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Costa G, Orbach D, Saulpic J, Sarda-Thibault H, Hanslik T, Brethon B, Tabone MD, Raimbault S, Papillard S, Guillaumat C, Nathanson S, Pellegrino B, Belloy M, Mesples B, Trioche P, Jaber H, Raimondo G, Gilet C, Cohen-Gogo S. Varicella post-exposure management for pediatric oncology patients. Bull Cancer 2022; 109:287-295. [PMID: 35093244 DOI: 10.1016/j.bulcan.2021.11.016] [Citation(s) in RCA: 2] [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: 09/22/2021] [Revised: 11/05/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The objective was to evaluate health care providers' (HCP) adherence to and efficacy of varicella post-exposure prophylaxis (PEP) recommendations. It was an observational, prospective, multicenter study set in Ile-de-France, France. METHODS All children under 18 with a cancer diagnosis, currently or within 3months of receiving cancer treatment, regardless of varicella zoster virus (VZV) serostatus or previous personal history of varicella, were eligible. Study participants with significant exposure were reviewed prospectively for PEP indications. Main outcome measures were the percentage of exposure situations for which HCP were guideline-compliant, the proportion of available VZV serostatuses and the incidence of breakthrough varicella after different PEP approaches. RESULTS A total of 51 patients from 15 centers were enrolled after 52 exposure episodes. Median age at exposure was 5 years (range, 1-15). Exposure within the household led to 38% of episodes. Prophylactic treatment consisted in specific anti-VZV immunoglobulins (V-ZIG) (n=19) or in oral aciclovir (n=15). No prophylactic treatment was given for 18 patients (in compliance, n=16). In compliance with guidelines, 17 patients received V-ZIG, 11 did not develop varicella (65%, [95% CI, 39-90%]); 15 received aciclovir, 13 did not develop varicella (87%, [95% CI, 67-100%]). Breakthrough varicella occurred in 11 patients, with simple clinical course in all cases; in 8/47 (17%) episodes when PEP was guideline-compliant versus 3/5 (60%) when not. DISCUSSION Recommendations have been respected and are efficient. PEP needs to be standardized and a study carried out to define the optimal approach. Anti-VZV immunization of seronegative family members should be encouraged.
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Affiliation(s)
- Guillaume Costa
- Centre Hospitalier Sud Francilien, Corbeil-Essonnes, Department of Pediatrics, 40, Avenue Serge Dassault, 91100 Corbeil-Essonnes, France
| | - Daniel Orbach
- PSL University, SIREDO oncology center (Care, Innovation and Research for Children, Adolescents and young Adults with Cancer) Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Juliette Saulpic
- Centre Médical et Pédagogique Edouard Rist, Department of Hemato-Oncology, 14, Rue Boileau, 75016 Paris, France
| | - Hélène Sarda-Thibault
- Centre Hospitalier Réné Dubos, Department of Pediatrics, 6, avenue de l'Île de France, 95300 Pontoise, France
| | - Thomas Hanslik
- CHU Ambroise Paré, Department of Internal Medicine, 9, Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - Benoit Brethon
- CHU Robert-Debré, Department of Pediatric Immuno-hematology, 48, Bd Sérurier, 75019 Paris, France
| | - Marie-Dominique Tabone
- Armand-Trousseau Sorbonne University Hospital, AP-HP, Department of Pediatric Hemato-Oncology, 26, Av. du Dr Arnold Netter, 75012 Paris, France
| | - Sandra Raimbault
- Institut Gustave Roussy, Department of Pediatric Oncology, 114, Rue Edouard Vaillant, 94805 Villejuif, France
| | - Solesne Papillard
- CHU Ambroise Paré, Department of Pediatrics, 9, Av. Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - Cécile Guillaumat
- Centre Hospitalier Sud Francilien, Corbeil-Essonnes, Department of Pediatrics, 40, Avenue Serge Dassault, 91100 Corbeil-Essonnes, France
| | - Sylvie Nathanson
- Centre Hospitalier André Mignot, Department of Pediatrics, 177, Rue de Versailles, 78150 Le Chesnay-Rocquencourt, France
| | - Béatrice Pellegrino
- Centre Hospitalier François Quesnay, Department of Pediatrics, 2 Bd Sully, 78200 Mantes-la-Jolie, France
| | - Marie Belloy
- Centre Hospitalier Robert Ballanger, Department of Pediatrics, Boulevard Robert Ballanger, 93602 Aulnay-sous-Bois, France
| | - Bettina Mesples
- CHU Louis Mourier, Department of Pediatrics, 178, rue des Renouillers, 92701 Colombes, France
| | - Pascale Trioche
- CHU Antoine Béclère, Department of Pediatrics, 157, Rue de la Porte de Trivaux, 92140 Clamart, France
| | - Hania Jaber
- Centre Hospitalier Simone Veil, Department of Pediatrics, 14, Rue de Saint-Prix, 95600 Eaubonne, France
| | - Graziella Raimondo
- Hospital Margency Croix-Rouge, Department of Pediatrics, 18, rue Roger Salengro, 95580 Margency, France
| | - Céline Gilet
- Regional care network for pediatric hematology-oncology-Ile-de-France (RIFHOP), 3-5, rue de Metz, 75010 Paris, France
| | - Sarah Cohen-Gogo
- The Hospital for Sick Children, Division of Hematology, Oncology, Department of Pediatrics, 555, University Avenue, Toronto, Canada.
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Boyer O, Baudouin V, Bérard É, Biebuyck-Gougé N, Dossier C, Guigonis V, Audard V, Klifa R, Leroy V, Ranchin B, Roussey G, Samaille C, Tellier S, Vrillon I. [Vaccine recommendations for children with idiopathic nephrotic syndrome]. Nephrol Ther 2020; 16:177-183. [PMID: 32278737 DOI: 10.1016/j.nephro.2019.09.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 11/16/2022]
Abstract
The specific treatment of idiopathic nephrotic syndrome is based on corticosteroid therapy and/or steroid-sparing immunosuppressive agents in children who are steroid-dependant or frequent relapsers (60-70 %). Patients have an increased infectious risk not only related to the disease during relapses (hypogammaglobulinemia and urinary leakage of opsonins) but also to treatments (corticosteroids or immunosuppressive agents) in period of remission. Vaccination is therefore particularly recommended in these patients. Potential vaccine risks are ineffectiveness, induction of vaccine disease and relapse of idiopathic nephrotic syndrome. Only live vaccines expose to the risk of vaccine disease: they are in general contra-indicated under immunosuppressive treatment. The immunogenicity of inactivated vaccines is reduced but persists. The immunogenic stimulus of vaccination may in theory trigger a relapse of the nephrotic syndrome. Nevertheless, this risk is low in the literature, and even absent in some studies. The benefit-risk ratio is therefore in favor of vaccination with respect to the vaccination schedule for inactivated vaccines, with wide vaccination against pneumococcus and influenza annually. Depending on the context and after expert advice, immunization with live vaccines could be discussed if residual doses/levels of immunosuppressive treatments are moderate and immunity preserved.
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Affiliation(s)
- Olivia Boyer
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France.
| | - Véronique Baudouin
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université de Paris, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - Étienne Bérard
- Service de néphrologie pédiatrique, CHU de Nice, Archet 2, 151, route Saint-Antoine de Ginestière, CS 23079, 06202 Nice cedex 3, France
| | - Nathalie Biebuyck-Gougé
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France
| | - Claire Dossier
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Robert-Debré, institut Imagine, université de Paris, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - Vincent Guigonis
- Département de pédiatrie, hôpital Mère-Enfant, 8, avenue Dominique-Larrey, 87042 Limoges cedex, France
| | - Vincent Audard
- Inserm U955, service de néphrologie et transplantation, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, université Paris-Est Créteil, CHU Henri Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Roman Klifa
- Service de néphrologie pédiatrique, centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, hôpital Necker-Enfants-malades, institut Imagine, université de Paris, 149, rue de Sèvres, 75015 Paris, France
| | - Valérie Leroy
- Service de néphrologie pédiatrique, CHU La Réunion, Site Félix Guyon, allée des Topazes, CS 11021, 97400 Saint-Denis, Réunion
| | - Bruno Ranchin
- Service de néphrologie pédiatrique, centre de référence néphrogone, CHU de Lyon, 59, boulevard Pinel, 69500 Bron, France
| | - Gwenaëlle Roussey
- Clinique médicale pédiatrique, CHU de Nantes, 5, allée de l'Île Gloriette, 44093 Nantes, France
| | - Charlotte Samaille
- Service de néphrologie pédiatrique, hôpital Jeanne de Flandre, centre hospitalo-universitaire de Lille, avenue Eugène-Avinée, 59000 Lille, France
| | - Stéphanie Tellier
- Service de néphrologie-rhumatologie-médecine interne pédiatrique, centre de référence des Maladies rénales rares du Sud-Ouest (SORARE), hôpital des enfants, 330, avenue de Grande-Bretagne, 31300 Toulouse, France
| | - Isabelle Vrillon
- Service de médecine infantile, secteur de néphrologie pédiatrique, hôpital d'Enfants de Brabois, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
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Abstract
Despite its benign characteristics, chickenpox is a childhood disease responsible for complications and deaths, particularly in the high-risk population. VariZIG®, not commercialized in France, is a good alternative for seronegative individuals exposed to the virus and not eligible for vaccination. The efficacy of routine vaccination has been demonstrated with a decrease in chickenpox incidence and with the development of herd immunity. Over time, the protective antibody titer of vaccinated people decreases and can be maintained by two doses of the vaccine. A tetravalent measles-mumps-rubella-chickenpox vaccine, used in the United States, has a good tolerability in spite of the occurrence of fever and febrile seizures. Routine vaccination would contribute to make savings in France, by reducing direct and indirect costs of chickenpox.
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Affiliation(s)
- Coralie Lo Presti
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital Nord, Chemin-des-Bourrely, 13915 Marseille cedex 20, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Christophe Curti
- Assistance publique-Hôpitaux de Marseille (AP-HM), service central de la qualité et de l'information pharmaceutiques (SCQIP), hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Marc Montana
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital Nord, Chemin-des-Bourrely, 13915 Marseille cedex 20, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Charléric Bornet
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital de la conception, 147, boulevard Baille, 13005 Marseille, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
| | - Patrice Vanelle
- Assistance publique-Hôpitaux de Marseille (AP-HM), pharmacie usage intérieur, hôpital de la conception, 147, boulevard Baille, 13005 Marseille, France; Laboratoire de pharmaco-chimie radicalaire, faculté de pharmacie, Aix-Marseille Université, CNRS, ICR, UMR 7273, 27, boulevard Jean-Moulin-CS30064, 13385 Marseille cedex 05, France.
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Ouédraogo MS, Korsaga Somé N, Tapsoba GP, Ouédraogo AN, Sondo KA, Inouss IA, Sanou ML, Konsem T, Sakandé J, Barro Traoré F, Niamba P, Traoré A. [Ecthyma gangrenosum of the eyelid after chickenpox]. Ann Dermatol Venereol 2016; 143:607-610. [PMID: 27476377 DOI: 10.1016/j.annder.2016.06.008] [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: 11/17/2015] [Revised: 02/06/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Ecthyma gangrenosum is most commonly seen in immunodepressed patients (cytotoxic chemotherapy, HIV infection, neutropenia or functional neutrophil deficiency, agammaglobulinemia). It is a rarely described complication in chicken pox. PATIENTS AND METHODS Herein we report the case of a girl aged 2 ½ years presenting in our dermatology department with ecthyma gangrenosum on the right upper eyelid secondary to varicella. The disease course was marked by fibrous scarring of the inner canthus with ptosis of the right upper eyelid. The retractile scarring caused disability. DISCUSSION There have been previous reports of the contribution of non-steroidal anti- inflammatory drugs (NSAIDs) to the appearance of necrotic cutaneous super infections during the course of chickenpox. The occurrence of such complications on an eyelid may be harmful not only for the function of the eye but it can also cause extensive aesthetic impairment. Subsequent aesthetic and functional impairment may be improved by corrective surgery.
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Affiliation(s)
- M-S Ouédraogo
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso; Université Ouaga I, Ouagadougou, Burkina Faso.
| | - N Korsaga Somé
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso; Université Ouaga I, Ouagadougou, Burkina Faso
| | - G-P Tapsoba
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso; Université Ouaga I, Ouagadougou, Burkina Faso
| | - A-N Ouédraogo
- Université Ouaga I, Ouagadougou, Burkina Faso; Service de dermatologie vénéréologie, centre Raoul-Follereau, Ouagadougou, Burkina Faso
| | - K-A Sondo
- Université Ouaga I, Ouagadougou, Burkina Faso; Service des maladies infectieuses, CHU Yalgado-Ouédraogo, Ouagadougou, Burkina Faso
| | - I-A Inouss
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso
| | - M-L Sanou
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso
| | - T Konsem
- Université Ouaga I, Ouagadougou, Burkina Faso; Service d'odontologie et de chirurgie maxillofaciale, CHU Yalgado-Ouédraogo, Ouagadougou, Burkina Faso
| | - J Sakandé
- Université Ouaga I, Ouagadougou, Burkina Faso; Service des laboratoires, CHU Yalgado-Ouédraogo, Ouagadougou, Burkina Faso
| | | | - P Niamba
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso; Université Ouaga I, Ouagadougou, Burkina Faso
| | - A Traoré
- Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso; Université Ouaga I, Ouagadougou, Burkina Faso
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Benjelloun H, Zaghba N, Yassine N, Bakhatar A, Bahlaoui A. [Varicella pneumonia associated with bilateral pleurisy in an immunocompetent adult]. Rev Pneumol Clin 2013; 69:287-290. [PMID: 23688722 DOI: 10.1016/j.pneumo.2013.03.002] [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: 12/11/2012] [Revised: 03/10/2013] [Accepted: 03/11/2013] [Indexed: 06/02/2023]
Abstract
Chickenpox is a viral infection usually benign and practically mandatory of the childhood. In the adult, it may know multivisceral complications as pneumonia in relationship with chickenpox which is the most frequent. One case of varicella pneumonia with a bilateral pleurisy has been noticed in a 38-year-old adult. The definite diagnosis has been based on clinical, biological and radiological arguments. Under an antiviral treatment, the evolution is favourable.
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Affiliation(s)
- H Benjelloun
- Service des maladies respiratoires, CHU Ibn Rochd, Casablanca, Maroc.
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