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Boulu X, Vaysse B, El Esper I, Meyer ME, Duhaut P, Salle V, Schmidt J. [Inflammatory syndrome of unknown origin and PET/CT: Economic and iatrogenic impacts of false positive]. Rev Med Interne 2023:S0248-8663(23)01275-4. [PMID: 38000918 DOI: 10.1016/j.revmed.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION PET/CT is regularly used to investigate inflammatory syndrome of unknown origin (IUO), but hypermetabolisms found are not always consistent with the final diagnosis. The objective of the study was to assess the cost attributed to the diagnostic work-up for these false positives. MATERIALS AND METHODS We conducted an ancillary study on a previous retrospective cohort from the internal medicine department at Amiens university hospital in patients who had a PET/CT scan between October 2004 and April 2017. Patients were included if PET/CT had been prescribed to investigate IUO. Among the 763 PET/CT performed, 144 met the inclusion criteria and a false-positive rate of 17.4% (n=25) was reported. RESULTS Among these 25 patients, 21 underwent further investigations. The most frequently found hypermetabolic territories were digestive (n=12, mean SUVmax 8 [±4.33]) and osteoarticular (n=11, mean SUVmax 4.33 [±1.15]). The total cost of the 13 prescribed consultations was €390, the total cost of the 40 additional tests was €4,476 (mainly digestive endoscopies and radiological tests) and the total cost of medical transport was €572. The total cost of the 35 days of hospitalization specifically required to investigate these false positives was €22,952. In 23.8% (n=5), these investigations led to the incidental discovery of tumor lesions. CONCLUSION The economic impact of false-positive PET/CT results does not appear to be negligible and merits a genuine prospective medico-economic study.
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Affiliation(s)
- X Boulu
- Médecine interne, CHU Amiens Picardie, 80054 Amiens, France; RECIF Amiens, CHU Amiens Picardie, 80054 Amiens, France.
| | - B Vaysse
- Département d'information médicale, CHU Amiens Picardie, 80054 Amiens, France
| | - I El Esper
- Médecine nucléaire et traitement de l'image, CHU Amiens Picardie, 80054 Amiens, France
| | - M-E Meyer
- Médecine nucléaire et traitement de l'image, CHU Amiens Picardie, 80054 Amiens, France
| | - P Duhaut
- Médecine interne, CHU Amiens Picardie, 80054 Amiens, France; RECIF Amiens, CHU Amiens Picardie, 80054 Amiens, France
| | - V Salle
- Médecine interne, CHU Amiens Picardie, 80054 Amiens, France; RECIF Amiens, CHU Amiens Picardie, 80054 Amiens, France
| | - J Schmidt
- Médecine interne, CHU Amiens Picardie, 80054 Amiens, France; RECIF Amiens, CHU Amiens Picardie, 80054 Amiens, France
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Zaouzaou L, Constans J, Brochot E, Bourgeois A, Dernoncourt A, Morain M, Boulu X, Karam J, Duhaut P, Schmidt J, Salle V. Troubles mnésiques persistants post-COVID-19 : intérêt de la recherche des anti-SARS-CoV-2 dans le LCR couplée à la spectro-IRM cérébrale ? Rev Med Interne 2022. [PMCID: PMC9724766 DOI: 10.1016/j.revmed.2022.10.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction La maladie post-COVID-19 se développe quelle que soit la gravité de l’infection à SARS-CoV-2 initiale et comporte un large éventail de manifestations cliniques parmi lesquelles figurent de nombreux troubles neurologiques tels que les céphalées, l’anosmie, des troubles de la mémoire…. Observation Nous rapportons le cas d’une patiente âgée de 68 ans adressée en consultation de médecine interne pour asthénie, troubles de la concentration et de la mémoire dans les suites d’une infection à SARS-CoV-2. Ses antécédents sont marqués par une HTA, un asthme, une thrombose veineuse profonde, une cholécystectomie, un œdème de Quincke avec choc anaphylactique aux AINS et une hypogammaglobulinémie modérée. On note une absence d’intoxication alcoolo-tabagique. La patiente a présenté en janvier 2021 une infection à SARS-CoV-2 avec fièvre et céphalées. La recherche de virus par PCR était négative lors de cet épisode avec secondairement une sérologie positive confirmant l’infection. Progressivement sont apparus des troubles de la mémoire et de la concentration. Son MMS était à 27/30. L’IRM cérébrale en juin 2021 montrait de multiples hypersignaux de la substance blanche. Un bilan a été réalisé en hôpital de jour avec réalisation d’une ponction lombaire. Le LCR retrouvait l’absence de leucocytes (< 1 élément/mm3), des hématies à 24 éléments/mm3 et une protéinorachie à 0,45 g/L. Les anticorps anti-rNMDA, anti-CASPR2, anti-rGABAb, anti-DPPX, anti-LGI1 et anti-AMPAr dans le LCR étaient négatifs. Absence de bande surnuméraire à l’isofocalisation. Les anticorps anti-SARS-CoV-2 dans le LCR étaient positifs à 108,7 UA/mL, la recherche de virus par PCR étant négative. Le rapport de Delpech était normal à 0,52 mais n’excluant pas une synthèse intrathécale d’IgG. Par ailleurs, l’index albumine LCR/albumine sérum était normal. Une polysomnographie ne retrouvait pas de syndrome d’apnées du sommeil. Une spectroscopie par IRM cérébrale en mai 2022 a mis en évidence une réaction gliale ainsi qu’une dysfonction neuronale au niveau de l’hippocampe et de la protubérance. Discussion Les séquelles neuropsychologiques post-COVID-19 témoignent d’une neuro-inflammation liée à l’activation de la microglie et à une réaction auto-immune [1]. La persistance de troubles cognitifs associée à la présence d’anticorps anti-SARS-CoV-2 dans le LCR 6 mois après COVID-19 a été rapportée chez une patiente de 57 ans [2]. Dans notre observation, la présence de ces anticorps peut témoigner d’une neuro-inflammation constatée sur la spectroscopie par IRM cérébrale. Une exploration biologique plus approfondie du LCR ainsi qu’une exploration par spectroscopie par IRM cérébrale pourraient être suggérées chez les patients présentant des troubles cognitifs plusieurs mois après une infection à SARS-CoV-2. Conclusion D’autres études seront nécessaires afin de mieux définir la place de la recherche des anticorps anti-SARS-CoV-2 dans le LCR chez les patients ayant des séquelles neurologiques majeures liées au COVID-19.
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Affiliation(s)
- L. Zaouzaou
- Médecine interne et recif, CHU Amiens, Amiens cedex,Auteur correspondant
| | | | - E. Brochot
- Virologie, CHU Amiens-Picardie Sud, Amiens
| | | | | | - M. Morain
- Médecine interne et recif, CHU Amiens, Amiens cedex
| | - X. Boulu
- Médecine interne et recif, CHU Amiens, Amiens cedex
| | - J.D. Karam
- Médecine interne et recif, CHU Amiens, Amiens cedex
| | - P. Duhaut
- Médecine interne et recif, CHU Amiens, Amiens cedex
| | - J. Schmidt
- Médecine interne et recif, CHU Amiens, Amiens cedex
| | - V. Salle
- Médecine interne et recif, CHU Amiens, Amiens cedex
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Coustal C, Goulabchand R, Labauge P, Guilpain P, Carra-Dallière C, Januel E, Jeziorski E, Salle V, Viallard J, Boutboul D, Fieschi C, Gobert D, Aladjidi N, Rullier P, Graveleau J, Piel-Julian M, Suarez F, Neven B, Mahlaoui N, Ayrignac X. Atteintes neurologiques multifacettes des déficits en CTLA4 : étude observationnelle nationale. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Serpier M, Thibault W, Nejjar I, Salle V, Masmoudi I. Paralysie du VI isolée révélant un cancer multimétastatique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.095] [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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Salle V, Gomila C, Picard C, Brulé A, Becquet N, Fuzellier D, Cailly A, Quignion D, Rose-Robert F, Schmidt J, Voyer A, Herpe Y, Galmiche A, Duhaut P. Étude prospective de prévalence des anticorps antiphospholipides conventionnels dans une population de sujets sains. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Metzelard M, Ullmer A, Schmidt J, Salle V, Smail A, Brault C, Duhaut P. Indice de masse corporelle syndrome inflammatoire et maladies autoimmunes. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.270] [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: 11/24/2022]
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Beauvillain Q, Dessirier F, Lombart F, Dadban A, Salle V, Morel P, Attencourt C, Lok C, Chaby G. Scléromyxœdème associé à une gammapathie monoclonale traité par lénalidomide et dexaméthasone. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.446] [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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Aubignat M, Schmidt J, Smail A, Duhaut P, Salle V. Quelle place pour la recherche des anticorps de spécificités étendues (prothrombine, phosphatidyléthanolamine et annexine V) dans le syndrome des antiphospholipides ? Étude rétrospective sur 95 patients. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and/or obstetrical manifestations and the persistent presence, at least 12 weeks apart, of antiphospholipid antibodies (aPL) such as lupus anticoagulant (LA) and/or anticardiolipin antibodies (ACL) and/or anti-β2 glycoprotein I antibodies (aβ2GPI). The finding of patients with clinical profile highly suggestive of APS but who are negative for conventional biological criteria has led to the concept of seronegative APS. In the last few years, new antigen targets and methodological approaches have been employed to more clearly identify this syndrome in patients with thrombosis or obstetrical complications without conventional aPL. Although seronegative APS is still controversial, there is increasing recognition of the existence of this subgroup. However, clinical relevance of non conventional aPL need to be confirmed by efforts toward standardizing new biological tools and longitudinal studies involving large cohort of patients.
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Affiliation(s)
- V Salle
- Service de médecine interne, CHU Amiens-Picardie, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France; Laboratoire de biochimie recherche, CHU Amiens-Picardie, Amiens, France.
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Salle V, Gomila C, Diouf M, Schmidt J, Galmiche A, Conte M, Smail A, Boulu X, Morel P, Marolleau J, Dersigny A, Herpe Y, Duhaut P. Dosage de l’annexine A2 au cours du myélome multiple. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.027] [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: 11/25/2022]
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Aubignat M, Smail A, Schmidt J, Salle V, Sevestre H, Duhaut P. Tumeurs brunes pelviennes : évolution sur 12 ans. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.222] [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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Rossi F, Chan Sui Ko A, Brault C, Salle V, Gabrion A, Schmidt J, Duhaut P. L’osétomyélite qui cachait le Rendu-Osler. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.226] [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: 10/25/2022]
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Salle V, Sagnier A, Diouf M, Schmidt J, Smail A, Galmiche A, Herpe Y, Duhaut P. Prevalence of anti-S100A10 antibodies in antiphospholipid syndrome patients. Thromb Res 2019; 179:15-19. [DOI: 10.1016/j.thromres.2019.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/19/2019] [Accepted: 04/23/2019] [Indexed: 12/24/2022]
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Loiseau P, Boulu X, Ouin E, Salle V. Hyperéosinophilie chronique sous pomalidomide : savoir y penser ! Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.232] [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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Smail A, Fontaine N, Aubignat M, Brault C, Salle V, Schmidt J, Duhaut P. Rôle du médecin généraliste dans la prise en charge du patient sous corticothérapie per os au long cours : enquête de pratiques à propos de 95 cas. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.197] [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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Metzelard M, Chaby G, Schmidt J, Duhaut P, Boulu X, Clement B, Lombart F, Ikoli J, Chatelain D, Baltazard T, Smail A, Salle V. Association psoriasis et syndrome Sjögren-like : quand la pathologie inflammatoire rencontre la pathologie auto-immune, nouvelle entité ou association fortuite ? Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.067] [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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Gourguechon C, Salle V, Brault C, Schmidt J, Karam J, Boulu X, Constans J, Sevestre H, Pater F, Galicier L, Duhaut P, Smail A. Efficacité du traitement par abatacept sur l’atteinte cérébrale cortico-dépendante secondaire à un déficit en CTLA-4. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.166] [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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Aubignat M, Schmidt J, Gourguechon C, Brault C, Salle V, Smail A, Duhaut P. Myopathies à anticorps anti-HMGCR : à propos de 5 cas. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.225] [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: 11/25/2022]
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Aubignat M, Schmidt J, Salle V, Smail A, Duhaut P. Les myopathies à anticorps anti-HMGCR en 2018 : état des lieux des connaissances. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.362] [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: 11/25/2022]
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Boulu X, Meyer M, Smail A, Salle V, Pater F, Duhaut P, Schmidt J. Rentabilité diagnostique du TEP/CT dans l’exploration d’un syndrome inflammatoire prolongé inexpliqué : à propos de 144 patients. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Duhaut P, Smail A, Salle V, Pater F, Brault C, Schmidt J. Consultations dans un service de médecine interne et aspects médico-économiques. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.274] [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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Aubignat M, Dernoncourt A, Gourguechon C, Schmidt J, Salle V, Smail A, Canaple S, Sevestre H, Duhaut P. Myopathie à anticorps anti-HMGCR associée à une méningite lymphocytaire et des anticorps anti-gangliosides et anti-sulfatides. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.226] [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: 10/14/2022]
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Aubignat M, Salle V, Gourguechon C, Smail A, Schmidt J, Sevestre H, Merle P, Duhaut P. Neuropathie motrice et ichtyose paranéoplasiques révélant un lymphome de Hodgkin. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.152] [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: 11/25/2022]
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Pater F, Delbarre M, Schmidt J, Salle V, Smail A, Gourguechon C, Duhaut P. Une sclérose latérale primitive/amyotrophique réversible ou le syndrome du moine copiste. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.209] [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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Aubignat M, Smail A, Salle V, Gourguechon C, Schmidt J, Duhaut P. Panniculite des cavaliers associés au froid (perniose des cavaliers) : à propos d’un cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.090] [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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Aubignat M, Schmidt J, Smail A, Salle V, Gourguechon C, Pater F, Duhaut P. Pathologies neuromusculaires et profession d’agriculteur : étude castémoins en milieu hospitalier. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stankovic K, Georgin Lavialle S, Buob D, Poitou-Bernert C, Salle V, Urbanski G, Guichard J, Grosbois B, Christides C, Amselem S, Grateau G. L’obésité est-elle une cause émergente d’amylose AA ? À propos d’une cohorte française de 12 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.347] [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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Siauve J, Lanoix J, Boursier A, Joseph C, Sejourne A, Vaidie A, Salle V, Hanat S, Denamps J, El Samad Y. Juste prescription d’antibiotiques, où en sommes-nous dans notre CHU ? Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.113] [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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Salle V, Schmidt J, Delbarre M, Gourguechon C, Pater F, Smail A, Duhaut P. Activité agricole et cancers hématologiques : étude cas-témoins dans un service de médecine interne. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Salle V, Schmidt J, Aubignat M, Galmiche A, Dernoncourt A, Smail A, Brulé A, Delbarre M, Gourguechon C, Pater F, Herpe Y, Duhaut P. Anticorps dirigés contre la protéine S100A10 au cours du syndrome des antiphospholipides. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Aubignat M, Karam J, Schmidt J, Salle V, Smail A, Sevestre H, Duhaut P. Lymphome intravasculaire ou vascularite cérébrale ? Un défi diagnostique et une question vitale. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.216] [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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Florentina P, Schmidt J, Dernoncourt A, Salle V, Gourguechon C, Smail A, Duhaut P. Agriculteurs et risque de cancers : étude cas-témoins prospective. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.035] [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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Sagnier A, Salle V, Schmidt J, Gourguechon C, Karam JD, Boulu X, Smail A, Metzelard M, Pater F, Duhaut P. Amylose AA et nodule thyroïdien : penser au cancer médullaire de la thyroïde ! Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.322] [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: 11/24/2022]
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Salle V, Schmidt J, Smail A, Mazière C, Conte MA, Brulé A, Mazière JC, Cadet E, Herpe YE, Duhaut P. Antibodies directed against annexin A2 and obstetric morbidity. J Reprod Immunol 2016; 118:50-53. [PMID: 27631133 DOI: 10.1016/j.jri.2016.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 01/11/2023]
Abstract
Acquired and inherited thrombophilia have both been reported to be associated with an increased risk of obstetric complications in early or later stages of pregnancy. Annexin A2 (ANXA2) is strongly expressed in vascular and placental tissues and plays a crucial role in fibrinolysis. The aim of the present study was to evaluate the prevalence of antibodies directed against ANXA2 in patients with recurrent miscarriage or obstetric complications. Anti-ANXA2 antibodies (aANXA2) were detected by ELISA in the sera from 46 women with obstetric morbidity, mainly recurrent miscarriage. The cut-off value for positivity was defined as 3 standard deviations above the mean optical density (OD) obtained in the sera from 42 female blood donors. The prevalence of aANXA2 in patients and healthy individuals was 15.2% and 2.3%, respectively. A statistically significant difference was observed between the 2 groups in terms of aANXA2 IgG titers (p=0.01). The highest aANXA2 levels were observed in sera from 2 patients with recurrent miscarriage and one patient with preeclampsia. aANXA2 could play a role in thrombotic mechanisms leading to recurrent pregnancy loss and placental vascular disease. Further studies are needed to determine whether ANXA2 is critical for maintenance of placental integrity.
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Affiliation(s)
- V Salle
- Department of Internal Medicine, Amiens University Hospital, France; INSERM U1088, Biochemistry Laboratory, Amiens University Hospital, France.
| | - J Schmidt
- Department of Internal Medicine, Amiens University Hospital, France
| | - A Smail
- Department of Internal Medicine, Amiens University Hospital, France
| | - C Mazière
- INSERM U1088, Biochemistry Laboratory, Amiens University Hospital, France
| | - M A Conte
- INSERM U1088, Biochemistry Laboratory, Amiens University Hospital, France
| | - A Brulé
- French Blood Establishment-North of France, France
| | - J C Mazière
- INSERM U1088, Biochemistry Laboratory, Amiens University Hospital, France
| | - E Cadet
- Department of Genetics, Amiens University Hospital, France
| | - Y E Herpe
- Biobank of Picardie, Amiens University Hospital, Amiens, France
| | - P Duhaut
- Department of Internal Medicine, Amiens University Hospital, France
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Salle V, Vittecoq O, Jouen-Beades F, Ménard JF, Ducroix JP, Godin M, Le Loët X, Tron F. Autoantibodies recognizing the 27 carboxy-terminal amino acids of calpastatin are associated with secondary Sjögren syndrome in systemic lupus erythematosus. Lupus 2016; 13:800-4. [PMID: 15540513 DOI: 10.1191/0961203303lu2017oa] [Citation(s) in RCA: 2] [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: 11/05/2022]
Abstract
The objective of this study was to determine in systemic lupus erythematosus (SLE) the prevalence and clinical significance of anticalpastatin antibodies (ACAST), an autoantibody population previously detected in sera from patients with various connective tissue diseases. Eighty-four patients with SLE (mean age: 30 years at diagnosis, females 77) that fulfilled ACR criteria were included in the study retrospectively. Several clinical and biological data were collected. ACAST were detected by a solid-phase enzyme linked immunosorbent assay (ELISA) using as antigen a synthetic peptide corresponding to the 27 C-terminal amino acids of calpastatin (CAST-C27). The prevalence of ACAST-C27 was 13% (11/84) in SLE patients. No correlation was found between the presence of ACAST-C27 and clinical manifestations such as thrombosis and vasculitis. Furthermore, no correlation was observed with the presence of antiphospholipid antibodies (APL). However, we found a statistically significant association between the presence of ACAST-C27 and that of secondary Sjögren syndrome ( P = 0.01). The conclusion is ACAST-C27 are not associated with thrombosis in SLE patients. The association observed between ACAST-C27 and secondary Sjögren syndrome suggests that ACAST-C27 might be useful in discriminating a clinical subgroup of SLE patients.
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Affiliation(s)
- V Salle
- Inserm U519 and Institut Fédératif de Recherche Multidisciplinaire sur les Peptides (IFR 23), Faculté de Médecine et de Pharmacie, Rouen, France.
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Karam J, Gourguechon C, Lacroix M, Brault C, Schmidt J, Pater F, Smail A, Salle V, Duhaut P. Thrombose veineuse abdominale et prise de créatine à but sportif : une association fortuite ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.171] [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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Ullmer A, Karam J, Gourguechon C, Pater F, Schmidt J, Duhaut P, Brault C, Smail A, Salle V. Maladie de Rendu-Osler et myélome multiple : une dangereuse association compliquant la prise en charge de l’hémopathie. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gourguechon C, Le Roy G, Schmidt J, Brault C, Smail A, Salle V, Duhaut P. Association myasthénie auto-immune et maladie de Crohn : diagnostic au cours de la grossesse orienté par la biopsie de glandes salivaires accessoires. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.116] [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: 11/25/2022]
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Gourguechon C, Royer B, Salle V, Schmidt J, Duhaut P, Marolleau J. Syndrome d’Evans de l’adulte : série rétrospective monocentrique de 15 cas. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schmidt J, Smail A, Roche B, Gay P, Salle V, Pellet H, Duhaut P. Incidence of Severe Infections and Infection-Related Mortality During the Course of Giant Cell Arteritis: A Multicenter, Prospective, Double-Cohort Study. Arthritis Rheumatol 2016; 68:1477-82. [DOI: 10.1002/art.39596] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 01/12/2016] [Indexed: 11/08/2022]
Affiliation(s)
- J. Schmidt
- Amiens University Hospital and Jules Verne University of Picardy; INSERM U-1088 Amiens France
| | - A. Smail
- Amiens University Hospital; Amiens France
| | - B. Roche
- Filieris Medical Center; Saint-Étienne France
| | - P. Gay
- Filieris Medical Center; Saint-Étienne France
| | - V. Salle
- Amiens University Hospital and Jules Verne University of Picardy; INSERM U-1088 Amiens France
| | | | - P. Duhaut
- Amiens University Hospital and Jules Verne University of Picardy; INSERM U-1088 Amiens France
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Thill P, Salle V, Smail A, Schmidt J, Duhaut P. Une maladie de Horton se révélant être une amylose AL…. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.136] [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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Salle V, Cordonnier C, Schmidt J, Mazière C, Smail A, Attencourt C, Mabille MP, Mazière JC, Makdassi R, Choukroun G, Diouf M, Duhaut P, Ducroix JP. Vascular expression of annexin A2 in lupus nephritis. J Clin Pathol 2015; 69:533-6. [PMID: 26511441 DOI: 10.1136/jclinpath-2015-203139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/05/2015] [Indexed: 11/04/2022]
Abstract
AIMS To evaluate vascular expression of annexin A2 (ANXA2) and its subunit S100A10 in lupus nephritis (LN). METHODS The present histological study included 14 patients with LN and 11 controls (patients with non-lupus kidney diseases). Kidney biopsies from patients with lupus were scored for lupus glomerulonephritis (according to the International Society of Nephrology/Renal Pathology Society 2003 classification) and vascular lesions (such as microthrombi and antiphospholipid syndrome nephropathy (APSN)). ANXA2 and S100A10 expression in glomerular and peritubular capillaries was evaluated by immunohistochemistry on tissue sections. The staining intensity score ranged from 0 (no expression) to 4 (intense expression). RESULTS In patients with LN, the median age (range) at first kidney biopsy was 36 (18-49). Vascular lesions were observed in six patients (including two with APSN). We observed intense expression of ANXA2 in glomerular and peritubular capillaries while expression of S100A10 was weaker. However, one of the patients with APSN showed strong S100A10 expression. Patients with LN and controls differed significantly in terms of S100A10 expression in peritubular capillaries. We also observed a statistical difference between patients who had LN with renal vascular lesions and those without renal vascular lesions in terms of ANXA2 expression in peritubular capillaries. CONCLUSIONS The presence of vascular lesions in LN appears to be associated with significant differences in the vascular expression of ANXA2. Vascular expression of ANXA2 was somewhat higher in LN. Vascular expression of S100A10 was somewhat lower in LN (except one of the two patients with APSN). Further studies of ANXA2's putative value as a biomarker of active LN or of vascular lesions in LN are required.
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Affiliation(s)
- V Salle
- Department of Internal Medicine, Amiens University Hospital, Amiens, France
| | - C Cordonnier
- Department of Pathology, Amiens University Hospital, Amiens, France
| | - J Schmidt
- Department of Internal Medicine, Amiens University Hospital, Amiens, France
| | - C Mazière
- INSERM U1088 Biochemistry Laboratory, Amiens University Hospital, Amiens, France
| | - A Smail
- Department of Internal Medicine, Amiens University Hospital, Amiens, France
| | - C Attencourt
- Department of Pathology, Amiens University Hospital, Amiens, France
| | - M P Mabille
- Department of Pathology, Amiens University Hospital, Amiens, France
| | - J C Mazière
- INSERM U1088 Biochemistry Laboratory, Amiens University Hospital, Amiens, France
| | - R Makdassi
- Department of Nephrology, Amiens University Hospital, Amiens, France
| | - G Choukroun
- Department of Nephrology, Amiens University Hospital, Amiens, France
| | - M Diouf
- Division of Clinical Research and Innovation, Amiens University Hospital, Amiens, France
| | - P Duhaut
- Department of Internal Medicine, Amiens University Hospital, Amiens, France
| | - J P Ducroix
- Department of Internal Medicine, Amiens University Hospital, Amiens, France
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Salle V, Chatelain D, Smail A, Schmidt J, Duhaut P. Profil étiologique des lymphoproliférations réactionnelles : étude rétrospective dans un service de médecine interne. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.241] [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: 11/25/2022]
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Boulu X, Patrier J, Sagnier A, Smail A, Schmidt J, Salle V. Hypophysite nécrosante : une sémiologie peu banale. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Roca F, Goeb V, Salle V, Vittecoq O, Levesque H, Duhaut P, Dominique S, Marie I. Pneumopathie interstitielle diffuse au cours du syndrome de Sjögren primitif : caractéristiques évolutives et facteurs prédictifs. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Salle V, Desblache J, Mahevas M, Smail A, Schmidt J, Capiod JC, Ducroix JP. [Fatal HHV-8-associated hemophagocytic syndrome in an HIV-negative patient]. Med Mal Infect 2014; 44:437-40. [PMID: 25239145 DOI: 10.1016/j.medmal.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/02/2014] [Accepted: 07/02/2014] [Indexed: 11/19/2022]
Affiliation(s)
- V Salle
- Service de médecine interne, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France.
| | - J Desblache
- Service de médecine interne, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - M Mahevas
- Service de médecine interne, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - A Smail
- Service de médecine interne, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J Schmidt
- Service de médecine interne, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J-C Capiod
- Laboratoire d'hématologie, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J-P Ducroix
- Service de médecine interne, CHU Amiens Nord, 1, place Victor-Pauchet, 80054 Amiens cedex 1, France
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Brault C, Salle V, Gourguechon C, Zerbib Y, Dahmani R, Duhaut P. Une double hémopathie lymphoïde traitée par bortezomib. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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49
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Brault C, Gourguechon C, Gouraud C, Salle V, Duhaut P. Une rhombencéphalite post-infectieuse. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.147] [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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50
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Zerbib Y, Schmidt J, Brault C, Legrain A, Smail A, Salle V, Duhaut P. Un inhibiteur acquis du facteur V. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.285] [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: 10/25/2022]
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