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5 results on '"Sabine Zaepfel"'

1. Extreme Hyperferritinemia: Causes and Prognosis

Author

Maxime Fauter, Sabine Mainbourg, Thomas El Jammal, Arthur Guerber, Sabine Zaepfel, Thomas Henry, Mathieu Gerfaud-Valentin, Pascal Sève, and Yvan Jamilloux

Subjects
hyperferritinemia, hemophagocytic lymphohistiocytosis, septic shock, hyperferritinemic syndrome, ferritin, General Medicine
Abstract

The significance of extreme hyperferritinemia and its association with certain diagnoses and prognoses are not well characterized. We performed a retrospective analysis of adult patients with at least one total serum ferritin (TSF) measurement ≥ 5000 µg/L over 2 years, in three university hospitals. Conditions associated with hyperferritinemia were collected, and patients were classified into 10 etiological groups. Intensive care unit (ICU) transfer and mortality rates were recorded. A total of 495 patients were identified, of which 56% had a TSF level between 5000 and 10,000 µg/L. There were multiple underlying causes in 81% of the patients. The most common causes were infections (38%), hemophagocytic lymphohistiocytosis (HLH, 18%), and acute hepatitis (14%). For TSF levels > 10,000 µg/L, there were no solid cancer or hematological malignancy without another cause of hyperferritinemia. Isolated iron-overload syndromes never exceeded TSF levels > 15,000 µg/L. Extreme hyperferritinemia (TSF levels > 25,000 µg/L) was associated with only four causes: HLH, infections, acute hepatitis and cytokine release syndromes. A total of 32% of patients were transferred to an ICU, and 28% died. Both ICU transfer rate and mortality were statistically associated with ferritin levels. An optimized threshold of 13,405 μg/L was the best predictor for the diagnosis of HLH, with a sensitivity of 76.4% and a specificity of 79.3%. Hyperferritinemia reflects a variety of conditions, but only four causes are associated with extreme hyperferritinemia, in which HLH and acute hepatitis are the most common. Extreme hyperferritinemia has a poor prognosis with increased mortality.

Published
2022
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2. Evaluation of Glycosylated Ferritin in Adult-Onset Still's Disease and Differential Diagnoses

Author

Arthur Guerber, Etienne Garneret, Thomas El Jammal, Sabine Zaepfel, Mathieu Gerfaud-Valentin, Pascal Sève, and Yvan Jamilloux

Subjects
glycosylated ferritin, adult-onset Still’s disease, diagnostic accuracy, hemophagocytic lympho-histiocytosis, General Medicine
Abstract

Glycosylated ferritin (GF) has been reported as a good diagnostic biomarker for adult-onset Still’s disease (AOSD), but only a few studies have validated its performance. We performed a retrospective study of all adult patients with at least one GF measurement over a 2-year period in one hospital laboratory. The diagnosis of AOSD was based on the expert opinion of the treating physician and validated by two independent investigators. Patients’ characteristics, disease activity, and outcome were recorded and compared. Twenty-eight AOSD and 203 controls were identified. Compared to controls, the mean GF was significantly lower (22.3% vs. 39.3, p < 0.001) in AOSD patients. GF had a high diagnostic accuracy for AOSD, independent of disease activity or total serum ferritin (AUC: 0.674 to 0.915). The GF optimal cut-off value for AOSD diagnosis was 16%, yielding a specificity of 89% and a sensitivity of 63%. We propose a modified diagnostic score for AOSD, based on Fautrel’s criteria but with a GF threshold of 16% that provides greater specificity and increases the positive predictive value by nearly 5 points. GF is useful for ruling out differential diagnoses and as an appropriate classification criterion for use in AOSD clinical trials.

Published
2022

3. Low glycosylated ferritin is a sensitive biomarker of severe COVID-19

Author

Pascal Sève, Maxime Fauter, Sébastien Viel, Yvan Jamilloux, Pierre Pradat, Marine Villard, Lorna Garnier, Sabine Zaepfel, Thomas Henry, Thierry Walzer, and Julie Fiscus

Subjects
Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Immunology, Betacoronavirus, Prognostic markers, Internal medicine, Correspondence, medicine, Humans, Immunology and Allergy, Prospective Studies, Pandemics, Aged, Aged, 80 and over, biology, business.industry, SARS-CoV-2, Disease progression, COVID-19, Diagnostic markers, Middle Aged, Ferritin, Hospitalization, Endocrinology, Infectious Diseases, Ferritins, biology.protein, Disease Progression, Biomarker (medicine), Female, business, Coronavirus Infections, Biomarkers
Published
2020
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4. Reference percentiles for paired arterial and venous umbilical cord blood gases: An indirect nonparametric approach

Author

Laurent Desmurs, Sabine Zaepfel, Régine Cartier, Muriel Doret-Dion, Denis Monneret, Laurence Chardon, Maison des Sciences de l'Homme et de la Société Sud-Est (MSHS Sud-Est), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Pascal Paoli (UPP)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon

Subjects
Male, 030213 general clinical medicine, medicine.medical_specialty, Percentile, Umbilical Veins, [SDV]Life Sciences [q-bio], Clinical Biochemistry, 030204 cardiovascular system & hematology, Umbilical cord, pCO2, Umbilical Arteries, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Oxygen saturation (medicine), Skewed data, business.industry, Nonparametric statistics, General Medicine, Carbon Dioxide, Hydrogen-Ion Concentration, Fetal Blood, Oxygen, % total haemoglobin, medicine.anatomical_structure, Concomitant, Cardiology, Female, business
Abstract

BACKGROUND Reference intervals for arterial and venous umbilical cord blood gas (UCBG) parameters are scarce, are mainly focused on pH, pO2, pCO2 and base deficit, and are usually assessed using parametric tests, despite a generally skewed data distribution. Here, the purpose is to determine reference percentiles for nine parameters of concomitant arterial and venous UCBG (CAV-UCBG) from neonates at birth, using nonparametric tests. METHODS Results of CAV-UCBG, assayed over a 4.5-year period, were extracted from a hospital laboratory database for pH, pCO2, pO2, oxygen saturation, concentration of total oxygen, total carbon dioxide, hydrogen carbonate, total haemoglobin, and acid-base excess. Exclusion criteria were: a venous-arterial pH difference

Published
2019
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5. Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial

Author

Bohé, Julien, Abidi, Hassane, Brunot, Vincent, Klich, Amna, Klouche, Kada, Sedillot, Nicholas, Tchenio, Xavier, Quenot, Jean-Pierre, Roudaut, Jean-Baptiste, Mottard, Nicolas, Thiollière, Fabrice, Dellamonica, Jean, Wallet, Florent, Souweine, Bertrand, Lautrette, Alexandre, Preiser, Jean-Charles, Timsit, Jean-François, Vacheron, Charles-Hervé, Ait Hssain, Ali, Maucort-Boulch, Delphine, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Fleyriat [Bourg en Bresse], CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Fondation de Coopération Scientifique Bourgogne Franche-Comté (FCS Bourgogne Franche-Comté), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital l'Archet, Unité de Recherche Clinique de la Côte d’Azur [Nice] (URRIS UR2CA), Université Côte d'Azur (UCA), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Laboratoire Microorganismes : Génome et Environnement (LMGE), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Université libre de Bruxelles (ULB), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), CONTROLe INdividualisé de la Glycémie (CONTROLING) Study Group: Aurèle Buzancais, Anne Marie Dupuy, Rémi Bruyère, Henri de Montclos, Marion Provent, Jocelyne Drai, Joëlle Goudable, Anne Mialon, Bernard Allaouchiche, Arnaud Friggeri, Véréna Landel, Hélène Boyer, Hervé Hyvernat, Céline Caruba-Bafghi, Edouard Soum, Christophe Leroy, Laurence Roszyk, Pierre Eric Danin, Julio Badie, Stefan Georgiev, Martine Laplace, Richard Jospe, Jérôme Morel, Ali Mofredj, Abdelbaki Azaouzi, Jean-Paul Aubry, Abdelhamid Fatah, Stanislas Ledochowski, Sabine Zaepfel, Eric Fontaine, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, École Pratique des Hautes Études (EPHE), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Unité de Recherche Clinique de la Côte d’Azur (URRIS UR2CA), Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA), Service de Biostatistiques [Lyon], and MORNET, Dominique

Subjects
[SDV] Life Sciences [q-bio], Glycated haemoglobin A1c, [SDV]Life Sciences [q-bio], Glucose control, Individualised glucose control, Hyperglycaemia, Insulin
Abstract

International audience; Purpose: Hyperglycaemia is an adaptive response to stress commonly observed in critical illness. Its management remains debated in the intensive care unit (ICU). Individualising hyperglycaemia management, by targeting the patient's pre-admission usual glycaemia, could improve outcome.Methods: In a multicentre, randomized, double-blind, parallel-group study, critically-ill adults were considered for inclusion. Patients underwent until ICU discharge either individualised glucose control by targeting the pre-admission usual glycaemia using the glycated haemoglobin A1c level at ICU admission (IC group), or conventional glucose control by maintaining glycaemia below 180 mg/dL (CC group). A non-commercial web application of a dynamic sliding-scale insulin protocol gave to nurses all instructions for glucose control in both groups. The primary outcome was death within 90 days.Results: Owing to a low likelihood of benefit and evidence of the possibility of harm related to hypoglycaemia, the study was stopped early. 2075 patients were randomized; 1917 received the intervention, 942 in the IC group and 975 in the CC group. Although both groups showed significant differences in terms of glycaemic control, survival probability at 90-day was not significantly different (IC group: 67.2%, 95% CI [64.2%; 70.3%]; CC group: 69.6%, 95% CI [66.7%; 72.5%]). Severe hypoglycaemia (below 40 mg/dL) occurred in 3.9% of patients in the IC group and in 2.5% of patients in the CC group (p = 0.09). A post hoc analysis showed for non-diabetic patients a higher risk of 90-day mortality in the IC group compared to the CC group (HR 1.3, 95% CI [1.05; 1.59], p = 0.018).Conclusion: Targeting an ICU patient's pre-admission usual glycaemia using a dynamic sliding-scale insulin protocol did not demonstrate a survival benefit compared to maintaining glycaemia below 180 mg/dL.

Published
2021
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