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52. Pleuropulmonary Manifestations of Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic Syndrome

Author

Borie, Raphael, primary, Debray, Marie Pierre, additional, Guedon, Alexis F., additional, Mekinian, Arsene, additional, Terriou, Louis, additional, Lacombe, Valentin, additional, Lazaro, Estibaliz, additional, Meyer, Aurore, additional, Mathian, Alexis, additional, Ardois, Samuel, additional, Vial, Guillaume, additional, Moulinet, Thomas, additional, Terrier, Benjamin, additional, Jamilloux, Yvan, additional, Heiblig, Mael, additional, Bouaziz, Jean-David, additional, Zakine, Eve, additional, Outh, Roderau, additional, Groslerons, Sylvie, additional, Bigot, Adrien, additional, Flamarion, Edouard, additional, Kostine, Marie, additional, Henneton, Pierrick, additional, Humbert, Sebastien, additional, Constantin, Arnaud, additional, Samson, Maxime, additional, Bertrand, Nadine Magy, additional, Biscay, Pascal, additional, Dieval, Celine, additional, Lobbes, Herve, additional, Jeannel, Juliette, additional, Servettaz, Amelie, additional, Adelaide, Leo, additional, Graveleau, Julie, additional, de Sainte-Marie, Benjamin, additional, Galland, Joris, additional, Guillotin, Vivien, additional, Duroyon, Eugénie, additional, Templé, Marie, additional, Georgin Lavialle, Sophie, additional, Kosmider, Olivier, additional, Audemard-Verger, Alexandra, additional, Haroche, Julien, additional, Amoura, Zahir, additional, Pha, Micheline, additional, Hie, Miguel, additional, Meghit, Kilifa, additional, Rondeau-Lutz, Murielle, additional, and Weber, Jean-Christophe, additional

Published
2022
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56. Prevalence of Positive QuantiFERON-TB Test among Sarcoid Uveitis Patients and its Clinical Implications in a Country Non-endemic for Tuberculosis.

Author

Garneret, Etienne, Jamilloux, Yvan, Gerfaud-Valentin, Mathieu, Kodjikian, Laurent, Trad, Salim, and Sève, Pascal

Subjects
*LATENT tuberculosis, *IRIDOCYCLITIS, *SARCOIDOSIS, *UVEITIS, *TUBERCULOSIS, *OLDER patients, *VISION disorders
Abstract

To report on the prevalence and clinical implications of positive QuantiFERON-TB (QFT) test results in the diagnostic evaluation of a cohort of consecutive sarcoid uveitis patients in France. Retrospective cross-sectional study. This study included consecutive sarcoid uveitis patients who all underwent QFT testing. A total of 234 patients were included in the study, among them 28 (12%) were QFT-positive. Previously treated tuberculosis (TB) was documented in 2 patients. QFT-positive patients were older (59 ± 16 years vs. 51 ± 18 years, p =.025) and more in proportion to suffer from chronic uveitis and panuveitis compared to QFT-negative patients. Moderate and severe visual impairment were significantly more frequent in the QFT-positive group (35.7% vs. 18.9%, p =.049 and 25.0% vs. 9.2%, p =.022, respectively). The significant proportion of QFT-positive patients (12%) in this large series of sarcoid uveitis patients makes us suggest not to exclude the diagnosis of sarcoidosis in case of positive QFT in a low-endemic country for tuberculosis, and to manage these patients early by initiating without delay systemic steroids associated with latent tuberculosis therapy. [ABSTRACT FROM AUTHOR]

Published
2023
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60. Extreme Hyperferritinemia: Causes and Prognosis

Author

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

Published
2022
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62. Ocular Inflammation Induced by Immune Checkpoint Inhibitors

Author

Chaudot, Florence, primary, Sève, Pascal, additional, Rousseau, Antoine, additional, Maria, Alexandre Thibault Jacques, additional, Fournie, Pierre, additional, Lozach, Pierre, additional, Keraen, Jeremy, additional, Servant, Marion, additional, Muller, Romain, additional, Gramont, Baptiste, additional, Touhami, Sara, additional, Mahmoud, Habeeb, additional, Quintart, Pierre-Antoine, additional, Dalle, Stéphane, additional, Lambotte, Olivier, additional, Kodjikian, Laurent, additional, and Jamilloux, Yvan, additional

Published
2022
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63. Ruxolitinib is more effective than other JAK inhibitors to treat VEXAS syndrome: a retrospective multicenter study

Author

Heiblig, Maël, primary, Ferrada, Marcela A., additional, Koster, Matthew T., additional, Barba, Thomas, additional, Gerfaud-Valentin, Mathieu, additional, Mékinian, Arsène, additional, Coelho, Henrique, additional, Fossard, Gaelle, additional, Barraco, Fiorenza, additional, Galicier, Lionel, additional, Bienvenu, Boris, additional, Hirsch, Pierre, additional, Vial, Guillaume, additional, Boutin, Anne Blandine, additional, Galland, Joris, additional, Le Guenno, Guillaume, additional, Bigot, Adrien, additional, Warrington, Kenneth J., additional, Kermani, Tanaz A., additional, Grayson, Peter C., additional, Patel, Bhavisha A., additional, Beck, David B., additional, Jamilloux, Yvan, additional, Fenaux, Pierre, additional, and Sujobert, Pierre, additional

Published
2022
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66. Usefulness of the QuantiFERON test for the diagnosis of tubercular uveitis and the predictions of response to antituberculosis treatment.

Author

Danjou, William, Pradat, Pierre, Jamilloux, Yvan, Gerfaud-Valentin, Mathieu, Kodjikian, Laurent, Trad, Salim, and Seve, Pascal

Abstract

Aims Few studies have evaluated the contribution of QuantiFERON test for the diagnosis of tubercular uveitis in non-endemic countries for tuberculosis (TB). The objective of the present study was to evaluate the value of the QuantiFERON test in a large cohort of patients with uveitis for both the diagnosis of tubercular uveitis and antituberculosis treatment (ATT) response prediction. Methods A single-centre retrospective study including consecutive adult patients with uveitis who were prescribed a QuantiFERON test between January 2003 and December 2019 was performed. Adjusted ORs (aORs) were calculated between patients with uveitis responding and not responding to ATT according to the Collaborative Ocular Tuberculosis Study (COTS) group diagnostic criteria. Sensitivity (SE), specificity (Sp), and positive and negative predictive values of the QuantiFERON test were calculated. Results A total of 1075 patients were included in the study; 178 (16.5%) were found positive using the QuantiFERON test. Among the 178 positive patients, 62 (35%) had a diagnosis of tubercular uveitis according to the updated COTS classification; all received ATT for 6 months; and 44/62 (71%) responded to ATT. A QuantiFERON test value of >2 IU/mL was associated with a greater chance of responding to ATT (aOR=36.7, 95% CI 7.2 to 185.9, p<0.001). The optimal threshold to maximise both Sp and SE for diagnosis of TB uveitis was 4 IU/mL. Conclusion One-sixth of the patients diagnosed with uveitis had a positive QuantiFERON test. The QuantiFERON threshold with the optimal SE and Sp for the diagnosis of tubercular uveitis was 4 IU/mL. [ABSTRACT FROM AUTHOR]

Published
2023
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69. Refractory Sarcoidosis: A Review

Author

El Jammal, Thomas, Jamilloux, Yvan, Gerfaud-Valentin, Mathieu, Valeyre, Dominique, and Sève, Pascal

Subjects
refractory sarcoidosis, JAK inhibitors, Review, anti-TNF
Abstract

Sarcoidosis is a multi-system disease of unknown etiology characterized by granuloma formation in various organs (especially lung and mediastinohilar lymph nodes). In more than half of patients, the disease resolves spontaneously. When indicated, it usually responds to corticosteroids, the first-line treatment, but some patients may not respond or tolerate them. An absence of treatment response is rare and urges for verifying the absence of a diagnosis error, the good adherence of the treatment, the presence of active lesions susceptible to respond since fibrotic lesions are irreversible. That is when second-line treatments, immunosuppressants (methotrexate, leflunomide, azathioprine, mycophenolate mofetil, hydroxychloroquine), should be considered. Methotrexate is the only first-line immunosuppressant validated by a randomized controlled trial. Refractory sarcoidosis is not yet a well-defined condition, but it remains a real challenge for the physicians. Herein, we considered refractory sarcoidosis as a disease in which second-line treatments are not sufficient to achieve satisfying disease control or satisfying corticosteroids tapering. Tumor necrosis alpha inhibitors, third-line treatments, have been validated through randomized controlled trials. There are currently no guidelines or recommendations regarding refractory sarcoidosis. Moreover, criteria defining non-response to treatment need to be clearly specified. The delay to achieve response to organ involvement and drugs also should be defined. In the past ten years, the efficacy of several immunosuppressants beforehand used in other autoimmune or inflammatory diseases was reported in refractory cases series. Among them, anti-CD20 antibodies (rituximab), repository corticotrophin injection, and anti-JAK therapy anti-interleukin-6 receptor monoclonal antibody (tocilizumab) were the main reported. Unfortunately, no clinical trial is available to validate their use in the case of sarcoidosis. Currently, other immunosuppressants such as JAK inhibitors are on trial to assess their efficacy in sarcoidosis. In this review, we propose to summarize the state of the art regarding the use of immunosuppressants and their management in the case of refractory or multidrug-resistant sarcoidosis.

Published
2020

73. Crystal‐storing histiocytosis and Bing‐Neel‐like syndrome revealing a small B‐cell lymphoma with plasmacytic differentiation, presumed to be a marginal zone lymphoma

Author

Lequain, Hippolyte, Gerfaud‐Valentin, Mathieu, Fontaine, Juliette, Ferrant, Emmanuelle, Grumet, Pierre, Jamilloux, Yvan, Traverse‐Glehen, Alexandra, and Sève, Pascal

Subjects
Medicine (General), R5-920, immune system diseases, hemic and lymphatic diseases, Bing‐Neel syndrome, Medicine, Case Report, crystal Storing histiocytosis, marginal zone lymphoma
Abstract

Crystal‐storing histiocytosis and Bing‐Neel syndrome are two diseases induced by paraproteins. Herein, we report a rare case of crystal‐storing histiocytosis associated with Bing‐Neel‐like neurological manifestations in the context of a small B‐cell lymphoma with plasmacytic differentiation, presumed to be a marginal zone lymphoma., This case shows the need to search for a B lymphoproliferative disorder after a crystal‐storing histiocytosis diagnosis and to hypothesize that a B‐lymphoproliferative disorder other than Waldenström macroglobulinemia can induce Bing‐Neel syndrome.

Published
2021

74. Pathogenesis of adult-onset Still's disease: new insights from the juvenile counterpart

Author

Jamilloux, Yvan, Gerfaud-Valentin, Mathieu, Martinon, Fabio, Belot, Alexandre, Henry, Thomas, and Sève, Pascal

Abstract

Adult-onset Still's disease (AOSD) is a rare inflammatory disease characterized by the classical triad of daily fever, arthritis, and typical salmon-colored rash. Recent accumulation of knowledge, mostly arising from hereditary autoinflammatory diseases and from the systemic-onset juvenile idiopathic arthritis (sJIA), has given raise to new hypotheses on the pathophysiology of AOSD. In this review, we first discuss on the continuum between AOSD and sJIA. Then, we summarize current hypotheses on the underlying pathogenesis: (1) an infectious hypothesis; (2) an autoinflammatory hypothesis; (3) a lymphohistiocytic hypothesis; and (4) a hyperferritinemic hypothesis. Finally, we present the recent data suggesting that patients with AOSD fall into two distinct subgroups with different courses, one with prominent systemic features and one with chronic arthritis.

Published
2021

76. Pleuropulmonary Manifestations of Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic Syndrome.

Author

Borie, Raphael, Debray, Marie Pierre, Guedon, Alexis F., Mekinian, Arsene, Terriou, Louis, Lacombe, Valentin, Lazaro, Estibaliz, Meyer, Aurore, Mathian, Alexis, Ardois, Samuel, Vial, Guillaume, Moulinet, Thomas, Terrier, Benjamin, Jamilloux, Yvan, Heiblig, Mael, Bouaziz, Jean-David, Zakine, Eve, Outh, Roderau, Groslerons, Sylvie, and Bigot, Adrien

Subjects
COMPUTED tomography, PLEURAL effusions, SYNDROMES
Abstract

Background: The vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a newly identified autoinflammatory disorder related to somatic UBA1 mutations. Up to 72% of patients may show lung involvement.Research Question: What are the pleuropulmonary manifestations in VEXAS syndrome?Study Design and Methods: One hundred fourteen patients were included in the French cohort of VEXAS syndrome between November 2020 and May 2021. Each patient included in the study who had an available chest CT scan was discussed in an adjudication multidisciplinary team and classified as showing potentially pleuropulmonary-specific involvement of VEXAS syndrome or others.Results: Fifty-one patients had a CT scan available for review and 45 patients (39%) showed pleuropulmonary abnormalities on chest CT scan that were considered related to VEXAS syndrome after adjudication. Most patients were men (95%) with a median age 67.0 years at the onset of symptoms. Among these 45 patients, 44% reported dyspnea and 40% reported cough. All 45 patients showed lung opacities on chest CT scan (including ground-glass opacities [87%], consolidations [49%], reticulation [38%], and septal lines [51%]) and 53% of patients showed pleural effusion. Most patients showed improvement with prednisone, but usually required > 20 mg/d. The main clinical and biological features as well the median survival did not differ between the 45 patients with pleuropulmonary involvement and the rest of the cohort, suggesting that the prevalence of pleuropulmonary involvement might have been underdiagnosed in the rest of the cohort.Interpretation: Pulmonary manifestations are frequent in VEXAS syndrome, but rarely are at the forefront. The initial outcome is favorable with prednisone and does not seem to lead to pulmonary fibrosis. [ABSTRACT FROM AUTHOR]

Published
2023
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77. Cardiovascular outcome in adult-onset Kawasaki disease

Author

Peter, Elise, Fraison, Jean-Baptiste, Harbaoui, Brahim, Koné-Paut, Isabelle, Dauphin, Claire, Gomard-Mennesson, Emeline, Hervier, Baptiste, De Boysson, Hubert, Varron, Loig, Keraen, Jérémy, Pugnet, Grégory, Gobert, Delphine, Bachmeyer, Claude, Humbert, Sébastien, Landron, Cédric, Roblot, Pascal, Cathébras, Pascal, Gerfaud-Valentin, Mathieu, Weber, Emmanuelle, Jamilloux, Yvan, Fain, Olivier, and Seve, Pascal

Published
2021
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79. Detection and Prediction of Macrophage Activation Syndrome in Still’s Disease

Author

Javaux, Clément, primary, El-Jammal, Thomas, additional, Neau, Pierre-Antoine, additional, Fournier, Nicolas, additional, Gerfaud-Valentin, Mathieu, additional, Perard, Laurent, additional, Fouillet-Desjonqueres, Marine, additional, Le Scanff, Julie, additional, Vignot, Emmanuelle, additional, Durupt, Stéphane, additional, Hot, Arnaud, additional, Belot, Alexandre, additional, Durieu, Isabelle, additional, Henry, Thomas, additional, Sève, Pascal, additional, and Jamilloux, Yvan, additional

Published
2021
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82. Clinical Efficacy of JAK Inhibitors in Patients with Vexas Syndrome: A Multicenter Retrospective Study

Author

Heiblig, Maël, primary, Ferrada, Marcela A, additional, Gerfaud-Valentin, Mathieu, additional, Barba, Thomas, additional, Mékinian, Arsène, additional, Koster, Matthew, additional, Coelho, Henrique, additional, Fossard, Gaelle, additional, Barraco, Fiorenza, additional, Galicier, Lionel, additional, Bienvenu, Boris, additional, Hirsch, Pierre, additional, Vial, Guillaume, additional, Boutin, Anne Blandine, additional, Le guenno, Guillaume, additional, Bigot, Adrien, additional, Warrington, Kenneth, additional, Kermani, Tanaz, additional, Jamilloux, Yvan, additional, Grayson, Peter C, additional, Patel, Bhavisha A., additional, Beck, David B., additional, Fenaux, Pierre, additional, and Sujobert, Pierre, additional

Published
2021
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83. Steroid hormone catabolites activate the pyrin inflammasome through a non-canonical mechanism

Author

Magnotti, Flora, primary, Chirita, Daria, additional, Dalmon, Sarah, additional, Martin, Amandine, additional, Bronnec, Pauline, additional, Sousa, Jeremy, additional, Helynck, olivier, additional, Lee, Wonyong, additional, Kastner, Daniel, additional, Chae, Jae Jin, additional, McDermott, Michael, additional, Belot, alexandre, additional, Popoff, Michel, additional, Seve, Pascal, additional, Georgin-Lavialle, Sophie, additional, Munier-Lehmann, Helene, additional, TRAN, Tu anh, additional, De Langhe, Ellen, additional, Wouters, Carine, additional, Jamilloux, Yvan, additional, and Henry, Thomas, additional

Published
2021
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86. Therapeutic drug monitoring guides the management of patients with chronic non-infectious uveitis treated with adalimumab: a retrospective study.

Author

Sejournet, Lucas, Kerever, Sebastien, Mathis, Thibaud, Kodjikian, Laurent, Jamilloux, Yvan, and Seve, Pascal

Abstract

Aim To assess the relevance of therapeutic drug monitoring (TDM) of adalimumab (ADA) treatment for the control of intraocular inflammation and treatment adjustment in chronic non-infectious uveitis (CNIU). Methods Retrospective study of CNIU patients treated with ADA and for whom at least one dosage of serum ADA level and an antibodies against ADA (AAA) serology were performed, between June 2003 and July 2019. Results A total of 44 ADA-treated patients benefited from a TDM. A total of 48/79 (61%) TDM were performed in responders, 11/79 (14%) in primary non-responders, and 20/79 (25%) in secondary non-responders. Responders had significantly higher ADA levels than non-responders (p=0.0004). AAA were detectable in six patients, they were primary non-responders (n=2), secondary non-responders (n=3) or responders (n=1). In the five non-responders and immunised patients, ADA was switched (to golimumab or methotrexate). Among non-responders, TDM led to an increased frequency of injections 12/31 (38%), increased dose 1/31 (3%) and switch of treatment 10/31 (32%) (one missing data). No modification of biotherapy was performed 7/31 (22%) and only local or oral corticotherapy was adjusted. In 24/31 cases of therapeutic adjustment in non-responders, an improvement was observed in 87% of cases. Among responders for whom the ADA level was above the efficacy threshold, the frequency of injections was decreased for 15/31 (48.4%) cases and no relapse was observed in 12/15 (80%) cases. Conclusion TDM of ADA treatment proved relevant to provide CNIU patients with a personalised and optimised treatment course (in terms of frequency and type of drug). [ABSTRACT FROM AUTHOR]

Published
2022
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92. Pleuropulmonary Manifestations of Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic (VEXAS) Syndrome

Author

Borie, Raphael, Debray, Marie Pierre, Guedon, Alexis F., Mekinian, Arsene, Terriou, Louis, Lacombe, Valentin, Lazaro, Estibaliz, Meyer, Aurore, Mathian, Alexis, Ardois, Samuel, Vial, Guillaume, Moulinet, Thomas, Terrier, Benjamin, Jamilloux, Yvan, Heiblig, Mael, Bouaziz, Jean-David, Zakine, Eve, Outh, Roderau, Groslerons, Sylvie, Bigot, Adrien, Flamarion, Edouard, Kostine, Marie, Henneton, Pierrick, Humbert, Sebastien, Constantin, Arnaud, Samson, Maxime, Bertrand, Nadine Magy, Biscay, Pascal, Dieval, Celine, Lobbes, Herve, Jeannel, Juliette, Servettaz, Amelie, Adelaide, Leo, Graveleau, Julie, de Sainte-Marie, Benjamin, Galland, Joris, Guillotin, Vivien, Duroyon, Eugénie, Templé, Marie, Bourguiba, Rim, Georgin Lavialle, Sophie, Kosmider, Olivier, Audemard-Verger, Alexandra, Haroche, Julien, Amoura, Zahir, Pha, Micheline, Hie, Miguel, Meghit, Kilifa, Rondeau-Lutz, Murielle, and Weber, Jean-Christophe

Abstract

The vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a newly identified autoinflammatory disorder related to somatic UBA1mutations. Up to 72% of patients may show lung involvement.

Published
2023
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93. Characteristics and Clinical Value of 18F-FDG PET/CT in the Management of Adult-Onset Still’s Disease: 35 Cases

Author

Brisset, Josselin, primary, Jamilloux, Yvan, additional, Dumonteil, Stephanie, additional, Lades, Guillaume, additional, Killian, Martin, additional, Gerfaud-Valentin, Mathieu, additional, Lemaire, Anne, additional, Chroboczek, Tomasz, additional, Liozon, Eric, additional, Gondran, Guillaume, additional, Sève, Pascal, additional, Monteil, Jacques, additional, Fauchais, Anne-Laure, additional, and Ly, Kim Heang, additional

Published
2021
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95. VEXAS syndrome in a woman

Author

Barba, Thomas, primary, Jamilloux, Yvan, additional, Durel, Cécile-Audrey, additional, Bourbon, Estelle, additional, Mestrallet, Fanélie, additional, Sujobert, Pierre, additional, and Hot, Arnaud, additional

Published
2021
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97. Evaluating the cost-consequence of a standardized strategy for the etiological diagnosis of uveitis (ULISSE study)

Author

de Parisot, Audrey, Jamilloux, Yvan, Kodjikian, Laurent, Errera, Marie-Hélène, Sedira, Neila, Heron, Emmanuel, Perard, Laurent, Cornut, Pierre-Loic, Schneider, Christelle, Rivière, Sophie, Ollé, Priscille, Pugnet, Grégory, Cathebras, Pascal, Manoli, Pierre, Bodaghi, Bahram, Saadoun, David, Baillif, Stéphanie, Tieulié, Nathalie, André, Marc, Chiambaretta, Fédéric, BONIN, Nicolas, Bielefeld, Philip, Bron, Alain, Mouriaux, Frédéric, Bienvenu, Boris, Amamra, Nassira, Guerre, Pascale, Decullier, Evelyne, Sève, Pascal, ULISSE, ., Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Sève, Pascal, Hospices Civils de Lyon (HCL), Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO), Equipe mobile de Gériatrie, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Pierre-Paul Riquet Hospital, Poison Control Center, Toulouse-Purpan University Hospital, Toulouse, France., Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Desgenettes Hospital, Partenaires INRAE, CHU Limoges, CHU Rouen, Normandie Université (NU), La Conception, Bicêtre Hospital, South Hospital, Rabelais Center, Hôpital Montchanin, Centre Hospitalier Universitaire [Rennes], Hôpital Chalon-sur-Saône, Hôpital Nantes, and The French Ministry of Health (PHRC 2009).

Subjects
Male, Bacterial Diseases, Pediatrics, Organes des sens, Pathology and Laboratory Medicine, Treponematoses, law.invention, Diagnostic Radiology, 0302 clinical medicine, Randomized controlled trial, law, Medicine and Health Sciences, Prospective Studies, Practice Patterns, Physicians', Prospective cohort study, health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Serodiagnosis, Multidisciplinary, Ophthalmologists, Radiology and Imaging, Middle Aged, Magnetic Resonance Imaging, 3. Good health, Serology, Infectious Diseases, Radiological weapon, Medicine, Female, France, Uveitis, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, Imaging Techniques, Science, Urology, Sensory Organs, MEDLINE, Sexually Transmitted Diseases, Tuberculin, Médecine humaine et pathologie, Research and Analysis Methods, Microbiology, 03 medical and health sciences, Diagnostic Medicine, Virology, medicine, Humans, Syphilis, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, 030203 arthritis & rheumatology, business.industry, Genitourinary Infections, Biology and Life Sciences, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, Tropical Diseases, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Ophthalmology, Viral Disease Diagnosis, 030221 ophthalmology & optometry, Etiology, Human health and pathology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; MAIN OBJECTIVE: To prospectively assess the cost-consequence of a standardized diagnostic strategy as to compared to an open one for the etiological diagnosis of uveitis. DESIGN: This was a prospective, non-inferiority, multicentre, randomized controlled trial. METHODS: We included all consecutive patients with uveitis who had visited at least one of the Departments of Ophthalmology. In the standardized group, patients had a minimal work-up regardless of the type of uveitis (including evaluation of the CBC, ESR, C-reactive protein, tuberculin skin test, syphilis serology and chest X-ray). Depending on ophthalmological findings, further investigations could be performed. In the open strategy, ophthalmologists were free to order any kind of investigation. The main outcome was the mean cost per patient of each strategy. RESULTS: 903 uveitis patients were included from January, 2010 to May, 2013. The mean cost per patient of the standardized strategy was 182.97 euros [CI 95% (173.14; 192.80)], and the mean cost per patient of the open strategy was 251.75 euros [CI 95% (229.24; 274.25)]. Therefore, the mean cost per patient of the standardized strategy was significantly lower than the mean cost per patient of the open strategy (p

Published
2020
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98. Refractory Sarcoidosis: A Review

Author

El Jammal,Thomas, Jamilloux,Yvan, Gerfaud-Valentin,Mathieu, Valeyre,Dominique, Sève,Pascal, El Jammal,Thomas, Jamilloux,Yvan, Gerfaud-Valentin,Mathieu, Valeyre,Dominique, and Sève,Pascal

Abstract

Thomas El Jammal,1 Yvan Jamilloux,1 Mathieu Gerfaud-Valentin,1 Dominique Valeyre,2 Pascal Sève1,3 1Department of Internal Medicine, Lyon University Hospital, Lyon, France; 2Department of Pneumology, Assistance Publique - Hôpitaux de Paris, Hôpital Avicenne et Université Paris 13, Sorbonne Paris Cité, Bobigny, France; 3Hospices Civils de Lyon, Pôle IMER, Lyon, F-69003, France, University Claude Bernard Lyon 1, HESPER EA 7425, Lyon F-69008, FranceCorrespondence: Pascal SèveService de Médecine Interne, Groupement Hospitalier Nord, 103 Grande rue de la Croix-Rousse, Lyon F-69004, FranceTel +33 426 732 636Fax +33 426 732 637Email pascal.seve@chu-lyon.frAbstract: Sarcoidosis is a multi-system disease of unknown etiology characterized by granuloma formation in various organs (especially lung and mediastinohilar lymph nodes). In more than half of patients, the disease resolves spontaneously. When indicated, it usually responds to corticosteroids, the first-line treatment, but some patients may not respond or tolerate them. An absence of treatment response is rare and urges for verifying the absence of a diagnosis error, the good adherence of the treatment, the presence of active lesions susceptible to respond since fibrotic lesions are irreversible. That is when second-line treatments, immunosuppressants (methotrexate, leflunomide, azathioprine, mycophenolate mofetil, hydroxychloroquine), should be considered. Methotrexate is the only first-line immunosuppressant validated by a randomized controlled trial. Refractory sarcoidosis is not yet a well-defined condition, but it remains a real challenge for the physicians. Herein, we considered refractory sarcoidosis as a disease in which second-line treatments are not sufficient to achieve satisfying disease control or satisfying corticosteroids tapering. Tumor necrosis alpha inhibitors, third-line treatments, have been validated through

Published
2020

99. Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis

Author

Sève, Pascal, primary, Pacheco, Yves, additional, Durupt, François, additional, Jamilloux, Yvan, additional, Gerfaud-Valentin, Mathieu, additional, Isaac, Sylvie, additional, Boussel, Loïc, additional, Calender, Alain, additional, Androdias, Géraldine, additional, Valeyre, Dominique, additional, and El Jammal, Thomas, additional

Published
2021
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100. LACC1 deficiency links juvenile arthritis with autophagy and metabolism in macrophages

Author

Omarjee, Ommar, primary, Mathieu, Anne-Laure, additional, Quiniou, Gaëlle, additional, Moreews, Marion, additional, Ainouze, Michelle, additional, Frachette, Cécile, additional, Melki, Isabelle, additional, Dumaine, Cécile, additional, Gerfaud-Valentin, Mathieu, additional, Duquesne, Agnès, additional, Kallinich, Tilmann, additional, Tahir Turanli, Eda, additional, Malcus, Christophe, additional, Viel, Sébastien, additional, Pescarmona, Rémi, additional, Georgin-Lavialle, Sophie, additional, Jamilloux, Yvan, additional, Larbre, Jean-Paul, additional, Sarrabay, Guillaume, additional, Magnotti, Flora, additional, Rice, Gillian I., additional, Bleicher, Francoise, additional, Reboulet, Jonathan, additional, Merabet, Samir, additional, Henry, Thomas, additional, Crow, Yanick J., additional, Faure, Mathias, additional, Walzer, Thierry, additional, and Belot, Alexandre, additional

Published
2021
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