Hospital, Toulouse, France
| | - P Agapé
- Department of Oncology and Haematology, Saint-Denis University Hospital, Saint-Denis de la Réunion, France
| | - A Delmer
- Department of Haematology, Reims University Hospital, Reims, France
| | - D Ranta
- Department of Haematology, Brabois University Hospital, Vandoeuvre les Nancy, France
| | - P Y Jeandel
- Department of Internal Medicine, Nice University Hospital, Nice, France
| | | | - L Frenzel
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - G Damaj
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Caen University Hospital, Caen, France
| | - V Eder
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France
| | - O Lortholary
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
- Department of Infectious Diseases and Tropical Medicine, Necker Children's Hospital, APHP, Pasteur Institute, Paris, France
| | - O Hermine
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - O Fain
- Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Saint Antoine Hospital, Paris, France
| | - M Soussan
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France.
- Sorbonne Paris Cité, Paris 13 University, Bobigny, France.
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Soussan M, Nicolas P, Schramm C, Katsahian S, Fain O, Mekinian A. THU0272 Diagnostic Performance and Disease Activity Assessment by FDG-PET in Large-Vessel Vasculitis: A Systematic Literature Review and Meta-Analysis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2610] [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: 11/03/2022]
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Abisror N, Mekinian A, Lavigne C, Vandenehende MA, Soussan M, Fain O. Tocilizumab in refractory Takayasu arteritis: Case series and literature review. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.175] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Soussan M, Abad S, Mékinian A, Dhote R, Eder V. Detection of asymptomatic aortic involvement in ANCA-associated vasculitis using FDG PET/CT. Clin Exp Rheumatol 2013; 31:S56-S58. [PMID: 23294518] [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] [Received: 04/04/2012] [Accepted: 06/13/2012] [Indexed: 06/01/2023]
Abstract
Large vessel involvement in ANCA-associated vasculitis is very rare. We report here on the case of two patients with ANCA-associated vasculitis and asymptomatic aortic arch involvement diagnosed using FDG-PET/CT. Because aortic involvement in ANCA-associated vasculitis is a potentially life-threatening condition, its early detection can be crucial. FDG-PET/CT may also provide new insights into large vessel involvement as part of the spectrum of ANCA-associated vasculitis.
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Affiliation(s)
- M Soussan
- University of Paris 13, Sorbonne Paris Cité, Bobigny, France.
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Cohen C, Mekinian A, Soussan M, Uzunhan Y, Eder V, Dhôte R, Valeyre D, Fain O. Le 18-FDG TEP/CT pourrait être un outil intéressant pour l’évaluation de l’activité des pneumopathies interstitielles au cours du syndrome de Gougerot-Sjogren primaire. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.022] [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: 10/27/2022]
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Mekinian A, Jaccard A, Soussan M, Launay D, Berthier S, Federici L, Lefevre G, Weinmann P, Valeyre D, Dhôte R, Fain O. Intérêt du TEP-scan au cours de l’amylose AL. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.302] [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: 11/16/2022]
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Aydin JM, Mekinian A, Soussan M, Langman B, Ouvrier MJ, Fain O. IRM cardiaque et TEP cardiaque dans le dépistage de l’atteinte cardiaque au cours du Churg et Strauss. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.240] [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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Soussan M, Mekinian A, Brillet PY, Khafagy A, Nicolas P, Vessieres A, Fain O, Brauner M, Weinmann P. Les différents profils de la tuberculose en TEP/scanner au FDG. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.276] [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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Soussan M, Chouahnia K, Kambouchner M, Khafagy A, Des Guetz G, Zelek LH, Martinod E, Morere JF. Assessment of pathologic response to neoadjuvant chemotherapy in locally advanced non-small cell lung cancer using FDG-PET/CT: SUVmax versus metabolic tumor volume. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e17528] [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: 11/20/2022] Open
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Abstract
Sarcoidosis is a juvenile systemic granulomatosis. Its polymorphic clinical presentation depends on its different localisations, thoracic and extrathoracic. The role of imaging is very important for all localisations; but for mediastinopulmonary involvement, which is the most frequent (>90% of cases), it plays a major role in detecting the disease, diagnosing it, its prognosis, decision-making regarding treatment of it and in the monitoring of its development. Standard radiography, which sometimes detects the disease, forms the basis for its four-stage prognostic classification. CT scanning enables the study of mediastinal and hilar lymphadenopathy and the study of parenchyma, making it possible to identify micronodules of lymphatic distributions, alveolar opacities, septal lines, ground-glass hyperintensities, nodules surrounded by a ring of satellite micronodules, peribronchovascular thickening; all potentially reversible lesions. Elsewhere, it highlights irreversible fibrous lesions: hilar peripheral linear opacities; septal linear opacities; bronchial distortion, honeycomb destruction or even perihilar fibrotic masses. Less frequently we can visualise bronchiolar or cystic involvement. Benign in most cases, the sarcoidosis prognosis becomes bleaker in the event of hemoptysis, Aspergillus colonisation or before the onset of pulmonary hypertension.
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Affiliation(s)
- P-Y Brillet
- Service de radiologie, hôpital Avicenne, 125 route de Stalingrad, Bobigny cedex, France.
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Despas F, Serrand J, Franchitto N, Labrunee M, Soussan M, Honton B, Galinier M, Senard JM, Pathak A. H011 Aortic valve remplacement normalizes sympathetic nerve activity in patient with severe aorticv stenosis. Arch Cardiovasc Dis 2009. [DOI: 10.1016/s1875-2136(09)72310-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lacout A, Soussan M, Bienvenot P, El Hajjam M, Lacombe P, Pelage JP. [Answer to February e-quid: diagnosis of a duodenal duplication]. J Radiol 2008; 89:355-357. [PMID: 18408637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Khalil A, Soussan M, Mangiapan G, Fartoukh M, Parrot A, Carette MF. Utility of high-resolution chest CT scan in the emergency management of haemoptysis in the intensive care unit: severity, localization and aetiology. Br J Radiol 2006; 80:21-5. [PMID: 16916805 DOI: 10.1259/bjr/59233312] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [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: 11/05/2022] Open
Abstract
The purpose of this study is to assess the utility of the chest high-resolution computed tomography (HRCT) scan for estimating the severity of haemoptysis, localize the bleeding site and to determine a cause of the bleeding. We reviewed 80 consecutive patients who were admitted to a respiratory intensive care unit (RICU) for haemoptysis and who underwent unenhanced HRCT scanning and fibre-optic bronchoscopy (FOB) within 48 h. The number and type of lobar involvement on the CT scan were correlated to prognostic factors, the amount of bleeding and the bleeding aetiology. We compared HRCT scan observations on localization and bleeding aetiology with FOB results. The number of involved lobes was correlated with the daily (p<0.001) and cumulative (p<0.001) volume of haemoptysis and found to be significantly greater in the group of patients who were mechanically ventilated and/or died (2.7 vs 1.8, p<0.03). FOB and HRCT localized the bleeding site or side, respectively, in 71 (89%) and 64 (80%) patients (p>0.05). Of the nine patients without FOB localization, HRCT localized the bleeding site in six patients (67%). The initial HRCT scan correctly identified 48 aetiologies (60%), whereas FOB identified only 2 proximal bronchogenic carcinomas. The extent of lobar involvement seen by HRCT is a prognostic factor correlated with the daily and cumulative volume of haemoptysis. FOB and HRCT are complementary techniques for bleeding site localization. HRCT-scan is also the best exam to determine the cause of haemoptysis, even while it is occurring.
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Affiliation(s)
- A Khalil
- Department of Radiology, Tenon Hospital, AP-HP, Paris, France.
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