Author: "Alban, Deroux" - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Alban, Deroux"' showing total 127 results

Start Over Author "Alban, Deroux"

127 results on '"Alban, Deroux"'

1. Treatment of non-systemic Sjögren's syndrome: Potential prevention of systematization with immunosuppressant agent/biotherapy

Author: Aude Belbézier, Thi Thu Thuy Nguyen, Mélanie Arnaud, Bruna Ducotterd, Marie Vangout, Alban Deroux, Catherine Mansard, Françoise Sarrot-Reynauld, and Laurence Bouillet
Subjects: Sjögren's syndrome, Biotherapy, Immunosuppressant agent, Immunologic diseases. Allergy, RC581-607
Abstract: Background: Sjögren's syndrome (SS) is a systemic autoimmune pathology manifested mainly by a dry syndrome, intense asthenia and arthromyalgia. Systemic manifestations may also occur. Since 2019, immunosuppressant agents (IS) or biotherapies are recommended only for patients with systemic involvement. However, before 2019, in some cases, paucisymptomatic patients had been treated with IS/biotherapies, often off-label. Objective: We propose to evaluate the benefit and safety of using IS/biotherapy in patients with SS without systemic involvement. Methods: We retrospectively collected the clinical records of all patients with SS diagnosed according to ACR/EULAR diagnostic criteria followed up between January 1980 and October 2023 at Grenoble University Hospital (France). Results: Eighty-three patients were included: 64 with an initially non-systemic form. Of these patients with an initially non-systemic form, 24 were treated with IS/biotherapy. None of them developed secondary systematization, whereas 11 out of 40 patients in the untreated group did (p
Published: 2024
Full Text: View/download PDF

2. Molecular Mechanisms of Endothelialitis in SARS-CoV-2 Infection: Evidence for VE-Cadherin Cleavage by ACE2

Author: Laurence Bouillet, Alban Deroux, Meryem Benmarce, Chloé Guérin, Laura Bouvet, Olivia Garnier, Donald K. Martin, and Isabelle Vilgrain
Subjects: endothelium, VE-cadherin, ACE2, SARS-CoV-2 infection, long COVID syndrome, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract: Long COVID-19 syndrome appears after Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2) infection with acute damage to microcapillaries, microthrombi, and endothelialitis. However, the mechanisms involved in these processes remain to be elucidated. All blood vessels are lined with a monolayer of endothelial cells called vascular endothelium, which provides a the major function is to prevent coagulation. A component of endothelial cell junctions is VE-cadherin, which is responsible for maintaining the integrity of the vessels through homophilic interactions of its Ca++-dependent adhesive extracellular domain. Here we provide the first evidence that VE-cadherin is a target in vitro for ACE2 cleavage because its extracellular domain (hrVE-ED) contains two amino acid sequences for ACE2 substrate recognition at the positions 256P-F257 and 321PMKP-325L. Indeed, incubation of hrVE-ED with the active ectopeptidase hrACE2 for 16 hrs in the presence of 10 μM ZnCl2 showed a dose-dependent (from 0.2 ng/μL to 2 ng/μL) decrease of the VE-cadherin immunoreactive band. In vivo, in the blood from patients having severe COVID-19 we detected a circulating form of ACE2 with an apparent molecular mass of 70 kDa, which was barely detectable in patients with mild COVID-19. Of importance, in the patients with severe COVID-19 disease, the presence of three soluble fragments of VE-cadherin (70, 62, 54 kDa) were detected using the antiEC1 antibody while only the 54 kDa fragment was present in patients with mild disease. Altogether, these data clearly support a role for ACE2 to cleave VE-cadherin, which leads to potential biomarkers of SARS-CoV-2 infection related with the vascular disease in “Long COVID-19”.
Published: 2023
Full Text: View/download PDF

3. Screening of hepatitis E in patients presenting for acute neurological disorders

Author: Aude Belbézier, Alban Deroux, Françoise Sarrot-Reynauld, Barbara Colombe, Annick Bosseray, Claire Wintenberger, Perrine Dumanoir, Maxime Lugosi, Isabelle Boccon-Gibod, Vincent Leroy, Maxime Maignan, Roselyne Collomb-Muret, Damien Viglino, Mathieu Vaillant, Lorella Minotti, Emeline Lagrange, Olivier Epaulard, Chantal Dumestre-Perard, Sébastien Lhomme, Julien Lupo, Sylvie Larrat, Patrice Morand, Carole Schwebel, Antoine Vilotitch, Jean-Luc Bosson, and Laurence Bouillet
Subjects: Hepatitis E, Neurological disorder, Acute hepatitis, Hepatitis, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract: Introduction: Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury. Method: A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data on patients with acute (
Published: 2020
Full Text: View/download PDF

4. Pregnancy outcomes in women with primary Sjögren's syndrome: an analysis of data from the multicentre, prospective, GR2 study

Author: Grégoire Martin de Frémont, Nathalie Costedoat-Chalumeau, Estibaliz Lazaro, Rakiba Belkhir, Gaëlle Guettrot-Imbert, Nathalie Morel, Gaétane Nocturne, Anna Molto, Tiphaine Goulenok, Elisabeth Diot, Laurent Perard, Nicole Ferreira-Maldent, Maelle Le Besnerais, Nicolas Limal, Nihal Martis, Noémie Abisror, Odile Debouverie, Christophe Richez, Vincent Sobanski, François Maurier, Gaëtan Sauvetre, Hervé Levesque, Marie-Agnès Timsit, Nathalie Tieulié, Pauline Orquevaux, Boris Bienvenu, Matthieu Mahevas, Thomas Papo, Céline Lartigau-Roussin, Elodie Chauvet, Emilie Berthoux, Françoise Sarrot-Reynauld, Loïc Raffray, Marion Couderc, Nicolas Martin Silva, Noémie Jourde-Chiche, Nicolas Belhomme, Thierry Thomas, Vincent Poindron, Viviane Queyrel-Moranne, Juliette Delforge, Camille Le Ray, Emmanuelle Pannier, Xavier Mariette, Véronique Le Guern, Raphaèle Seror, Alexandra AUDEMARD-VERGER, Emmanuel AZZI, Béatrice BANNEVILLE, Antoine BAUDET, Constance BEAUDOUIN BAZIRE, Cristina BELIZNA, Alexandre Belot, Ygal BENHAMOU, Alice Berezné, Fanny BERNARD-GUERVILLY, Sabine BERTHIER, Holy BEZANAHARY, Lisa BIALE, Adrien BIGOT, Claire BLANCHARD-DELAUNAY, Anne CALAS, Julien CAMPAGNE, Pascal CATHEBRAS, Claire CAZALETS, Benjamin CHAIGNE, Olivia CHANDESRIS, Jérémy CHATELAIS, Emmanuel CHATELUS, Fleur COHEN, Bernard Combe, Céline COMPARON, Pascal COQUERELLE, Louise DAMIAN, Eric DAUGAS, Mathilde DE MENTHON, Claire DE MOREUIL, Estelle DELATTRE, Azeddine DELLAL, Catherine Deneux-Tharaux, Amélie DENIS, Camille DEPROUW, Emmanuelle DERNIS, Alban DEROUX, Sandra DESOUCHES, Philippe Dieudé, Guillaume DIREZ, Maxime Dougados, Marine DRIESSEN, Aurélie DU THANH, Laetitia DUNOGEANT, Cécile DURANT, Cécile-Audrey DUREL, Isabelle DURIEU, Florence EBOUE, Elisabeth Elefant, Olivier FAIN, Bruno FAUTREL, René-Marc FLIPO, Aline FRAZIER, Antoine FROISSART, Sophie GEORGIN-LAVIALLE, Elisabeth GERVAIS, Bertrand GODEAU, François Goffinet, Anne GOMPEL, Laure GOSSEC, Philippe GOUPILLE, Claire GRANGE, Constance GUILLAUD-DANIS, Eric HACHULLA, Sabine HOEFSLOOT, Aurélie HUMMEL, Patrick JEGO, Stéphanie JOBARD, Laurence JOSSELIN-MAHR, Marc LAMBERT, Vincent LANGLOIS, Delphine LARIVIERE, Claire LARROCHE, Augustin LATOURTE, Christian LAVIGNE, Thomas LE GALLOU, Gaëlle LEROUX, Jean Guillaume LETAROUILLY, Frédéric LIOTÉ, Laurence Loeuillet, Jonathan London, Valentine Loustau, Pierre LOZAC'H, Emmanuel MAHEU, Hélène MAILLARD, Hubert MAROTTE, Agathe MASSEAU, Arsène MEKINIAN, Sara Melboucy Belkhir, Corinne Miceli-Richard, Martin MICHAUD, Marc MICHEL, Olivier MORANNE, Chafika MORATI-HAFSAOUI, Guillaume MOULIS, Luc MOUTHON, Barbara NICOLAS, Jacky Nizard, Jérémy ORA, Rodérau OUTH, Elisabeth PASQUIER, Jean-Loup PENNAFORTE, Antoinette PERLAT, Hélène PETIT-BAUER, Evangeline PILLEBOUT, Jean-Maxime PIOT, Agnès PORTIER, Olivier Pourrat, Xavier PUECHAL, Gregory PUGNET, Manon REDONDIN, Alexis REGENT, Mélanie RORIZ, Laurent SAILLER, Léa SAVEY, Marc SCHERLINGER, Nicolas SCHLEINITZ, Jérémie Sellam, Loïc Sentilhes, Aude SERVAIS, Perrine SMETS, Christelle SORDET, Martin SOUBRIER, Katia STANKOVIC-STOJANOVIC, Geoffrey URBANSKI, Véronique VEIT, Emmanuelle WEBER, and Cécile YELNIK
Subjects: Rheumatology, Immunology, Immunology and Allergy
Published: 2023

5. Acute and Chronic Sarcoid Arthropathies: Characteristics and Treatments From a Retrospective Nationwide French Study

Author: Carlotta Cacciatore, Pierre Belnou, Sara Thietart, Carole Desthieux, Mathilde Versini, Noemie Abisror, Sébastien Ottaviani, Gregoire Cormier, Alban Deroux, Azeddine Dellal, Nicolas Belhomme, Nathalie Saidenberg Kermanac'H, Philippe Khafagy, Martin Michaud, Sylvain Lanot, Fabrice Carrat, Olivier Fain, and Arsène Mékinian
Subjects: sarcoid arthropathy, outcome, methotrexate, infliximab, sarcoidosis, Medicine (General), R5-920
Abstract: Introduction: We aimed to analyze patients with acute and chronic joint involvements in sarcoidosis.Methods: This is a retrospective multicenter analysis of patients with proven sarcoidosis, as defined by clinical, radiological, and histological criteria, with at least one clinical and/or ultrasonographic synovitis.Results: Thirty-nine patients with sarcoid arthropathy were included, and among them 19 had acute sarcoidosis (Lofgren's syndrome). Joint involvement and DAS44-CRP were not significantly different in acute and chronic sarcoid arthropathies. Acute forms were more frequent than chronic sarcoid arthropathy in Caucasians, without any difference of sex or age between these 2 forms. Joint involvement was frequently more symmetrical in acute than chronic forms (100 vs. 70%; p < 0.05), with a more frequent involvement in wrists and ankles in acute forms, whereas the tender and swollen joint counts and the DAS44-CRP were similar between the 2 groups. Skin lesions were significantly more frequent in patients with acute forms [17 (89%) vs. 5 (25%); p < 0.05] and were erythema nodosum in all patients with Löfgren's syndrome and sarcoid skin lesions in those with chronic sarcoidosis. Among 20 patients with chronic sarcoidosis, treatment was used in 17 (85%) cases, and consisted in NSAIDs alone (n = 5; 25%), steroids alone (n = 5; 25%), hydroxychloroquine (n = 2; 20%), methotrexate (n = 3; 15%), and TNF inhibitors (n = 2; 10%). A complete/partial joint response was noted in 14 (70%) cases with a DAS44-CRP reduction of 2.07 [1.85–2.44] (from 3.13 [2.76–3.42] to 1.06 [0.9–1.17]; p < 0.05).Conclusion: Sarcoid arthropathies have different clinical phenotypes in acute and chronic forms and various treatment regimens such as hydroxychloroquine and methotrexate could be used in chronic forms.
Published: 2020
Full Text: View/download PDF

6. Characterisation of a high-risk profile for maternal thrombotic and severe haemorrhagic complications in pregnant women with antiphospholipid syndrome in France (GR2): a multicentre, prospective, observational study

Author: Anne Murarasu, Gaëlle Guettrot-Imbert, Véronique Le Guern, Cécile Yelnik, Viviane Queyrel, Nicolas Schleinitz, Nicole Ferreira-Maldent, Elisabeth Diot, Geoffrey Urbanski, Emmanuelle Pannier, Estibaliz Lazaro, Odile Souchaud-Debouverie, Pauline Orquevaux, Nicolas Belhomme, Nathalie Morel, Elodie Chauvet, François Maurier, Maëlle Le Besnerais, Noemie Abisror, Tiphaine Goulenok, Françoise Sarrot-Reynauld, Alban Deroux, Elisabeth Pasquier, Claire de Moreuil, Holy Bezanahary, Laurent Pérard, Nicolas Limal, Vincent Langlois, Anne Calas, Bertrand Godeau, Christian Lavigne, Eric Hachulla, Fleur Cohen, Ygal Benhamou, Loïc Raffray, Mathilde de Menthon, Nathalie Tieulié, Vincent Poindron, Luc Mouthon, Maddalena Larosa, Elisabeth Eléfant, Loic Sentilhes, Anna Molto, Catherine Deneux-Tharaux, Nathalie Costedoat-Chalumeau, Emmanuel Azzi, Béatrice Banneville, Antoine Baudet, Constance Beaudouin-Bazire, Cristina Belizna, Rakiba Belkhir, Alice Berezne, Emilie Berthoux, Sabine Berthier, Lisa Biale, Boris Bienvenu, Claire Blanchard-Delaunay, Pascal Cathebras, Claire Cazalets, Benjamin Chaigne, Olivia Chandesris, Jérémy Chatelais, Emmanuel Chatelus, Pascal Coquerelle, Marion Couderc, Juliette Delforge, Amélie Denis, Sandra Desouches, Philippe Dieudé, Guillaume Direz, Marine Driessen, Aurélie Du Thanh, Laetitia Dunogeant, Cécile Durant, Isabelle Durieu, Marc Fabre, Olivier Fain, René-Marc Flipo, Aline Frazier, Antoine Froissart, Sophie Georgin-Lavialle, Elisabeth Gervais, Anne Gompel, Laure Gossec, Phillipe Goupille, Claire Grange, Constance Guillaud-Danis, Aurélie Hummel, Moez Jallouli, Patrick Jego, Stéphane Jobard, Laurence Josselin-Mahr, Noémie Jourde-Chiche, Anne-Sophie Korganow, Marc Lambert, Delphine Lariviere, Claire Larroche, Céline Lartigau-Roussin, Augustin Latourte, Thomas Le Gallou, Gaëlle Leroux, Hervé Levesque, Frédéric Lioté, Jonathan London, Valentine Loustau, Emmanuel Maheu, Matthieu Mahevas, Hélène Maillard, Xavier Mariette, Hubert Marotte, Nicolas Martin-Silva, Nihal Martis, Agathe Masseau, Arsène Mekinian, Sara Melboucy-Belkhir, Martin Michaud, Marc Michel, Chafika Morati-Hafsaoui, Jacky Nizard, Jérémy Ora, Jean-Loup Pennaforte, Antoinette Perlat, Hélène Petit Bauer, Evangeline Pillebout, Jean-Maxime Piot, Agnès Portier, Gregory Pugnet, Manon Redondin, Alexis Regent, Christophe Richez, Mélanie Roriz, Laurent Sailler, Gaëtan Sauvêtre, Léa Savey, Vincent Sobanski, Christelle Sordet, Martin Soubrier, Katia Stankovic Stojanovic, Thierry Thomas, Marie-Agnès Timsit, and Vassilis Tsatsaris
Subjects: Rheumatology, Immunology, Immunology and Allergy
Published: 2022

7. Clinical spectrum and therapeutic management of auto-immune myelofibrosis: a nation-wide study of 30 cases

Author: Philippe Mertz, Emilie Chalayer, Zahir Amoura, Pascal Cathebras, Laurent Chiche, Nathalie Coestedoat, Alban Deroux, Elisabeth Diot, Stéphane Durupt, Emmanuel Forestier, Audrey Gorse, Laurent Hudier, Martin Killian, Olivier Lambotte, Claire Lecomte, Emmanuel Ledoult, Camille Martinez, Alexis Mathian, Anne Sophie Morin, Nicolas Noel, Marc Pineton De Chambrun, Louis Terriou, Jean Sibilia, Jacques-Eric Gottenberg, Anne-Sophie Korganow, Laurent Arnaud, and Thierry Martin
Subjects: Diseases of the blood and blood-forming organs, RC633-647.5
Published: 2020
Full Text: View/download PDF

8. Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults

Author: Marion Dollat, Benjamin Chaigne, Grégoire Cormier, Nathalie Costedoat-Chalumeau, François Lifermann, Alban Deroux, Emilie Berthoux, Emmanuelle Dernis, Thomas Sené, Gilles Blaison, Olivier Lambotte, Benjamin Terrier, Jérémie Sellam, Luc De Saint-Martin, Laurent Chiche, Nicolas Dupin, and Luc Mouthon
Subjects: Human parvovirus B19, Arthritis, Vasculitis, Glomerulonephritis, Peripheral neuropathy, Intravenous immunoglobulin, lupus, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background To describe extra-haematological manifestations associated with human parvovirus B19 (HPV-B19) infection. Methods We conducted a nationwide multicentre study to retrospectively describe the characteristics and outcome of extra-haematological manifestations in French adults. Results Data from 25 patients followed from 2001 to 2016 were analysed. Median age was 37.9 years (range: 22.7–83.4), with a female predominance (sex ratio: 4/1). Only 3 patients had an underlying predisposing condition (hemoglobinopathy or pregnancy). The most common manifestations were joint (80%) and skin (60%) involvement. Four patients (16%) had renal involvement (endocapillary proliferative or membranoproliferative glomerulonephritis, focal segmental glomerulosclerosis). Three patients (12%) had peripheral nervous system involvement (mononeuritis, mononeuritis multiplex, Guillain-Barré syndrome) and 2 (8%) presented muscle involvement. Other manifestations included hemophagocytic lymphohistiocytosis (n = 1), myopericarditis and pleural effusion (n = 1), and lymphadenopathy and splenomegaly mimicking lymphoma with spleen infarcts (n = 1). Immunological abnormalities were frequent (56.5%). At 6 months, all patients were alive, and 54.2% were in complete remission. In 2 patients, joint involvement evolved into rheumatoid arthritis. Six patients (24%) received intravenous immunoglobulin (IVIg), with a good response in the 3 patients with peripheral nervous system involvement. Conclusions HPV-B19 infection should be considered in a wide range of clinical manifestations. Although the prognosis is good, IVIg therapy should be discussed in patients with peripheral nerve involvement. However, its efficacy should be further investigated in prospective studies.
Published: 2018
Full Text: View/download PDF

9. ANCA-associated scleritis: impact of ANCA on presentation, response to therapy and outcome

Author: Laura Perray, Yann Nguyen, Gaëlle Clavel Refregiers, Thibaud Chazal, Emmanuel Héron, Clara Pouchelon, Bertrand Dunogué, Nathalie Costedoat-Chalumeau, Anne Murarasu, Alexis Régent, Xavier Puéchal, Benjamin Thoreau, François Lifermann, Julie Graveleau, Miguel Hié, Antoine Froissart, Antoine Baudet, Alban Deroux, Christian Lavigne, Sébastien Puigrenier, Rafik Mesbah, Thomas Moulinet, Claire Vasco, Sabine Revuz, Grégory Pugnet, Virginie Rieu, Anaïs Combes, Antoine Brézin, and Benjamin Terrier
Subjects: Rheumatology, Pharmacology (medical)
Abstract: Objectives To describe characteristics, treatment, and outcome of isolated antineutrophil cytoplasm antibody (ANCA)-associated scleritis at diagnosis, in comparison with idiopathic scleritis with negative ANCA tests. Methods This retrospective case control multicentre study was performed within the French Vasculitis Study Group (FVSG) network and in three French tertiary ophthalmologic centres. Data of patients with scleritis without any systemic manifestation and with positive ANCA results were compared to those of a control group of patients with idiopathic scleritis with negative ANCA tests. Results 120 patients, including 38 patients with ANCA-associated scleritis and 82 control patients, diagnosed between January 2007 and April 2022, were included. Median follow-up was 28 months (IQR 10–60). Median age at diagnosis was 48 (IQR 33–60) and 75% were female subjects. Scleromalacia was more frequent in ANCA-positive patients (p = 0.027). 54% had associated ophthalmologic manifestations, without significant differences. ANCA-associated scleritis more frequently required systemic medications, including glucocorticoids (76% versus 34%, p 5 mg/L at diagnosis was the only significant risk factor of progression to systemic AAV (adjusted HR 5.85; 95%CI 1.10–31.01; p = 0.038). Conclusion Isolated ANCA-associated scleritis are mostly anterior scleritis with higher risk of scleromalacia than ANCA-negative idiopathic scleritis and are more often difficult-to-treat. One third of patients with PR3- or MPO-ANCA scleritis progressed to systemic AAV.
Published: 2023

10. CpaA Is a Glycan-Specific Adamalysin-like Protease Secreted by Acinetobacter baumannii That Inactivates Coagulation Factor XII

Author: Ursula Waack, Mark Warnock, Andrew Yee, Zachary Huttinger, Sara Smith, Ayush Kumar, Alban Deroux, David Ginsburg, Harry L. T. Mobley, Daniel A. Lawrence, and Maria Sandkvist
Subjects: Acinetobacter baumannii, CpaA, factor XII, O-linked glycosylation, metalloprotease, thrombosis, Microbiology, QR1-502
Abstract: ABSTRACT Antibiotic-resistant Acinetobacter baumannii is increasingly recognized as a cause of difficult-to-treat nosocomial infections, including pneumonia, wound infections, and bacteremia. Previous studies have demonstrated that the metalloprotease CpaA contributes to virulence and prolongs clotting time when added to human plasma as measured by the activated partial thromboplastin time (aPTT) assay. Here, we show that CpaA interferes with the intrinsic coagulation pathway, also called the contact activation system, in human as well as murine plasma, but has no discernible effect on the extrinsic pathway. By utilizing a modified aPTT assay, we demonstrate that coagulation factor XII (fXII) is a target of CpaA. In addition, we map the cleavage by CpaA to two positions, 279-280 and 308-309, within the highly glycosylated proline-rich region of human fXII, and show that cleavage at the 308-309 site is responsible for inactivation of fXII. At both sites, cleavage occurs between proline and an O-linked glycosylated threonine, and deglycosylation of fXII prevents cleavage by CpaA. Consistent with this, mutant fXII (fXII-Thr309Lys) from patients with hereditary angioedema type III (HAEIII) is protected from CpaA inactivation. This raises the possibility that individuals with HAEIII who harbor this mutation may be partially protected from A. baumannii infection if CpaA contributes to human disease. By inactivating fXII, CpaA may attenuate important antimicrobial defense mechanisms such as intravascular thrombus formation, thus allowing A. baumannii to disseminate. IMPORTANCE Ventilator-associated pneumonia and catheter-related bacteremia are the most common and severe infections caused by Acinetobacter baumannii. Besides the capsule, lipopolysaccharides, and the outer membrane porin OmpA, little is known about the contribution of secreted proteins to A. baumannii survival in vivo. Here we focus on CpaA, a potentially recently acquired virulence factor that inhibits blood coagulation in vitro. We identify coagulation factor XII as a target of CpaA, map the cleavage sites, and show that glycosylation is a prerequisite for CpaA-mediated inactivation of factor XII. We propose adding CpaA to a small, but growing list of bacterial proteases that are specific for highly glycosylated components of the host defense system.
Published: 2018
Full Text: View/download PDF

11. Hypereosinophilia: Biological investigations and etiologies in a French metropolitan university hospital, and proposed approach for diagnostic evaluation.

Author: Martin Peju, Alban Deroux, Hervé Pelloux, Laurence Bouillet, and Olivier Epaulard
Subjects: Medicine, Science
Abstract: OBJECTIVES:We aimed to evaluate the usefulness of biological investigations in cases of eosinophilia in our area (French Alps). METHODS:We retrospectively included all adult patients attending the infectious disease and internal medicine units between 2009 and 2015 with eosinophilia ≥1 G/l. RESULTS:We identified 298 cases (129 women and 169 men). In 139 patients, eosinophilia had not been addressed. In the 159 others, the cause of eosinophilia was identified in 118 (74.2%). The main identified causes at the time were drug reactions (24.5%, mostly β-lactams and allopurinol), infectious diseases (17.0%), vasculitis (8.2%), autoimmune diseases (6.9%), and malignant diseases (6.2%). In patients with a skin rash, eosinophilia was significantly more often investigated, and a diagnosis significantly more often made. Helminthosis were mainly diagnosed in tropical travelers (18/24) excepting toxocariasis (3 non-travelers). Stool examination for helminthosis was positive in 5/76 patients (6.6%) (all tropical travelers); 391 helminth serologies were performed in 91 patients, with 7.9% being positive (all but 3 positive cases were travelers). Anti-neutrophil cytoplasmic antibodies (ANCA) were positive in 26/112 patients (23.2%), with 9 cases of vasculitis identified. CONCLUSIONS:Drug-related eosinophilia is the main etiology. Search for helminthosis is not recommended among non-travelers (excepting toxocariasis). ANCA should be performed early so as not to overlook vasculitis.
Published: 2018
Full Text: View/download PDF

12. Angiopathie rétinienne sévère survenue sous patisiran

Author: Aurélie Madelon, Laurence Bouillet, Olivier Gavard, Sarah Perez-Roustit, Alban Deroux, and Benoit Lohberger Timsit
Subjects: business.industry, Medicine, business
Published: 2021

13. Tocilizumab in Behçet Disease: A Multicenter Study of 30 Patients

Author: Mohamed-Yacine Khitri, Alessandra Bartoli, Georgina Maalouf, Alban Deroux, Carlo Salvarani, Giacomo Emmi, Omer Karadag, Gerard Espinosa, Mathilde Leclercq, Gabriele Simonini, Mathieu Vautier, Patrice Cacoub, and David Saadoun
Subjects: Rheumatology, Immunology, Immunology and Allergy
Abstract: ObjectiveTo evaluate tocilizumab (TCZ) efficacy in patients with refractory Behçet disease (BD).MethodsThis is a multicenter study of 30 patients fulfilling the international criteria for BD and treated with TCZ at different European referral centers. The clinical response was evaluated at 6 months from TCZ initiation.ResultsNinety percent of patients with BD were refractory or intolerant to anti–tumor necrosis factor (anti-TNF) agents. Overall, TCZ was effective in 25 (83%) patients with BD of whom 18 (60%) and 7 (23%) were complete and partial responders, respectively. The complete response was 67%, 60%, and 42% in patients with uveitis (18/30), neurological manifestations (5/30), and mucocutaneous and/or articular (7/30) manifestations, respectively. TCZ had a significant steroid-sparing effect allowing patients to decrease their median daily prednisone dose from 20 (IQR 10-40) mg/day to 9 (IQR 5-13) mg at 6 months (P< 0.001). The number of patients with BD needing concomitant disease-modifying antirheumatic drug therapy fell from 7 (23%) to 4 (13%) at 6 months. Mild to moderate side effects were observed in 6 (20%) patients, and 3 (10%) presented with serious adverse events (pneumonia, intestinal perforation, and septicemia) requiring therapy discontinuation in 2 cases.ConclusionTCZ seems to be an effective alternative to anti-TNF agents in treating BD-related uveitis and neurological manifestations.
Published: 2023

14. Evaluating biological nutritional status in elderly people with unscheduled hospitalisation

Author: Marie, Beaud, Bernard, Lardy, Jean-Luc, Bosson, Alban, Deroux, and Pascal, Couturier
Abstract: A reliable interpretation of albumin levels is essential when assessing nutrition in elderly people, but this is complex as it is affected by a number of parameters. The main objective of this study was to evaluate whether a correction formula proposed for prolonged inflammation could be extrapolated to acute biological inflammation situations: corrected albuminemia = measured albuminemia + CRP/25. This prospective, single-centre observation study included patients over 65 years of age who were the subject of an unscheduled hospitalisation in the geriatrics and internal medicine departments of Grenoble University Hospital, excluding carriers of active neoplasia, hepatic insufficiency, nephrotic syndrome and those who continued to present with an acute biological inflammation on the eighth day. Clinical and biological samples were taken on the first and eighth days. The primary objective was the comparison of albumin levels, corrected using the formula on day (d) 1, with albumin levels measured on d8. One hundred and seventy-five patients were analysed. Average CRP was 64 (3; 324) mg/L on d1 and 24 (3; 99) mg/L on d8. Between the corrected albumin levels on d1 and albumin levels measured on d8, the correlation was ρ = 0.58, 95% CI [0.47; 0.67], P 0.001, with a mean difference of 2.9 (-13.5; 18) mg/L, 95% CI [-3.68-2.20], P 0.001. Between the albumin levels measured on d1 and d8, the correlation was ρ = 0.74, 95%CI [0.66; 0.80], P 0.001, with a mean difference of 0.4 (-14; 11) mg/L, 95%CI [-0.24; 1.02], P = 0.23. The proposed formula cannot be extrapolated to acute inflammatory situations. Albumin levels appear to be stable during acute biological inflammation. Albumin levels could be used as a reference for biological nutritional assessments and be integrated into the patient's clinical history.
Published: 2022

15. Glutathione S Transferases Polymorphisms Are Independent Prognostic Factors in Lupus Nephritis Treated with Cyclophosphamide.

Author: Alexandra Audemard-Verger, Nicolas Martin Silva, Céline Verstuyft, Nathalie Costedoat-Chalumeau, Aurélie Hummel, Véronique Le Guern, Karim Sacré, Olivier Meyer, Eric Daugas, Cécile Goujard, Audrey Sultan, Thierry Lobbedez, Lionel Galicier, Jacques Pourrat, Claire Le Hello, Michel Godin, Rémy Morello, Marc Lambert, Eric Hachulla, Philippe Vanhille, Guillaume Queffeulou, Jacky Potier, Jean-Jacques Dion, Pierre Bataille, Dominique Chauveau, Guillaume Moulis, Dominique Farge-Bancel, Pierre Duhaut, Bernadette Saint-Marcoux, Alban Deroux, Jennifer Manuzak, Camille Francès, Olivier Aumaitre, Holy Bezanahary, Laurent Becquemont, and Boris Bienvenu
Subjects: Medicine, Science
Abstract: OBJECTIVE:To investigate association between genetic polymorphisms of GST, CYP and renal outcome or occurrence of adverse drug reactions (ADRs) in lupus nephritis (LN) treated with cyclophosphamide (CYC). CYC, as a pro-drug, requires bioactivation through multiple hepatic cytochrome P450s and glutathione S transferases (GST). METHODS:We carried out a multicentric retrospective study including 70 patients with proliferative LN treated with CYC. Patients were genotyped for polymorphisms of the CYP2B6, CYP2C19, GSTP1, GSTM1 and GSTT1 genes. Complete remission (CR) was defined as proteinuria ≤0.33g/day and serum creatinine ≤124 µmol/l. Partial remission (PR) was defined as proteinuria ≤1.5g/day with a 50% decrease of the baseline proteinuria value and serum creatinine no greater than 25% above baseline. RESULTS:Most patients were women (84%) and 77% were Caucasian. The mean age at LN diagnosis was 41 ± 10 years. The frequency of patients carrying the GST null genotype GSTT1-, GSTM1-, and the Ile→105Val GSTP1 genotype were respectively 38%, 60% and 44%. In multivariate analysis, the Ile→105Val GSTP1 genotype was an independent factor of poor renal outcome (achievement of CR or PR) (OR = 5.01 95% CI [1.02-24.51]) and the sole factor that influenced occurrence of ADRs was the GSTM1 null genotype (OR = 3.34 95% CI [1.064-10.58]). No association between polymorphisms of cytochrome P450s gene and efficacy or ADRs was observed. CONCLUSION:This study suggests that GST polymorphisms highly impact renal outcome and occurrence of ADRs related to CYC in LN patients.
Published: 2016
Full Text: View/download PDF

16. New insights on IgA vasculitis with underlying solid tumor: a nationwide French study of 30 patients

Author: Le Sébastien Burel, Zahir Amoura, Achille Aouba, Anne-Sophie Darrigade, François Maillot, Christian Combe, Alexandra Audemard-Verger, Guillaume Moulis, Hubert de Boysson, Arsène Mekinian, Antoine Hankard, Jean-Marie Michot, Carole Vandamme-Giard, Alexandre Karras, Florent Guerville, G. Maigné, Geoffrey Urbanski, Alban Deroux, Etienne Rivière, Benoit Brihaye, Benjamin Terrier, and Johan Chanal
Subjects: Adult, Male, Vasculitis, medicine.medical_specialty, Henoch-Schonlein purpura, IgA Vasculitis, Malignancy, Gastroenterology, Rheumatology, Neoplasms, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Cancer, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Immunoglobulin A, IgA vasculitis, Adenocarcinoma, Female, France, business
Abstract: IgA vasculitis (IgAV) frequently occurs during or after a mucosal infection; it also rarely occurs in patients with cancer. We hypothesized that cancer could impact the baseline characteristics and/or outcome of vasculitis. We aimed to describe the presentation of IgAV in patients with cancer (IgAV ca+) compared to patients without cancer.We conducted a nationwide retrospective study of adult patients in France who presented with both IgAV and cancer. Baseline characteristics were described and compared with those of the 260 patients included in a nationwide French IgAV study.Thirty patients were included. The mean age was 69 ± 12 years; 80% were men. Compared to patients without underlying cancer, IgAV ca+ patients were older (69 ± 12 vs. 50 ± 18 years; p 0.0001) and they presented more frequently with necrotic purpura (53 vs. 26%; p 0.002) and intra-alveolar hemorrhage (10 vs. 0.5%; p 0.0001). IgAV ca+ patients frequently had elevated serum IgA levels (79 vs. 53%; p 0.034); most (n = 22, 73%) had adenocarcinoma or urothelial carcinoma involving the large intestines (n = 6), bladder (n = 5), and lung (n = 5). Most IgAV ca+ patients had progressive cancer (n = 21); a minority had metastatic disease (n = 2) at IgAV diagnosis. After a median follow-up of 3 months, 8 deaths were observed but none was related to IgAV.Compared to their noncancer counterpart, patients with IgAV related to cancer were older and more frequently presented with necrotizing purpura, intra-alveolar hemorrhage, and elevated serum IgA levels. Adult patients with IgAV and these latter characteristics should be carefully screened for cancer. Key Points • Clinical and biological characteristics of patients presenting with IgAV are distinct depending on the underlying cause of vasculitis related to cancer. • Patients with IgAV related to cancer are older, and compared to their counterparts without IgAV, they present more frequently with necrotic purpura, alveolar hemorrhage, and elevated serum IgA levels. • All adult patients with IgAV should be screened for cancer, and there should be a focus on elderly male patients presenting with necrotic purpura and/or alveolar hemorrhage.
Published: 2020

17. [Prevalence and characteristics of serum autoantibodies in patients followed for infertility at Grenoble University Hospital]

Author: Pascale Hoffman, Chloé Wackenheim, Laurence Bouillet, Alban Deroux, Nadia Alfaidy, Chantal Dumestre-Pérard, CHU Grenoble, Institut de Biologie et Pathologie [CHU Grenoble] (IBP), CHU Grenoble-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Biologie du Cancer et de l'Infection (BCI ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA), CCSD, Accord Elsevier, Barrière Naturelle et Infectiosité (TIMC-IMAG-BNI), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Clinique de médecine interne, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Invasion mechanisms in angiogenesis and cancer (IMAC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), and Hôpital Michallon
Subjects: 0301 basic medicine, Infertility, medicine.medical_specialty, Anti-nuclear antibody, medicine.disease_cause, Autoimmunity, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, medicine, skin and connective tissue diseases, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, Autoimmune disease, Gynecology, Pregnancy, 030219 obstetrics & reproductive medicine, biology, business.industry, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Retrospective cohort study, General Medicine, medicine.disease, 3. Good health, stomatognathic diseases, 030104 developmental biology, Fertility Disorders, biology.protein, Antibody, business
Abstract: International audience; Introduction: Fertility disorders in autoimmune diseases are well described. However, little is known about the presence of a humoral serum autoimmunity in case of infertility (antinuclear antibodies, ACAN or antiphospholipid, APL) without criteria of autoimmune disease.Methods: We studied the prevalence, associated factors, and efficacy of immunomodulatory therapy in patients with unexplained infertility. Two groups were created retrospectively among patients followed in medically assisted procreation (PMA) for infertility: a group with serum autoimmunity (AI+) (ACAN, APL or anti-thyroperoxidase antibodies) and a group without serum autoimmunity (HAVE-). Clinical, biological, and therapeutic data were collected.Results: The prevalence of autoimmunity was 33% among consultant patients. One hundred patients were seen in internal medicine consultation, 70 were included in the AI+ group and 30 in the AI- group. In the AI+ group, 76% had ACANs, 29% had anti-TPOs and 23% had APLs. There was a significant correlation between ACAN level and the presence of endometriosis (P=0.048). Immunomodulatory therapy was introduced for 68 of the 70 women in the AI+ group; pregnancy occurred in 28 patients (40%) during the treatment period, compared with 7 in the "AI-" group (23%), with a tendency to significance (P=0.09). In conclusion, there is an increased prevalence of serum autoimmunity in patients with fertility disorders, possibly with the efficacy of an immunomodulatory treatment to confront prospective therapeutic studies.
Published: 2019

18. Immune thrombocytopenia with clinical significance in systemic lupus erythematosus: a retrospective cohort study of 90 patients

Author: Mickaël Roussotte, Mathieu Gerfaud-Valentin, Arnaud Hot, Sylvain Audia, Bernard Bonnotte, Thomas Thibault, Hervé Lobbes, Guillaume Le Guenno, Radjiv Goulabchand, Pascal Cathebras, Loig Varron, Jean François Dufour, Alban Deroux, Caroline Compain, Antoine Baudet, Ludovic Karkowski, Laurent Pérard, Mikael Ebbo, Jean-Christophe Lega, Pascal Sève, Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Interne [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Métropole Savoie [Chambéry], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Hôpital d'Instruction des Armées Desgenettes, Service de Santé des Armées, Centre d'Immunologie de Marseille - Luminy (CIML), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Purpura, Thrombocytopenic, Idiopathic, Lupus, Thrombosis, Antiphospholipid, Thrombocytopenia, Immune thrombocytopenia, Thrombopoietin receptor agonists, Rheumatology, Haemorrhage, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, immune system diseases, Splenectomy, Humans, Lupus Erythematosus, Systemic, Pharmacology (medical), Rituximab, Receptors, Thrombopoietin, Retrospective Studies
Abstract: Objectives To describe the characteristics, treatment and outcome of patients with immune thrombocytopenia with clinical significance (ITPCS) associated with SLE. Methods This retrospective multicentre study included SLE patients who experienced ≥1 ITPCS (defined as ITP with attributable bleeding disorders and/or a platelet count 8 and/or WHO score >2. Results A total of 90 patients were included, the median (range) follow-up duration was 80 (6–446) months. ITP was diagnosed before SLE in 25 patients. They presented a high rate of autoimmune haemolytic anaemia (15%), antiphospholipid antibody (62%) and antiphospholipid syndrome (19%). The 25 (28%) patients who experienced MBG had significantly more bleedings at ITP diagnosis and higher bleeding scores, and serositis and thrombosis during follow-up. They required significantly more treatment lines, transfusions and hospitalizations. The 11 (12%) patients who experienced no bleeding event presented a significantly more restricted SLE phenotype (cutaneous and/or articular). Patients received a mean (range) of 4.2 (1–11) treatment lines. Corticosteroids and HCQ allowed ITPCS overall response in one-third of patients. The median relapse-free survival of rituximab (n = 34), AZA (n = 19), MMF (n = 8), thrombopoietin-receptor agonists (n = 16) and splenectomy (n = 19) were 53, 31.5, 61, 24.5 and 78 months, respectively. Four patients experienced thrombotic events after splenectomy and one occurred under thrombopoietin-receptor agonist treatment. Conclusion SLE-ITCS patients displayed a high rate of haematological abnormalities and MBG patients exhibited higher morbidity. Management of thrombocytopenia was highly heterogeneous and many options seem viable.
Published: 2021

19. Myasthenia Gravis Associated with Acute Hepatitis E Infection in Immunocompetent Woman

Author: Aude Belbezier, Alban Deroux, Françoise Sarrot-Reynauld, Sylvie Larrat, and Laurence Bouillet
Subjects: hepatitis E virus, myasthenia gravis, MuSK protein, antibodies, immunoglobulins, intravenous, Medicine, Infectious and parasitic diseases, RC109-216
Published: 2014
Full Text: View/download PDF

20. Impact of aging on phenotype and prognosis in IgA vasculitis

Author: Stanislas Faguer, Noémie Le Gouellec, François Maurier, Bertrand Lioger, Patrice Cacoub, Noémie Jourde-Chiche, Sébastien Sanges, Christian Lavigne, Benjamin Terrier, Julie Goutte, Geoffrey Urbanski, Zahir Amoura, Aurélie Hummel, Evangeline Pillebout, Sophie Deriaz, Loic Raffray, Alban Deroux, Alexandra Audemard-Verger, Elisabeth Diot, Guillaume Moulis, Nicole Feirreira-Maldent, Johan Chanal, François Maillot, A. Baldolli, Loïc Guillevin, Jean-François Augusto, Eric Thervet, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre hospitalier [Valenciennes, Nord], Innate Immunity and Immunotherapy (CRCINA-ÉQUIPE 7), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), LUNAM Université [Nantes Angers Le Mans], Département de Néphrologie-Dialyse-Transplantation [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), PRES Université Nantes Angers Le Mans (UNAM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IRD-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de recherche clinique Biomarqueurs d’urgence et de réanimation (GRC 14 - BIOSFAST), Sorbonne Université (SU), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Ambroise Paré [AP-HP], Service de médecine interne et gérontologie clinique [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Vasculaire [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Université Paris Descartes - Paris 5 (UPD5), Hôpital Cochin [AP-HP], Plateforme Histologie, Immunomarquage et Microdissection laser [Institut Cochin] (HistIM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)
Subjects: 0301 basic medicine, Immunoglobulin A, Adult, Male, Vasculitis, medicine.medical_specialty, Aging, Henoch-Schonlein purpura, Disease, 03 medical and health sciences, IgA vasculitis, 0302 clinical medicine, Rheumatology, Internal medicine, medicine, Humans, Pharmacology (medical), Aged, Retrospective Studies, 030203 arthritis & rheumatology, biology, business.industry, Age Factors, Retrospective cohort study, Middle Aged, medicine.disease, renal involvement, Purpura, 030104 developmental biology, Phenotype, Quartile, age, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, biology.protein, outcome, Kidney Failure, Chronic, Female, prognosis, medicine.symptom, business, Henoch–Schönlein purpura
Abstract: Objectives Immunoglobulin A vasculitis (IgAV) is a small-vessel vasculitis most frequently benign in children while more severe in adults. We aimed to study the impact of age on presentation and outcome of adult IgAV. Methods We conducted a nationwide retrospective study including 260 IgAV patients. Patients were divided into four quartiles according to the age at IgAV diagnosis: Results Mean age at diagnosis was 50.1 (18) years and 63% were male. IgAV diagnosed in the lowest quartile of age was associated with more frequent joint (P 6 months, clinical response and relapse rates were similar between the four groups. Median follow-up was of 17.2 months (9.1–38.3 months). Renal failure at the end of follow-up was significantly more frequent in the highest quartile of age (P = 0.02), but the occurrence of end-stage renal disease was similar in all groups. Last, overall and IgAV-related deaths were associated with increase in age. Conclusion Aging negatively impacts the severity and outcome of IgAV in adults. Younger patients have more frequent joint and gastrointestinal involvement, while old patients display more frequent severe purpura and glomerulonephritis.
Published: 2021

21. Acrosyndrome paroxystique révélant une carence en vitamine C

Author: S. Lejeune, L. Geneletti, B. Colombe, B. Lohberger Timsit, Alban Deroux, and M. Lugosi
Subjects: Gynecology, medicine.medical_specialty, business.industry, medicine, General Medicine, business
Published: 2019

22. Diagnostic biologique des angioedèmes bradykiniques : les recommandations du CREAK

Author: David Launay, Gaëlle Hardy, Guillaume Armengol, Julien Faure, Claire de Moreuil, Bernard Floccard, Frederica Defendi, C. Mansard, Nicolas Marmion, Alban Deroux, Laurence Bouillet, Anne Gompel, Roland Jaussaud, Yann Olliver, Isabelle Boccon-Gibod, Nicolas Javaud, Chantal Dumestre-Pérard, Lucile Sorin, Etienne Beaudouin, Aureli Du Than, Olivier Fain, Fabien Pelletier, Stéphane Gayet, Laurent Sailler, Jean Yves Cesbron, Anne Sarrat, Stephane Guez, Centre National de Reference des Angioedemes à Kinines, CHU Grenoble, Service d'immunologie [CHU Grenoble], CHU de Grenoble, Barrière Naturelle et Infectiosité (TIMC-IMAG-BNI), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Service de gynécologie et d'endocrinologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Reims Champagne-Ardenne (URCA), Service d’Allergologie, Centre Hospitalier Emile Durkheim [Epinal] (CH Epinal / CHED), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de dermatologie, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Hôpital Saint-Jacques-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Louis Mourier - AP-HP [Colombes], Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Service de Médecine Interne [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Orange Labs [Lannion], and France Télécom
Subjects: 0301 basic medicine, medicine.medical_specialty, MESH: Complement C1 Inhibitor Protein, Bradykinin, MESH: Algorithms, MESH: Angioedemas, Hereditary, MESH: Comorbidity, Context (language use), MESH: Fibrinolysin, MESH: Kallikreins, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, MESH: Pregnancy, 0302 clinical medicine, MESH: Early Diagnosis, MESH: Child, Internal medicine, medicine, MESH: Angioedema, MESH: Hereditary Angioedema Types I and II, MESH: Lupus Erythematosus, Systemic, 030203 arthritis & rheumatology, MESH: Bradykinin, Pregnancy, MESH: Humans, Lupus erythematosus, biology, Angioedema, business.industry, MESH: Symptom Assessment, MESH: Angiotensin-Converting Enzyme Inhibitors, Angiotensin-converting enzyme, General Medicine, MESH: Hematologic Diseases, medicine.disease, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, 030104 developmental biology, chemistry, MESH: Pregnancy Complications, Hereditary angioedema, biology.protein, Antibody, medicine.symptom, business, MESH: Female, MESH: Factor XII
Abstract: International audience; Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. In case of C1Inh deficiency, you have to identify hereditary from acquired forms. C1q and anti-C1Inh antibody tests are useful for acquired BK-AE. SERPING1 gene screening must be done if a hereditary angioedema is suspected, even if there is no family context (de novo mutation 15 %). If a hereditary BK-AE with normal C1Inh is suspected, F12 and PLG gene screening is suitable.
Published: 2019

23. Utilisation des biothérapies au cours des vascularites urticariennes

Author: Selim Aractingi, N. Le Gouellec, Frederic Vandergheynst, Delphine Gobert, Marielle Roux, Noémie Abisror, Nicolas Kluger, Giacomo Emmi, Alban Deroux, Yannick Gombeir, Anne-Sophie Korganow, Marie Jachiet, M. Cid, J. Hernandez, Nicolas Dupin, Lucas Maisonobe, Giulia Cassone, Aurélie Foucher, Marc Fabre, and Benjamin Terrier
Subjects: Gastroenterology, Internal Medicine
Published: 2021

24. COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study

Author: Jérôme Avouac, Elodie Drumez, Eric Hachulla, Raphaèle Seror, Sophie Georgin-Lavialle, Soumaya El Mahou, Edouard Pertuiset, Thao Pham, Hubert Marotte, Amélie Servettaz, Fanny Domont, Pascal Chazerain, Mathilde Devaux, Pascal Claudepierre, Vincent Langlois, Arsène Mekinian, Alexandre Thibault Jacques Maria, Béatrice Banneville, Bruno Fautrel, Jacques Pouchot, Thierry Thomas, René-Marc Flipo, Christophe Richez, Florence Aeschlimann, Christian Agard, Nassim Ait-Abdallah, Jean-David Albert, Didier Alcais, Jean-Sébastien Allain, Yannick Allanore, Blanca Amador-Borreiro, Zahir Amoura, Emma Andre, Anaïs Arbault, Jean-Benoît Arlet, Laurent Arnaud, Denis Arniaud, Herliette Arty-Hue, Lucie Atlan, Alexandra Audemard-Verger, Christine Audoin-Pajot, Victor Audren, Maxime Bach-Bunner, Hélène Bacquet-Deschryver, Brigitte Bader-Meunier, Nathalie Balandraud, Jean-Charles Balblanc, Stéphane Bally, Frédéric Banal, Pierre Barbery, Thomas Barnetche, Audre Barrelet, André Basch, Vincent Baumier, Guillaume Bayer, Sophie Bayle, Catherine Beauvais, Rudie Beinat, Véronique Belin, Rakiba Belkhir, Ruben Benainous, Alexandre Belot, Mohammed Benammar, Mathilde Benhamou, Ygal Benhamou, Ahmed Benmansour, Pascal Bennet, Brigitte Bernoux-Manat, Elise Berthet, Emilie Berthoux, Ewa Bertolini, Adrien Bigot, Aurélia Bisson-Vaivre, Gilles Blaison, Gilles Bolla, Olivier Bonidan, Christine Bonnet, Raphaël Borie, Marie Bossert, Laurence Boudou, Françoise Bouhour, Kévin Bouiller, Bastien Bouldoires, Karima Boussoualim, Eric Bouvard, Regine Brondino, Pierre Buchlin, Laurence Cabantous, Patrice Cacoub, Simon Cadiou, Maurizio Carteni, Aurélia Carbasse, Brice Castel, Pascal Cathebras, Hervé Caumont, Annalisa Celant, Benjamin Chaigne, Benoît Chaillous, Romuald Champy, Agnès Charcot, Pierre Charles, Isabelle Charlot-Lambrecht, Caroline Charpin, Emmanuel Chatelus, Bernard Chaudier, Pascale Chertok, Xavier Chevalier, Maxime Chevreau, Emilie Chotard, Delphine Chu Miow Lin, Gaëlle Clavel, Cyril Clavel-Osorio, Fleur Cohen, Gregory Cohen, Marie-Eve Colette-Cedoz, Nived Collercandy, Antoine Colombey, Chloé Comarmond, Bernard Combe, Céline Comparon, Elodie Constant, Pascal Coquerelle, Justine Corli, Clémence Corre, Nathalie Costedoat-Chalumeau, Marie Couret, Natacha Courvoisier, Fabienne Coury-Lucas, Cécile Coutarel, Fabrice Coutier, Richard Damade, Laurence Daver-Malaterre, Sarahe Dehimat, Michel Delahousse, Emilie Barrois-Delattre, Delphine Denarie, Camille Deprouw, Emanuelle Dernis, Alban Deroux, Renaud Desbarbieux, Elise Descamps, Chantal Deslandre, Marie Desmurs, Jacques Despaux, Marie Desplats, Frédérick Detree, Valérie Devauchelle-Pensec, Robin Dhote, Philippe Dieude, Yannick Dieudonne, Elisabeth Diot, Guillaume Direz, Djamal-Dine Djeddi, Sarah Douvier, Béatrice Drouet, Catherine Duc, Angélique Ducornet, Carine Dufauret-Lombard, Alain Duhamel, Cécile Dumaine, Anne-Elisabeth Dumel, Chantal Dumoulin-Richez, Agnès Duquesne, Géraldine Durand, Mariane Durandin-Truffinet, Pierre-Marie Duret, Maïka Duval, Mikaël Ebbo, Esther Ebstein, Andra Economu-Dubosc, Stéphanie Emilie, Romain Euvrard, Philippe Evon, Sylvie Fabre, Dorothée Fagedet, Meryem Farhat, Marion Fauconier, Jacques Fechtenbaum, Renaud Felten, Fanny Fernandes, Nicole Ferreira-Maldent, Elodie Feurer, Amandine Fichet, Françoise Flaisler, Nans Florens, Violaine Foltz, Elisabeth Fontanges, Jennifer Foret, Anne-Claire Fougerousse, Anne Fouque-Aubert, Catherine Foutrier-Morello, Hélène Francois-Pradier, Léa Frantzen, Pierre Fritz, Antoine Froissart, Jean Fulpin, Piera Fuzibet, Francis Gaches, Laurence Gagneux-Lemoussu, Mélanie Penhoat-Gahier, Joris Galland, Frédérique Gandjbakhch, Nicole Garnier, Thomas Garraud, Jean-François Garrot, Romain Gastaldi, Véronique Gaud-Listrat, Maud Gauthier-Prieur, Dana Georgescu, Nathalie Gerard, Elisabeth Gervais, Christelle Gibert, Eric Gibert, Ghislaine Gill, Jérôme Gillard, Mélanie Gilson, Pauline Gimonnet, Jeanine-Sophie Giraudet-Le Quintrec, Aude Giraud-Morelet, Baptiste Glace, Camille Glanowski, Bertrand Godeau, Bruno Gombert, Camille Gonnet-Gracia, Tiphaine Goulenok, Philippe Goupille, Olivier Gourmelen, Sophie Govindaraju-Audouard, Franck Grados, Martine Grall-Lerosey, Bruno Grardel, Anne Grasland, Gilles Grateau, Monica Groza, Constance Guillaud, Séverine Guillaume, Caroline Guillibert, Xavier Guillot, Philippe Guilpain, Aline Gury, Marie-Hélène Guyot, Cécile Hacquard-Bouder, Marie-Noelle Havard, Jean-Pierre Hellier, Pascal Hennequin, Basile Henriot, Julien Henry, Véronique Hentgen, Marion Hermet, Muriel Herasse, Julie Hernandez, Miguel Hie, Pascal Hilliquin, Olivier Hinschberger, Ambre Hittinger-Roux, Jan Holubar, Christophe Hudry, Serge Huguenel, Clara Jaccard, Jean-Michel, Jacquemier, Bénédicte Jamard, Catherine Jan, Sylvie Jean, Mathieu Jouvray, Pierre-Antoine Juge, Laurent Juillard, Denis Jullien, Anna Kabala, Abdelkrim Kabchou, Ludovic Karkowski, Françoise Karman, Farid Kemiche, Jérémy Keraen, Pierre Kieffer, Isabelle Kone-Paut, Abdeldajallil Koreichi, Marie Kostine, Sylvain La Batide Alanore, Pierre Lafforgue, Sophie Lahalle, Marc Lambert, Isabelle Lambrecht, Sylvain Lanot, Aurélia Lanteri, Jean-Paul Larbre, Augustin Latourte, Christian Lavigne, Sophie Le Guen Guegan, Guillaume, Le Guenno, Diane Leguy, Agnès Lebrun, Emmanuel Ledoult, Nathalie Legoupil, Erick Legrand, Charlotte Lejeune, Olivier Leloire, Christophe Leroux, Rémi Leroy, Marie Leroy-Gouix, Tifenn Leturcq, Amélie Leurs, Céline Leveque-Michaud, François-Xavier Limbach, Frédéric Liote, Anne Lohse, Pierre Lozac'h, Virginie Lucas, Aurélie Madelon, Nadine Magy-Bertrand, Matthieu Mahevas, Hélène Maillard, Thibault Maillet, Sandrine Malochet-Guinamand, Quentin Mangon, Sylvie Marchou-Lopez, Nathalie Margarit, Thierry Marhadour, Xavier Mariette, Claire Martin, Alexis Mathian, François Maurier, Frédéric Maury, Betty Mazet-Guillaume, Arnaud Mazouyez, Hassan Mazyad, Nadia Mehsen-Cetre, Ulrich Meinzer, Isabelle Melki, Laurent Messer, Corinne Miceli, Martin Michaud, Catherine Michel, Matthias Michel, Mathilde Michon, Anne-Marie Milesi-Lecat, Anna Molto, Marie Moly, Olivier Moranne, Gautier Morel, Hugo Morel, Jacques Morel, Franck Morin, Laurence Moulinier, Guillaume Moulis, Bertrand Moura, Minh Nguyen, Sabine Nicolas-Vullierme, Hubert Nielly, Gaétane Nocturne, Aurore Nottez, Henri-Olivier Ollagnon, Isabelle Pacaud-Vitoux, Anne Pagnier, Caroline Paris, Antoine Parrot, Tristan Pascart, Yasmina Pascaud-Mansour, Lætitia Paulin, Stephan Pavy, Laurent Perard, Yves-Marie Pers, Micheline Pha, Maud Pichon, Audrey Pierreisnard, Gabrielle Pizana, Sylvaine Poignant, Elsa Poix, Agnès Portier, Antoine Poulet, Samira Plassard, Grégory Pugnet, Déborah Puyraimond-Zemmour, Pierre Quartier-Dit-Maire, Marion Quenet, Viviane Queyrel, Loïc Raffray, Philippe Remy, Myriam Renard, Jessica Rene, Sabine Revuz, Bénédicte Rey, Gaëlle Richard-Colmant, Etienne Riviere, Sébastien Riviere, Sophie Robin, Julien Rohmer, Isabelle Roitg, Mélanie Romier, Michel Rolland, Mélanie Roriz, Carole Rosenberg, Linda Rossi, Olivier Roth, Sid-Ahmed Rouidi, Mathilde Roumier, Mickaël Rousiere, Clémentine Rousselin, Bénédicte Rouviere, Christian Roux, Fabienne Roux, Marielle Roux, Nicolas Roux, Diane Rouzaud, Sylvie Rozenberg, Isabelle Sacco, Fatiha Sadji, Laurent Sailler, Carine Salliot, Jean-Hugues Salmon, Alain Saraux, Jean Schmidt, Julie Seguier, Jérémie Sellam, Eric Senbel, Thomas Sene, Patricia Senet, Pascal Seve, Aurélie Sicaud, Perrine Smets, Vincent Sobanski, Christelle Sordet, Elisabeth Sornay-Rendu, Odile Souchaud-Debouverie, Lætitia Sparsa, Lionel Spielmann, Sarah Steib, Chloé Stavris, Catherine Straus, Victor Strotz, Paulina Szafors, Séverine Taffignon-Clave, Justine Simoens, Claire Theillac, Nora Tenenbaum, Benoît Thomachot, Nathalie Tieulie, Soizic Tiriau, Alice Tison, Eric Toussirot, Ludovic Trefond, Sophie Trijau, Sébastien Trouillier, Anne-Priscille Trouvin, Marie-Elise Truchetet, Marc Ulrich, Jacques Vaquier, Eric Veillard, Laurent Veillon, Guillaume Vial, Jean-François Viallard, Judith Victor, Claire Vidon, Mathias Vidon, Camille Vigne, Alexandre Virone, Ursula Warzocha, Daniel Wendling, Claude Werle, Cécile Wibaux, Alexandra Willems, Michel Wisniewski, Juliette Woessner, Bernadette Xerri-Campano, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Tourcoing, Centre Hospitalier René Dubos [Pontoise], Assistance Publique - Hôpitaux de Marseille (APHM), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie Intégrative du Tissu Osseux (LBTO), Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique - Epidémiologie Clinique Saint-Etienne (CIC-EC), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Pitié-Salpêtrière [AP-HP], Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Epidemiology in Dermatology and Evaluation in Therapeutics (EpiDermE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Saint-Antoine [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Bordeaux [Bordeaux], Composantes innées de la réponse immunitaire et différenciation (CIRID), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie intégrative du tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Saint Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Nord (Saint Etienne), centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Service de rhumatologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de rhumatologie [CH Gustave Dron, Tourcoing], Centre Hospitalier Gustave Dron [Tourcoing], Hopital Réné Dubos, Université Paris 1 Panthéon-Sorbonne - UFR Science Politique (UP1 UFR11), and Université Paris 1 Panthéon-Sorbonne (UP1)
Subjects: medicine.medical_specialty, Immunology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, immune system diseases, law, hemic and lymphatic diseases, Internal medicine, Clinical endpoint, Immunology and Allergy, Medicine, 030212 general & internal medicine, 030203 arthritis & rheumatology, business.industry, Hazard ratio, Odds ratio, Articles, medicine.disease, Intensive care unit, 3. Good health, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Rheumatoid arthritis, Cohort, Rituximab, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study, medicine.drug
Abstract: Summary Background Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases. Methods In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis vs others]). Odds ratios and hazard ratios and their 95% CIs were calculated as effect size, by dividing the two population mean differences by their SD. This study is registered with ClinicalTrials.gov, NCT04353609. Findings Between April 15, 2020, and Nov 20, 2020, data were collected for 1090 patients (mean age 55·2 years [SD 16·4]); 734 (67%) were female and 356 (33%) were male. Of the 1090 patients, 137 (13%) developed severe COVID-19 and 89 (8%) died. After adjusting for potential confounding factors, severe disease was observed more frequently (effect size 3·26, 95% CI 1·66–6·40, p=0·0006) and the duration of hospital stay was markedly longer (0·62, 0·46–0·85, p=0·0024) in the 63 patients in the rituximab group than in the 1027 patients in the no rituximab group. 13 (21%) of 63 patients in the rituximab group died compared with 76 (7%) of 1027 patients in the no rituximab group, but the adjusted risk of death was not significantly increased in the rituximab group (effect size 1·32, 95% CI 0·55–3·19, p=0·53). Interpretation Rituximab therapy is associated with more severe COVID-19. Rituximab will have to be prescribed with particular caution in patients with inflammatory rheumatic and musculoskeletal diseases. Funding None.
Published: 2021

25. Clinical spectrum and therapeutic management of auto-immune myelofibrosis: a nation-wide study of 30 cases

Author: Stéphane Durupt, Emmanuel Forestier, Alban Deroux, Laurent Hudier, Emmanuel Ledoult, Nicolas Noel, Martin Killian, Olivier Lambotte, Marc Pineton de Chambrun, Anne Sophie Morin, Emilie Chalayer, Audrey Gorse, Laurent Chiche, Pascal Cathébras, Thierry Martin, Philippe Mertz, Jean Sibilia, Zahir Amoura, Claire Lecomte, Jacques-Eric Gottenberg, Louis Terriou, Nathalie Coestedoat, C. Martinez, Laurent Arnaud, Anne-Sophie Korganow, A. Mathian, Elisabeth Diot, Les Hôpitaux Universitaires de Strasbourg (HUS), Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de Référence des Maladies Auto-immunes et Systémiques Rares Est Sud Ouest (CNR RESO), Institut de Cancérologie Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen [Fondation Ambroise Paré - Marseille], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Michallon, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Tours (UT), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Hospitalier Métropole Savoie [Chambéry], CH de Saint-Malo [Broussais], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Médipole Hôpital Mutualiste Villeurbanne, CHU Lille, Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Jean Verdier [AP-HP], and Université de Strasbourg (UNISTRA)
Subjects: business.industry, MEDLINE, Aucun, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, Bioinformatics, medicine.disease, Auto immune, Primary Myelofibrosis, Humans, Medicine, Letters to the Editor, business, Myelofibrosis
Abstract: International audience; No abstract available
Published: 2021

26. Évaluation des réunions de concertation pluridisciplinaire de médecine interne au CHU Grenoble Alpes

Author: Alban Deroux, B. Colombe, B. Lohberger Timsit, M. Lugosi, and Laurence Bouillet
Subjects: 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Political science, Gastroenterology, Internal Medicine, 030212 general & internal medicine, Humanities
Abstract: Resume Introduction Les reunions de concertation pluridisciplinaire (RCP) ont pour objectif de proposer la meilleure prise en charge aux patients en fonction de l’etat de la science. Si la RCP d’oncologie a su demontrer son importance, ce n’est pas le cas de la RCP de medecine interne. Methode Nous avons conduit une etude descriptive retrospective au sein du CHU de Grenoble Alpes, incluant les donnees issues de 247 comptes rendus de RCP etablis sur la periode de janvier 2013 a fevrier 2019. Nous avons examine les elements relatifs aux patients, a la tenue des seances et aux avis rendus par la RCP. Les discussions pouvaient concerner une prise en charge diagnostique et/ou therapeutique. Resultats Trois specialites medicales, parmi lesquelles la medecine interne, etaient representees au cours des reunions. Sur le plan des avis diagnostiques, 18 % des dossiers necessitaient l’avis d’un medecin specialiste, 12 % des dossiers etaient consideres « complexes ». Sur le plan therapeutique, des recommandations etaient disponibles dans 35 % des cas ; 50 % des propositions therapeutiques concernaient des therapeutiques onereuses, hors-AMM dans 75 % de ces situations. Les comptes rendus mentionnaient le referentiel utilise pour la prise de decision dans 6 % des cas. L’avis formule par la RCP etait applique dans 72 % des cas. Conclusion La RCP de medecine interne repond a un reel besoin de la part des medecins, dans l’interet final du patient. Une analyse prospective serait interessante pour une meilleure definition des criteres d’evaluation de ces RCP.
Published: 2020

27. Caractéristiques cliniques, pronostic et traitements des syndromes de microangiopathie thrombotique au cours du lupus : une étude descriptive multicentrique de 144 cas français

Author: Z. Amoura, R. Lhote, F. Cohen Aubart, M. Pineton De Chambrun, L. Galicier, Priscille Couture, Jean-Jacques Boffa, M. Hie, Naïke Bigé, Alban Deroux, P. Coppo, and A. Mathian
Subjects: Gastroenterology, Internal Medicine
Abstract: Introduction L’association d’une microangiopathie thrombotique (MAT) et d’un lupus systemique (LS) est un evenement rare, dont la frequence varie entre 1 et 4 %. Des signes clinico-biologiques ou histologiques de MAT peuvent etre retrouves dans plusieurs entites au cours du lupus : purpura thrombotique thrombocytopenique autoimmun (PTT), MAT associee aux glomerulonephrites (MAT-GN), syndrome catastrophique des antiphospholipides (CAPS) ou syndrome HELLP en cours de grossesse. La presentation clinique initiale de ces entites est parfois indiscernable pour le clinicien alors que leur traitement peut etre tres different. Leur distinction precoce est indispensable au traitement rationnel des MAT associees au LS. L’objectif de cette etude etait de decrire le phenotype clinique des MAT au cours du LS selon une analyse en cluster, et d’en preciser le pronostic et les traitements en fonction des sous-types precedemment decrits. Patients et methodes Etude retrospective multicentrique de janvier 1987 a avril 2019 au sein de 37 services hospitalo-universitaires. Les criteres d’inclusion etaient l’association d’un LS et d’une MAT definie soit par la presence d’une anemie hemolytique microangiopathique et d’une thrombopenie peripherique, soit par une image histologique renale. Resultats 119 patients (12 hommes et 107 femmes) ayant presente 144 episodes de MAT ont ete inclus. L’âge median au diagnostic de LS etait de 25 ans [7-58]. La MAT survenait au cours d’un LS deja connu dans 71,5 % des cas, etait inaugurale dans 23 % des cas et precedait le diagnostic de LS dans 5,5 % des cas. Apres relecture de l’ensemble des dossiers, un diagnostic retrospectif a ete attribue a chaque episode de MAT : 71 cas (49,3 %) de PTT, 44 cas (30,6 %) de MAT-GN, 19 cas (13,2 %) de CAPS probable, 2 cas de HELLP (1,4 %), un SHU atypique (0,7 %) et 7 MAT inclassees (4,8 %). La duree mediane de suivi etait de 152 mois [1-460]. Les atteintes cliniques du LS etaient : cutanee aigue (n = 95, 80 %), nephrologique (n = 66, 56 %), pleuropericardique (n = 56, 47 %), cytopenies auto-immunes (n = 47, 40 %) et articulaire (n= 33, 28 %). Les facteurs favorisant la MAT etaient : poussee de LS (n = 87), infection (n = 25), grossesse et peri-partum (n = 10), rupture therapeutique (n = 9) et arret des anticoagulants (n = 6). Apres une analyse en cluster de l’ensemble de la cohorte, 3 groupes principaux se degageaient : – Cluster 1 : correspondant aux PTT. Au diagnostic de MAT, ces patients avaient significativement plus de purpura, plus d’atteintes neurologiques, et un taux de plaquettes plus bas que dans les autres groupes (taux de plaquettes median = 11 G/L, p – Cluster 2 : correspondant aux MAT-GN. Le taux median de creatinine etait de 302 μmol/L, significativement plus eleve que dans les autres groupes (p – Cluster 3 : correspondant aux patients atteints de CAPS. Ils avaient une haptoglobine (mediane = 4,15 g/L) et un fibrinogene (mediane = 0,65 g/L) significativement plus eleves que dans les deux autres groupes (p Ces trois clusters classaient les patients de maniere similaire aux cliniciens dans 83,6 % des cas. Le traitement des MAT a comporte (seul ou en association) : corticotherapie (n = 138), echanges plasmatiques (n = 99) rituximab (n= 45), cyclophosphamide (n= 50), immunoglobulines intraveineuses (n = 19), mycophenolate mofetil (n = 34), azathioprine (n = 11), vincristine (n = 8), ciclosporine (n = 3), eculizumab (n = 7), antiagregant plaquettaire (n = 59), anticoagulation efficace (n = 56) et/ou une epuration extra-renale en urgence (n = 39). Parmi les 71 cas de PTT, 60 ont eu des echanges plasmatiques et seulement 19 etaient refractaires. Une ou plusieurs rechutes de MAT etaient survenues chez 17 patients. 9 patients etaient decedes. En fin de suivi, les patients avec une MAT-GN etaient plus souvent transplantes ou en dialyse continue (p Conclusion La MAT associee au LS est un syndrome heterogene. Trois entites principales (PTT, MATGN et CAPS) peuvent se distinguer au diagnostic sur des elements clinico-biologiques rapides et permettre un traitement cible plus precoce.
Published: 2021

28. Screening of hepatitis E in patients presenting for acute neurological disorders

Author: Sébastien Lhomme, Chantal Dumestre-Pérard, Vincent Leroy, Lorella Minotti, Emeline Lagrange, Patrice Morand, Jean-Luc Bosson, M. Lugosi, Claire Wintenberger, Roselyne Collomb-Muret, Aude Belbézier, Maxime Maignan, Damien Viglino, Françoise Sarrot-Reynauld, Sylvie Larrat, Perrine Dumanoir, Isabelle Boccon-Gibod, Alban Deroux, Carole Schwebel, A. Bosseray, Antoine Vilotitch, Mathieu Vaillant, Julien Lupo, Laurence Bouillet, Olivier Epaulard, B. Colombe, Clinique de médecine interne, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre Hospitalier Universitaire [Grenoble] (CHU), Pôle Psychiatrie et Neurologie [Grenoble], Service d'immunologie [CHU Grenoble], CHU de Grenoble, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Virologie [Toulouse], CHU Toulouse [Toulouse], Département de virologie [Grenoble], Institut de biologie structurale (IBS - UMR 5075), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA), Radiopharmaceutiques biocliniques (LRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), 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)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Biologie du Cancer et de l'Infection (BCI ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications Grenoble - UMR 5525 (TIMC-IMAG)
Subjects: 0301 basic medicine, Male, viruses, Neurological disorder, medicine.disease_cause, Serology, Hepatitis, 0302 clinical medicine, Hepatitis E virus, Seroepidemiologic Studies, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Prospective Studies, Acute hepatitis, MESH: Acute Disease / epidemiology, Adult, Aged, Aged, 80 and over, Brachial Plexus Neuritis / epidemiology, Female, France / epidemiology, Guillain-Barre Syndrome / epidemiology, Hepatitis Antibodies / blood, Hepatitis E / blood, Hepatitis E / diagnosis, Hepatitis E / epidemiology, Hepatitis E / immunology, Hepatitis E virus / immunology, Humans Immunoglobulin M / blood, Middle Aged, Nervous System Diseases / epidemiology, Nervous System Diseases / immunology, RNA, Viral / blood, Reverse Transcriptase Polymerase Chain Reaction, Transaminases / blood, Young Adult, education.field_of_study, lcsh:Public aspects of medicine, virus diseases, General Medicine, Hepatitis E, 3. Good health, Infectious Diseases, Acute Disease, RNA, Viral, France, medicine.medical_specialty, 030106 microbiology, Population, Guillain-Barre Syndrome, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Internal medicine, medicine, Seroprevalence, Brachial Plexus Neuritis, Humans, lcsh:RC109-216, Hepatitis Antibodies, education, Transaminases, business.industry, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Immunoglobulin M, Elevated transaminases, Nervous System Diseases, business
Abstract: International audience; Introduction: Hepatitis E virus (HEV) infection has been reported to be associated with neurological disor-ders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determinedthe prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic,non-vascular neurological injury.Method: A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data onpatients with acute (
Published: 2020

29. Dermatomyosite à anticorps anti-MDA5 sévère associée à un cancer et contrôlée par inhibiteur de JAK

Author: O. Benveniste, B. Colombe, S. Viel, C. Jalles, M. Tardieu, M. Lugosi, Alban Deroux, and CHU Grenoble
Subjects: 030203 arthritis & rheumatology, Ruxolitinib, medicine.medical_specialty, Cyclophosphamide, business.industry, [SDV]Life Sciences [q-bio], Gastroenterology, Cancer, Gamma globulin, Dermatomyositis, medicine.disease, Small-cell carcinoma, 3. Good health, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Methylprednisolone, Interferon, Internal medicine, Internal Medicine, medicine, business, medicine.drug
Abstract: Dermatomyositis is an idiopathic inflammatory myopathy with various clinical and serological profiles, including poor prognosis forms for which aggressive immunosuppressive treatment is warranted. We report the case of a 60-year-old woman referred to our hospital for an anti-melanoma differentiation-associated 5 gene antibody-positive dermatomyositis (MDA5 DM) with rapidly progressive interstitial pneumonia, typical cutaneous features and muscular impairment. Treatment with high-dose methylprednisolone, cyclophosphamide and gamma globulin was performed, but the patient remained corticodependant. Blood detection of positive interferon signature justified the administration of an anti-JAK1/2, leading to the clinical remission and the regression of the interferon signature. After 12 months of follow up, a small cell carcinoma was discovered, raising the question of a paraneoplastic syndrome, for which the most recent datas are quite reassuring for this kind of MDA5 DM. The presentation of this case is of twofold interest: describing one of the first report of successful treatment of intereronopathy MDA5 DM with ruxolitinib and highlighting an association with a cancer, which is not expected for this phenotype of dermatomyositis.
Published: 2020

30. P79 Predictors of adverse neonatal outcome during the pregnancy of women with antiphospholipid syndrome in the French GR2 prospective study

Author: P. Orquevaux, O. Souchaud-Debouverie, Estibaliz Lazaro, François Maurier, Véronique Le Guern, Alban Deroux, Gaëlle Guettrot-Imbert, Maëlle Le Besnerais, Catherine Deneux-Tharaux, Nathalie Costedoat-Chalumeau, A. Murarasu, and Patrick Jego
Subjects: Lupus anticoagulant, medicine.medical_specialty, Pregnancy, Placental abruption, HELLP syndrome, Obstetrics, business.industry, medicine.disease, Preeclampsia, Antiphospholipid syndrome, medicine, Small for gestational age, business, Prospective cohort study
Abstract: Introduction Data about the predictors of adverse neonatal outcome in pregnant women with antiphospholipid syndrome (APS) are sparse. The main study on this subject is the prospective American study PROMISSE on 144 carriers of antiphospholipid antibodies.1 We report the first results of the French study, GR2. Methods Inclusion criteria were: (1) an ongoing pregnancy at 12 weeks of gestation (WG), (2) conceived before May 2018, (3) of a woman with APS.2 Exclusion criteria were proteinuria (ratio >1 g/g), serum creatinine >100 µmol/L, and multifetal pregnancy. The composite primary outcome included an intrauterine fetal death (IUFD), a neonatal death, placental insufficiency (fetal growth restriction, preeclampsia, HELLP syndrome, and/or placental abruption) leading to a delivery ≤34 WG, and/or a small for gestational age (SGA) ≤3rd percentile. Results We analysed 119 pregnancies in 119 patients: 53% thrombotic and 47% obstetric only APS; 60% had lupus anticoagulant (LA) and 26% associated SLE. Treatment included aspirin (99%), heparin (98%, in the therapeutic range for 50%), and hydroxychloroquine (62%). The primary outcome was observed in 14% of pregnancies: 3% IUFD, 8% delivery ≤34WG due to placental insufficiency and/or 5% of SGA (and no neonatal death). It was observed in 20% of the pregnancies with LA compared with 7% for women negative for LA (P=0.096). This outcome did not differ according to anticardiolipin or antiβ2GP1 antibody status, or prior thrombosis (14%, versus 14% for women with only obstetric APS). There was a trend toward more adverse neonatal outcomes in case of prior arterial thrombosis (29% versus 12%, P=0.07). The rate of adverse neonatal outcomes did not differ among the women with or without associated SLE (29% versus 26%, P=0.77). In multivariate analysis, independent features associated with pregnancy failure were: in a serological model, LA positive status (ORa=8.5, 95%CI[1.0–71.5]) and in a serological and clinical model, ‘non-white’ skin colour (ORa=6.1, 95%CI[1.1–34.7]). Conclusion The rate of adverse neonatal outcomes tended to be lower than in the PROMISSE study (14% versus 19%), although the women included here were theoretically more severe (definite APS). One potential explanation might be that our patients were all treated. In keeping with the PROMISSE study, LA and skin colour were the main predictors of neonatal outcome. Acknowledgement Fondation pour la Recherche Medicale (M2R201806006403) References Lockshin MD, et al. Arthritis Rheum. 2012; 64;2311–8. Miyakis S, et al. J Thromb Haemost. 2006; 4 ;295–306. Andreoli L, et al. Ann Rheum Dis. 2017; 76; 476–85.
Published: 2020

31. Dramatic but suspensive effect of interleukin-1 inhibitors for persistent urticarial vasculitis: a French multicentre retrospective study

Author: Julien Wipff, Thomas Bettuzzi, Marie Jachiet, Selim Aractingi, Benjamin Terrier, Meryem-Maud Farhat, Marc Fabre, Alban Deroux, Nicolas Dupin, Laurence Bouillet, and Nora Kramkimel
Subjects: Adult, Male, Vasculitis, 0301 basic medicine, Systemic disease, medicine.medical_specialty, Urticaria, Immunology, Dapsone, General Biochemistry, Genetics and Molecular Biology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Refractory, Humans, Immunology and Allergy, Medicine, Urticarial vasculitis, Retrospective Studies, 030203 arthritis & rheumatology, Biological Products, business.industry, Interleukin, Retrospective cohort study, Middle Aged, medicine.disease, Dermatology, Treatment Outcome, 030104 developmental biology, Female, Rituximab, France, business, Interleukin-1, medicine.drug, Systemic vasculitis
Abstract: Urticarial vasculitis (UV) is rare systemic disease characterised by a dermal capillary inflammation responsible of long-lasting urticarial lesions, and sometimes some systemic manifestations.1 2 UV can be separated into two different entities: hypocomplementemic UV (HUV) and normocomplementemic UV (NUV). Treatment of UV depends on the severity of the disease and the occurrence of relapses. In patients refractory to colchicine or dapsone, glucocorticoids (GCs), conventional immunosuppressive agents or rituximab (RTX) can be used,1 2 leading to significant morbidity. Interleukin-1β (IL-1β) inhibitors are biologics mainly used in autoinflammatory diseases.3 We report here a French retrospective multicentr study of patients treated with IL-1β inhibitors for persistent disease despite GCs and/or immunosuppressive agents. This French retrospective multicentre study was conducted in four departments of Dermatology and Internal Medicine. We included patients with persistent UV to at …
Published: 2019

32. Utilisation des biothérapies dans le traitement des vascularites urticariennes

Author: José Hernández-Rodríguez, Selim Aractingi, Caroline Freguin, A.-L. Pinault, Marie Geisler, Frederic Vandergheynst, Lucas Maisonobe, Marie Jachiet, Anne-Sophie Korganow, Giacomo Emmi, Marc Fabre, Audrey Benyamine, Nicolas Kluger, François Chasset, Yannick Gombeir, Giulia Cassone, Marielle Roux, Marie-Sylvie Doutre, Aurélie Foucher, Laurence Bouillet, Dimitri Titeca-Beauport, Delphine Gobert, Benjamin Terrier, Noémie Abisror, Georgina Espígol-Frigolé, Alban Deroux, Nicolas Dupin, and Noémie Le Gouellec
Subjects: Ocean Engineering, Safety, Risk, Reliability and Quality
Published: 2021

33. Traitement de la thrombopénie immunologique cliniquement significative secondaire au lupus érythémateux systémique : étude rétrospective de 90 patients en vie réelle

Author: Pascal Sève, Alban Deroux, T. Thibault, Jean-François Dufour, M. Roussotte, C. Compain, M. Ebbo, G. Le Guenno, Arnaud Hot, A. Baudet, Hervé Lobbes, L. Karkowski, R. Goulabchand, Pascal Cathébras, Laurent Perard, L. Varron, M. Gerfaud-Valentin, and Jean-Christophe Lega
Subjects: Gastroenterology, Internal Medicine
Abstract: Introduction Approximativement 20 % des lupiques presentent une thrombopenie immunologique (TI). La TI cliniquement significative (TICS) secondaire au lupus erythemateux systemique (LES) (TICS-LES) concernerait quant a elle 5 % des patients [1] . La prise en charge de la TICS-LES ne fait pas consensus a l’ere des traitements recemment developpes pour la TI primaire. Patients et methodes Etude retrospective dans 15 services de medecine interne du Centre-Est et Sud, incluant des adultes lupiques (criteres ACR et SLICC), presentant une TICS (TI [2] , l’activite du LES par le SLEDAI, le test de Farr et le complement. Les sujets presentant ≥ 1 EH OMS > 2 ou Khellaf > 8 definissaient le groupe « EH majeur (EHM) ». La reponse (R)/non reponse (NR) a chacun des traitements de la TICS etait definie selon le consensus international [3] . Les traitements de fond (TF) comprenaient les immunosuppresseurs (IS), le rituximab (RTX), et la splenectomie. Les evenements de morbi-mortalite etaient analyses. Les variables qualitatives etaient comparees selon le Test de Fisher, la non-significativite (NS) definie par p > 0,05. Resultats Quatre vingt dix patients (80 femmes) avec un suivi median de 80 mois [6–446] etaient inclus. Le diagnostic de TI precedait celui de LES (28 %), etait concomitant (47 %), ou lui succedait (25 %). Sept malades (8 %) presentaient un LES « hematologique pur ». Chez 34 des 52 (65,4 %) patients chez qui l’information etait disponible, le LES etait actif lors de la TICS. 54 malades (62 %) presentaient des anticorps antiphospholipides (APL), 16 (18 %) un syndrome des APL. Au total, 215 EH chez 79 malades etaient repertories ;45 revelaient la TI. Le groupe EHM comprenait 25 malades. Au cours du suivi, 11 patients (9 EHM) recevaient ≥ 1 transfusion de concentres erythrocytaires et 14 (7 EHM) des concentres plaquettaires. Le groupe EHM motivait plus d’hospitalisations (256 sur les 485 repertoriees, p Conclusion 28 % des TICS-LES presentent ici ≥ 1 EHM et une morbidite plus elevee (plus d’hospitalisations, de TF, de transfusions). Parmi les TF, l’AZA souvent propose en premiere intention, permet 74 % de R. Le MMF semble rentable comme IS de recours. La proportion de R au RTX parait meilleure apres echec d’un IS ou de la splenectomie qui est a eviter avec seulement 42 % de R persistante et un surrisque thrombotique et de poussee lupique.
Published: 2020

34. La maladie associée aux IgG4 à début pédiatrique ou « juvénile » existe-t-elle ? A propos d’une série descriptive de 25 cas

Author: Alban Deroux, M. Ebbo, François Lhote, B. Rohmer, Estibaliz Lazaro, B. De Sainte Marie, Nathalie Morel, Nicolas Schleinitz, Brigitte Bader-Meunier, K.P. Agbo-Kpati, V. Rebours, M. Hamidou, and D. Urbina
Subjects: 030203 arthritis & rheumatology, 03 medical and health sciences, 0302 clinical medicine, Gastroenterology, Internal Medicine, 030212 general & internal medicine
Abstract: Introduction La maladie associee aux IgG4 (MAG4) est une pathologie fibro-inflammatoire localisee ou systemique caracterisee par des lesions histologiques typiques. D’un point de vue epidemiologique, elle touche preferentiellement l’homme avec un âge moyen au diagnostic du plus de 60 ans [1] . La survenue d’une MAG4 dans l’enfance ou chez l’adulte jeune est exceptionnelle et rarement rapportee [2] . Nous presentons une etude descriptive ainsi qu’une revue de la litterature de cas debutant avant l’âge de 25 ans. Les donnees ont ensuite ete comparees a une cohorte adulte. Materiels et methodes Les observations de notre cohorte ont ete recueillies par un appel a observations national aupres des societes savantes et du recueil d’observations national de la MAG4. Les cas de la litterature ont ete recueillies par une recherche systematique sur PubMed et GoogleScholar. Les criteres d’inclusion retenus etaient : un âge aux 1e symptomes ≤ 25 ans et un diagnostic de MAG4 retenu selon les criteres CDC [3] ou les criteres diagnostiques specifiques d’organe. Nous avons repris les donnees d’une cohortre adulte francaise respectant les memes criteres d’inclusion CDC et avec âge des 1ers symptomes > 25 ans. Resultats Deux patients etaient exclus de l’analyse en raison de diagnostics genetiques finalement retenus. Parmi les 23 patients inclus, 12 (52 %) etaient de sexe feminin. Un antecedent familial concomittant de MAG4 etait retrouve chez une patiente. Des atypies cliniques ou biologiques etaient retrouvees chez 8 patients. Une histologie etait disponible chez 21 patients (91 %), avec des seuils de plasmocytes IgG4+ eleves chez 17 d’entre eux (81 %). Des atypies histologiques etaient associees chez 4 d’entre eux. Lorsque les criteres de classification ACR/EULAR 2019 etaient appliques, 14 (60 %) avaient un score ≥ 20, mais 3 d’entre eux presentaires au moins un critere d’exclusion. Le traitement de 1ere ligne etait represente par une corticotherapie seule chez 15 patients (65 %), avec l’absence de reponse chez 1 patient. Le recours a d’autres traitements concernait 12 patients (52 %) avec une duree moyenne de suivi de 43 mois. Nous avons recense 74 observations dans la litterature, avec des donnees similaires. Lorsques les donnees etaient comparees aux adultes, on retrouvait de facon significative plus de femmes, plus de presentations febriles, et un nombre de rechute ou de 2nd ligne plus importants dans la cohorte pediatrique et juvenile. Discussion Nous rapportons ici la plus large cohorte de cas jeunes de MAG4 selon les criteres CDC et specifiques d’organes. La predominance masculine semble moins marquee dans cette population. Alors que les atteintes d’organes sont le plus souvent typiques, des atypies cliniques, biologiques ou histologiques sont retrouvees chez une proportion importante des patients. Conclusion Un diagnostic de MAG4 peut etre pose chez des patients jeunes, de moins de 25 ans. Alors qu’une partie d’entre eux semble presenter un tableau typique de la maladie, une proportion significative des patients de diagnostic pediatrique presentent des atypies, qui peuvent evoquer la possibilite de formes “secondaires”, devant faire eliminer l’ensemble des diagnostics differentiels incluant des pathologies monogeniques associees.
Published: 2020

35. Characteristics and Management of IgA Vasculitis (Henoch-Schönlein) in Adults: Data From 260 Patients Included in a French Multicenter Retrospective Survey

Author: Loic Raffray, Noémie Jourde-Chiche, Benjamin Terrier, Julie Goutte, Alice Bérezné, Boris Bienvenu, Marc André, Aurélie Hummel, Jean-François Augusto, Geoffrey Urbanski, Agnès Dechartres, Nathalie Costedoat-Chalumeau, Christian Lavigne, Xavier Puéchal, Elie Zagdoun, Charlotte Girard, Eric Thervet, Bertrand Lioger, Mélanie Roriz, Patrice Cacoub, Arsène Mekinian, Alexandra Audemard-Verger, Stanislas Faguer, Johan Chanal, Guillaume Moulis, A. Baldolli, Noémie Le Gouellec, Nihal Martis, Evangeline Pillebout, Etienne Rivière, Loïc Guillevin, Sébastien Sanges, Zahir Amoura, Alban Deroux, François Maurier, and Mélanie Catroux
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, Univariate analysis, Henoch-Schonlein purpura, business.industry, Immunology, Retrospective cohort study, Odds ratio, medicine.disease, Logistic regression, Confidence interval, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, IgA vasculitis, Rheumatology, Internal medicine, Propensity score matching, medicine, Immunology and Allergy, 030212 general & internal medicine, business
Abstract: Methods: Data on clinical characteristics, histologic features, and treatment response from 260 patients with IgAV included in a French multicenter retrospective survey were analyzed. Efficacy data were compared using different statistical models. Results: The mean ± SD age of the patients with IgAV at diagnosis was 50.1 ± 18 years, and 63% of patients were male. Baseline manifestations included purpura (100%), arthralgias/arthritis/myalgia (61%), glomerulonephritis (70%), and/or gastrointestinal involvement (53%). Thirty percent of patients showed renal failure at baseline. In univariate analysis, the response to therapy was 80% (64 of 80) in patients treated with corticosteroids (CS) alone, compared to 77% (23 of 30) in patients treated with CS plus cyclophosphamide (CYC) and 59% (10 of 17) in patients treated with colchicine (P = 0.17). Multivariable analysis showed that treatment with CS or CS plus CYC was more effective than colchicine in achieving a response. Efficacy differences were demonstrated using different statistical models: in the multivariable logistic regression model, odds ratio (OR) 3.68, 95% confidence interval (95% CI) 1.10–12.33 (P = 0.03); in the inverse probability weighting on propensity score model, OR 3.75, 95% CI 1.28–10.99 (P = 0.02). The efficacy of CS plus CYC as compared to CS alone was discordant according to the analytic method used. Analysis with the multivariable logistic regression model did not demonstrate a difference between CS plus CYC and CS alone (OR 0.88, 95% CI 0.29–2.67; P = 0.82). In contrast, inverse probability weighting on propensity score showed that CS plus CYC was more effective than CS alone (OR 1.79, 95% CI 1.00–3.20; P = 0.049). Conclusion: This series constitutes the largest series of adults with IgAV reported in the literature so far. It provides data on clinical and histologic presentation and therapeutic efficacy, suggesting that CS alone appears to be a reasonable first‐line therapy in patients with IgAV, while the benefit of adding CYC to CS remains uncertain.
Published: 2017

36. Vascularite hypocomplémentémique urticarienne associée à une glomérulonéphrite membrano-proliférative sévère et polyadénopathies

Author: Alban Deroux, Loic Falque, Hubert Gheerbrant, M. Lugosi, Diane Giovannini, and Fanny Andry
Subjects: Lupus erythematosus, medicine.diagnostic_test, business.industry, 030232 urology & nephrology, Glomerulonephritis, General Medicine, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Multidetector computed tomography, Biopsy, medicine, 030212 general & internal medicine, Nuclear medicine, business, Vasculitis, Positron Emission Tomography-Computed Tomography
Abstract: La Presse Medicale - In Press.Proof corrected by the author Available online since samedi 13 mai 2017
Published: 2017

37. Intravenous immunoglobulins in systemic sclerosis: Data from a French nationwide cohort of 46 patients and review of the literature

Author: Camille Francès, Christophe Deligny, Bernard Imbert, Emmanuel Chatelus, L. Boukari, Noémie Le Gouellec, Claire Cazalets, Patricia Senet, Arsène Mekinian, Thierry Martin, Patrick Jego, Christian Agard, Thomas Quemeneur, David Launay, Pierre-Yves Hatron, Alexis Mathian, Sébastien Rivière, Alain Le Quellec, Alban Deroux, Grégory Pugnet, Alain Lescoat, Thomas Sené, Silvia Speca, Olivier Fain, Sébastien Sanges, Eric Hachulla, Sylvain Dubucquoi, Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Strasbourg, Immunopathologie et chimie thérapeutique (ICT), Institut de biologie moléculaire et cellulaire (IBMC), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], CH Valenciennes, CHU Tenon [AP-HP], CHU Grenoble, Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe Hospitalier Diaconesses Croix Saint-Simon, Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], CHU Pitié-Salpêtrière [AP-HP], Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Service de Médecine Interne [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de la Recherche Scientifique (CNRS)-Institut de biologie moléculaire et cellulaire (IBMC), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Service de dermatologie et allergologie [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares [CHU Pitié Salpêtrière], Service de Médecine Interne 2, maladies auto-immunes et systémiques [CHU Pitié-Salpêtrière], Institut E3M [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut E3M [CHU Pitié-Salpêtrière], CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Lille Inflammation Research International Center (LIRIC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Service de Dermatologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre National de Référence du Lupus Systémique, Syndrome des Anticorps Anti-phospholipides et Maladies Auto-immunes Systémiques Rares[CHU Pitié Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut E3M [CHU Pitié-Salpêtrière]
Subjects: 0301 basic medicine, medicine.medical_specialty, medicine.drug_class, Deep vein, Immunology, Population, Intravenous immunoglobulins, Systemic inflammation, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Immunology and Allergy, education, Adverse effect, Retrospective Studies, 030203 arthritis & rheumatology, education.field_of_study, Scleroderma, Systemic, business.industry, Immunoglobulins, Intravenous, Middle Aged, medicine.disease, Fibrosis, Thrombosis, 3. Good health, Surgery, Discontinuation, Treatment Outcome, 030104 developmental biology, medicine.anatomical_structure, Inflammatory myopathies, Joint pain, Systemic sclerosis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Corticosteroid, Female, France, medicine.symptom, business
Abstract: International audience; BACKGROUND:As intravenous immunoglobulins (IVIG) exhibit immunomodulatory and antifibrotic properties, they may be a relevant treatment for systemic sclerosis (SSc). The objectives of this work were thus to report on the efficacy and safety of IVIG in a population of SSc patients and to review the available literature.METHODS:46 patients from 19 French centers were retrospectively recruited. They were included if they had a diagnosis of SSc and received at least 1 IVIG infusion at a dosage >1g/kg/cycle. Relevant data collected at IVIG discontinuation were compared to those collected at IVIG initiation. A comprehensive literature review was performed.RESULTS:We observed a significant improvement of muscle pain (74% vs. 20%, p
Published: 2017

38. Idiopathic Non-histaminergic Angioedema: Successful Treatment with Omalizumab in Five Patients

Author: Laurence Bouillet, Isabelle Boccon-Gibod, Aurélie Du Thanh, Charles Faisant, Alban Deroux, C. Mansard, Centre Hospitalier Universitaire [Grenoble] (CHU), Pathogénèse et contrôle des infections chroniques (PCCI), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )-Université de Montpellier (UM)
Subjects: Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Immunology, Omalizumab, Immunoglobulin E, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Anti-Allergic Agents, medicine, Humans, Immunology and Allergy, Angioedema, Adverse effect, Chronic urticaria, Aged, 80 and over, non-histaminergic angioedema, biology, business.industry, Histaminergic, Middle Aged, Dermatology, 3. Good health, Treatment Outcome, 030228 respiratory system, Anesthesia, Disease Progression, Histamine H1 Antagonists, biology.protein, omalizumab, Female, Symptom Assessment, medicine.symptom, Idiopathic angioedema, business, Biomarkers, medicine.drug, Rare disease
Abstract: International audience; Idiopathic non-histaminergic acquired angioedema (InH-AAE) is a rare disease characterized by AE resistant to antihistamines and a chronic course. We report five new cases of InH-AAE (two women and three men) with a rapid and dramatic response to the anti-immunoglobulin-E antibody omalizumab. In our literature review, we found 13 other relevant cases with a good response to this treatment. Overall, in 6 out of 18 patients, the doses of omalizumab required to prevent recurrences of attacks were higher than the licensed dose for chronic urticaria. No significant adverse effects have been reported.
Published: 2016

39. Efficacité des anti-TNFα dans le traitement des granulomatoses orofaciales : étude rétrospective, multicentrique de 62 cas

Author: François Chasset, Jean-David Bouaziz, Olivier Fain, Laurence Bouillet, A. Mekinian, M. Dumas-Lattaque, P. Bonnet, Y. Le Corre, Delphine Staumont-Sallé, Guillaume Lefèvre, C. Fievet, and Alban Deroux
Subjects: Gastroenterology, Internal Medicine
Abstract: Introduction Le terme granulomatose orofaciale (GOF) regroupe : la cheilite granulomateuse de Miescher, le syndrome de Melkersson-Rosenthal et les granulomatoses secondaires a une maladie de Crohn (MC) ou une sarcoidose. Les traitements actuellement utilises en premiere ligne sont la corticotherapie generale, les cyclines, la dapsone ou la clofazimine. L’utilisation des anti-TNFα dans cette indication est limitee. Patients et methodes Nous rapportons une serie retrospective et multicentrique de 62 GOF dont 13 etaient traitees par anti-TNFα, menee au sein de 6 CHU francais de 1993 a 2019. Les patients inclus presentaient une atteinte clinique compatible et une confirmation histologique. Les GOF etaient classees comme localisees, locoregionales ou secondaires a une pathologie granulomateuse. La reponse clinique etait classee en reponse soutenue sans rechute, reponse initiale avec rechute ou reponse insuffisante, et en echec primaire. Une etude specifique des patients traites par anti-TNFα etait realisee avec analyse du type de GOF traitee, du taux de reponse et du profil de tolerance. Resultats Les taux de reponse soutenue avec l’hydroxychloroquine, les cyclines et de la corticotherapie intralesionnelle etait respectivement de 16 %, 25 % et 77,8 %. La dapsone permettait 50 % de reponse soutenue mais sur un faible effectif. Les antibiotiques a visee anti-infectieuse, les antihistaminiques et le valaciclovir etaient inefficaces avec respectivement 73,3 %, 80 % et 81,2 % d’echec primaire. L’efficacite paraissait insuffisante avec un taux cumule de rechute ou d’echec primaire de 100 % pour la clofazimine, 91,7 % pour la corticotherapie systemique et 89,5 % en topique, 67 % pour l’azathioprine, 60 % pour le methotrexate et les macrolides. Les anti-TNFα etaient le seul traitement associe a une reponse soutenue (p = 0,03). La duree de suivi et le nombre de lignes de traitements anterieurs etaient significativement plus importants pour les GOF traitees par anti-TNFα (p = 0,0007 et p = 0,001 respectivement). Une reponse initiale aux anti-TNFα etait obtenue chez 12/13 patients (92,3 %) avec un delai median de reponse de 3,06 mois (IC95 % [0,47–5,2]). Les anti-TNF etaient prescrits en association a un autre traitement dans 46,1 % des cas. Une rechute survenait chez 7 patients (53,8 %) en premiere ligne d’anti-TNFα apres un delai median de 35 mois (minimum 7,6–maximum 63,3 mois). Les GOF secondaires a une sarcoidose ou une MC etaient le seul facteur associe a la prescription des anti-TNFα (p = 0,01). Il n’existait pas de difference significative pour le risque de rechute ou d’arret des anti-TNFα entre l’adalimumab et l’infliximab ni entre les GOF localisees/locoregionales ou secondaires. Des effets indesirables survenaient chez 9 patients (69,2 %) sans effet indesirable grave. Conclusion Les anti-TNF semblent efficaces dans les GOF. Ils pourraient etre proposes en premiere ligne en cas de GOF secondaire invalidante et discuter au cas par cas dans les autres situations.
Published: 2019

40. Vascularites à IgA associées à des cancers solides : étude nationale multicentrique rétrospective de 30 patients et comparaison à la cohorte nationale IGAVAS

Author: Alexandra Audemard-Verger, B. Brihaye, Antoine Hankard, Elodie Rivière, M. Ficheux, Benjamin Terrier, Albertine Aouba, Alban Deroux, G. Maigné, A. Mekinian, J-M. Michot, and Geoffrey Urbanski
Subjects: Gastroenterology, Internal Medicine
Abstract: Introduction La vascularite a IgA (V-IgA) est une vascularite systemique associee a des depots d’IgA1. Classiquement decrite comme secondaire a une infection muqueuse ou comme une forme idiopathique, quelques cas de V-IgA ont ete rapportes au cours ou dans la proximite du diagnostic de neoplasie, et leur relation causale a ete suspectee. Nous rapportons ici une serie de patients atteints de V-IgA et de cancers dans le but de decrire leur phenotype et leur profil evolutif comparativement a des patients atteints de V-IgA indemnes de neoplasie. Patients et methodes Nous avons conduit une etude retrospective multicentrique au sein des services de Medecine Interne et d’Oncologie. Les patients colliges (> 18 ans) devaient presenter une neoplasie solide et une V-IgA histologiquement prouvee. L’intervalle entre les diagnostics respectifs des deux entites ne devait pas exceder 24 mois. Les donnees clinicobiologiques de ces patients ont ete comparees a celles issues de la cohorte nationale de V-IgA (IGAVAS). Resultats Trente patients ont ete inclus. L’âge moyen au diagnostic etait de 69 ans (± 12 ans) et 80 % des patients etaient de sexe masculin. Les manifestations au diagnostic de la V-IgA incluaient une atteinte articulaire, digestive et renale dans respectivement 33, 23 et 57 % des cas. En comparaison aux patients de la cohorte IGAVAS, les patients atteints de cancer et de V-IgA etaient plus âges (69 vs 50 ans p Conclusion La proximite temporelle du diagnostic d’une neoplasie, surtout muco-glandulaire, et d’une V-IgA conferent a cette derniere, comparativement aux autres formes decrites (idiopathiques ou post-infectieuses), des caracteristiques cliniques et demographiques particulieres que sont : un âge au diagnostic plus avance, un caractere plus souvent necrotique du purpura et une plus grande frequence d’hemorragie intra-alveolaire. Le suivi therapeutique a plus long terme des patients montrant cette association devrait permettre d’etudier la correlation, les profils evolutifs et le lien de causalite entre ces des deux affections.
Published: 2019

41. Amibiase : au cours de rapports sexuels, un mode de transmission sous-estimé ?

Author: Laurence Bouillet, M. Lugosi, B. Lohberger Timsit, Alban Deroux, and B. Colombe
Subjects: 03 medical and health sciences, 0302 clinical medicine, 030231 tropical medicine, Gastroenterology, Internal Medicine, 030212 general & internal medicine
Abstract: Resume Introduction L’amibiase est une maladie parasitaire cosmopolite, en troisieme place des maladies parasitaires les plus meurtrieres. La seule espece d’amibe pathogene est Entamoeba histolytica. Sa transmission est non seulement liee au peril fecal, mais aussi sexuelle avec des cas decrits de transmission chez des hommes ayant des relations homosexuelles. Notre objectif etait de rapporter un cas de transmission inhabituelle et de discuter l’impact de ces nouveaux modes de transmission sur la prise en charge du patient. Observation Nous decrivons le cas d’un homme de 27 ans ayant presente une amibiase hepatique en dehors de tout sejour en zone d’endemie. A l’issu de l’interrogatoire du patient, le mode de contamination semblait etre un rapport heterosexuel non protege avec une nouvelle partenaire 4 mois avant le diagnostic. Il n’y avait pas de co-infection par le virus de l’immunodeficience humaine ou le virus de l’hepatite B. Conclusion Cette observation incite a aussi evoquer l’amibiase dans le bilan d’une diarrhee dysenterique ou d’un abces hepatique chez nos patients en dehors de sejour en zone d’endemie et de rapports homosexuels entre hommes.
Published: 2018

42. Temporal Arteritis Revealing Antineutrophil Cytoplasmic Antibody-Associated Vasculitides: A Case-Control Study

Author: Vivane Queyrel, François Maurier, Grégory Pugnet, L. Delaval, Daniel Engelbert Blockmans, Cécile-Audrey Durel, Luc Mouthon, Julien Desblache, Guillaume Le Guenno, Laurence Jousselin-Mahr, Olivier Aumaître, Loïc Guillevin, Christian Agard, Flora Schein, Cyril Garrouste, Hassan Kassem, Ludovic Trefond, L Swiader, Estibaliz Lazaro, Virginie Rieu, Alban Deroux, Maxime Samson, Pascal Godmer, Henry Dupuy, Cédric Landron, Pascal Cathébras, Benjamin Terrier, and Karim Sacre
Subjects: Male, Delayed Diagnosis, Gastroenterology, 0302 clinical medicine, Immunology and Allergy, 030212 general & internal medicine, Treatment Failure, Fibrinoid necrosis, Nose, Large-vessel vasculitis, Aged, 80 and over, Hazard ratio, Headache, Middle Aged, Temporal Arteries, medicine.anatomical_structure, Female, France, Vasculitis, medicine.medical_specialty, Fever, Immunology, Giant Cell Arteritis, Vision Disorders, Pain, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Sweating, Diagnosis, Differential, 03 medical and health sciences, Rheumatology, Internal medicine, Weight Loss, medicine, Diplopia, Humans, Arteritis, Glucocorticoids, Anti-neutrophil cytoplasmic antibody, Aged, Proportional Hazards Models, Retrospective Studies, 030203 arthritis & rheumatology, Scalp, business.industry, giant cell arteritis, Case-control study, medicine.disease, Giant cell arteritis, Cough, Jaw, Polymyalgia Rheumatica, Asthenia, Case-Control Studies, temporal arteritis, business, ANCA-associated vasculitis
Abstract: OBJECTIVE: Temporal arteritis (TA) is a typical manifestation of giant cell arteritis (GCA). Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are rarely revealed by TA manifestations, leading to a risk of misdiagnosis of GCA and inappropriate treatments. This study was undertaken to describe the clinical, biologic, and histologic presentations and outcomes in cases of TA revealing AAV (TA-AAV) compared to controls with classic GCA. METHODS: In this retrospective case-control study, the characteristics of patients with TA-AAV were compared to those of control subjects with classic GCA. Log-rank test, with hazard ratios (HRs) and 95% confidence intervals (95% CIs), was used to assess the risk of treatment failure. RESULTS: Fifty patients with TA-AAV (median age 70 years) were included. Thirty-three patients (66%) presented with atypical symptoms of GCA (ear, nose, and throat involvement in 32% of patients, and renal, pulmonary, and neurologic involvement in 26%, 20%, and 16% of patients, respectively). Blood samples were screened for ANCAs at the time of disease onset in 33 patients, and results were positive in 88%, leading to a diagnosis of early TA-AAV in 20 patients. The diagnosis of AAV was delayed a median interval of 15 months in 30 patients. Compared to controls with GCA, patients with TA-AAV were younger (median age 70 years versus 74 years), were more frequently men (48% versus 30%), and had high frequencies of atypical manifestations and higher C-reactive protein levels (median 10.8 mg/dl versus 7.0 mg/dl). In patients with TA-AAV, temporal artery biopsy (TAB) showed fibrinoid necrosis and small branch vasculitis in 23% of patients each, whereas neither of these characteristics was evident in controls with GCA. Treatment failure-free survival was comparable between early TA-AAV cases and GCA controls, whereas those with delayed TA-AAV had a significantly higher risk of treatment failure compared to controls (HR 3.85, 95% CI 1.97-7.51; P < 0.0001). CONCLUSION: TA-AAV should be considered diagnostically in cases of atypical manifestations of GCA, refractoriness to glucocorticoid treatment, or early relapse. Analysis of TAB specimens for the detection of small branch vasculitis and/or fibrinoid necrosis could be useful. Detection of ANCAs should be performed in cases of suspected GCA with atypical clinical features and/or evidence of temporal artery abnormalities on TAB. ispartof: ARTHRITIS & RHEUMATOLOGY vol:73 issue:2 pages:286-294 ispartof: location:United States status: published
Published: 2019

43. Mast cell activation diseases and chronic spontaneous urticaria: Common points and differences

Author: Aurélie Madelon, C. Mansard, Alexis Bocquet, Alban Deroux, Isabelle Boccon-Gibod, and Laurence Bouillet
Subjects: Urticaria, business.industry, Cell Degranulation, Mast cell activation, Chronic disease, Immunology, Chronic Disease, Immunology and Allergy, Medicine, Humans, Chronic Urticaria, Mast Cells, business, Chronic urticaria, Mastocytosis
Published: 2019

44. Large-vessel vasculitis diagnosed between 50 and 60 years: Case-control study based on 183 cases and 183 controls aged over 60 years

Author: Hervé Devilliers, Loïc Guillevin, Daniel Engelbert Blockmans, Alexis Régent, Kevin Bouiller, Olivier Espitia, Alice Bérezné, Christian Agard, Maxime Samson, Laure Delaval, Yann Nguyen, Alexandre Balageas, Mélanie Roriz, Karim Sacre, Alban Deroux, Hubert de Boysson, Aurélie Daumas, Sébastien Humbert, Stéphane Vinzio, M. Puyade, V. Grobost, Estibaliz Lazaro, François Maurier, Grégory Pugnet, O. Souchaud-Debouverie, Virginie Rieu, Henry Dupuy, Claire de Moreuil, Thierry Zenone, Cécile-Audrey Durel, Ygal Benhamou, Laurent Arnaud, Eric Liozon, Mikael Ebbo, François Lifermann, Benjamin Terrier, Aix Marseille Université (AMU), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de médecine interne [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre hospitalier universitaire de Poitiers (CHU Poitiers), University Hospital Gasthuisberg [Leuven], Service de Médecine Interne [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Médecine Interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Cochin [AP-HP], Service de médecine interne et maladies systémiques (SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de médecine interne, Hôpital Sainte-Blandine-Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Centre hospitalier de Valence, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine Interne [Dax], Centre Hospitalier de Dax, Sarcomes osseux et remodelage des tissus calcifiés - Phy-Os [Nantes - INSERM U1238] (Phy-Os), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Bretagne Loire (UBL)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Clermont-Ferrand, Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier de Pau, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), service de maladies infectieuses CHU J Minjoz Besancon, Service de Médecine Interne [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Chirurgie otologique mini-invasive robotisée, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5), Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), University Hospital Gasthuisberg, CHU Toulouse [Toulouse], Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville)-Hôpital Sainte-Blandine, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université Bretagne Loire (UBL), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), and Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, Immunology, Takayasu arteritis, Giant Cell Arteritis, Outcome measures, 03 medical and health sciences, 0302 clinical medicine, Large vessel vasculitis, Refractory disease, Immunology and Allergy, Medicine, Humans, cardiovascular diseases, Age of Onset, 10. No inequality, skin and connective tissue diseases, Large-vessel vasculitis, Aged, Retrospective Studies, 030203 arthritis & rheumatology, Aged, 80 and over, business.industry, Refractory Disease, Case-control study, Middle Aged, medicine.disease, Dermatology, 3. Good health, Giant cell arteritis, 030104 developmental biology, Case-Control Studies, cardiovascular system, Female, business, Vasculitis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Age at onset of large-vessel vasculitis (LVV) is commonly used to distinguish giant cell arteritis (GCA) and Takayasu arteritis (TA). However, LVV between age 50 and 60 years may be difficult to classify.We conducted a retrospective study including LVV aged between 50 and 60 years at onset (LVVWe included 183 LVV
Published: 2019

45. [Prevalence and characteristics of serum autoantibodies in patients followed for infertility at Grenoble University Hospital]

Author: Chloé, Wackenheim, Pascale, Hoffman, Chantal, Dumestre-Pérard, Laurence, Bouillet, Nadia, Alfaidy, and Alban, Deroux
Subjects: Endometriosis, Autoimmunity, Autoantigens, Iodide Peroxidase, Immunomodulation, Pregnancy, Antibodies, Antinuclear, Iron-Binding Proteins, Antibodies, Antiphospholipid, Humans, Female, Embryo Implantation, France, Infertility, Female, Autoantibodies, Retrospective Studies
Abstract: Fertility disorders in autoimmune diseases are well described. However, little is known about the presence of a humoral serum autoimmunity in case of infertility (antinuclear antibodies, ACAN or antiphospholipid, APL) without criteria of autoimmune disease.We studied the prevalence, associated factors, and efficacy of immunomodulatory therapy in patients with unexplained infertility. Two groups were created retrospectively among patients followed in medically assisted procreation (PMA) for infertility: a group with serum autoimmunity (AI+) (ACAN, APL or anti-thyroperoxidase antibodies) and a group without serum autoimmunity (HAVE-). Clinical, biological, and therapeutic data were collected.The prevalence of autoimmunity was 33% among consultant patients. One hundred patients were seen in internal medicine consultation, 70 were included in the AI+ group and 30 in the AI- group. In the AI+ group, 76% had ACANs, 29% had anti-TPOs and 23% had APLs. There was a significant correlation between ACAN level and the presence of endometriosis (P=0.048). Immunomodulatory therapy was introduced for 68 of the 70 women in the AI+ group; pregnancy occurred in 28 patients (40%) during the treatment period, compared with 7 in the "AI-" group (23%), with a tendency to significance (P=0.09). In conclusion, there is an increased prevalence of serum autoimmunity in patients with fertility disorders, possibly with the efficacy of an immunomodulatory treatment to confront prospective therapeutic studies.
Published: 2019

46. Arthritis in primary Sjögren's syndrome:Characteristics, outcome and treatment from French multicenter retrospective study

Author: Guillaume Denis, Maxime Dougados, Arsène Mekinian, N. Costedoat-Chalumeau, Geoffrey Urbanski, Alban Deroux, Xavier Mariette, Olivier Fain, Abdou Diallo, Raphaèle Seror, Jean-Benoît Arlet, Adrien Mirouse, Jérémie Sellam, Dominique Fischer-Dumont, Christian Lavigne, Azeddine Dellal, Eric Vicaut, Anne-Laure Fauchais, Centre de Recherche Saint-Antoine [CRSA], Service de rhumatologie, Hôpital Lariboisière, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Limoges, Centre Hospitalier Universitaire [Grenoble] [CHU], Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité [CRESS (U1153 / UMR_A_1125 / UMR_S_1153)], Laboratoire d’Électrotechnique et d’Électronique de Puissance - ULR 2697 [L2EP], Service de Médecine Interne [CHU HEGP], Service de médecine interne et gérontologie clinique [Angers], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Centre Hospitalier Universitaire [Grenoble] (CHU), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d’Électrotechnique et d’Électronique de Puissance - EA 2697 (L2EP), Ecole Centrale de Lille-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Haute Etude d'Ingénieurs-Université de Lille, Sorbonne Université (SU), Centre de référence des syndromes drépanocytaires majeurs-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Hôpital avicenne, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris 13 (UP13)-Hôpital Avicenne, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Centre de référence des syndromes drépanocytaires majeurs, Hôpital Avicenne [AP-HP], Gestionnaire, Hal Sorbonne Université, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Laboratoire d’Électrotechnique et d’Électronique de Puissance - ULR 2697 (L2EP), Centrale Lille-Haute Etude d'Ingénieurs-Université de Lille-Arts et Métiers Sciences et Technologies, and HESAM Université (HESAM)-HESAM Université (HESAM)
Subjects: 0301 basic medicine, Male, musculoskeletal diseases, medicine.medical_specialty, Immunology, Arthritis, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Synovitis, medicine, Immunology and Allergy, Humans, Lymph node, Retrospective Studies, 030203 arthritis & rheumatology, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, DMARDS, 3. Good health, Regimen, 030104 developmental biology, medicine.anatomical_structure, Sjogren's Syndrome, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Rheumatoid arthritis, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Primary Sjögren's syndrome, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Rituximab, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Sjogren s, business, medicine.drug
Abstract: International audience; OBJECTIVE: To describe the characteristics and the outcome of primary Sjögren Syndrome (pSS) associated arthritis and to compare the efficacy of different therapeutic regimen.METHODS: We conducted a retrospective study using Club Rhumatisme and Inflammation (CRI) and French Internal Medicine Society (SNFMI) networks. All patients with a diagnosis of pSS and at least one episode of clinical and/or echographic synovitis were included. Patients with synovitis (cases) were compared to pSS patients without synovitis (controls).RESULTS: 57 patients (93% women) were included with a median age of 54 years [45-63]. Patients with synovitis had more frequently lymph node enlargement (12.3% vs. 1.8%, p = .007) and a higher ESSDAI score (8 [6-12] vs. 2 [1-4], p
Published: 2019

47. CpaA Is a Glycan-Specific Adamalysin-like Protease Secreted by Acinetobacter baumannii That Inactivates Coagulation Factor XII

Author: Harry L. T. Mobley, Zachary M Huttinger, Sara N. Smith, Ursula Waack, David Ginsburg, Ayush Kumar, Daniel A. Lawrence, Andrew Yee, Alban Deroux, Mark Warnock, and Maria Sandkvist
Subjects: Acinetobacter baumannii, 0301 basic medicine, Molecular Biology and Physiology, Proteases, metalloprotease, Virulence Factors, Virulence, Coagulation Factor XII, Microbiology, Virulence factor, Adamalysin, Mice, 03 medical and health sciences, type II secretion system, Bacterial Proteins, Virology, Animals, Humans, Blood Coagulation, thrombosis, Factor XII, biology, CpaA, factor XII, Chemistry, Angioedemas, Hereditary, Middle Aged, biology.organism_classification, QR1-502, 3. Good health, 030104 developmental biology, Coagulation, Mutation, Metalloproteases, Mice, Inbred CBA, Prothrombin Time, O-linked glycosylation, Female, Partial Thromboplastin Time, Research Article
Abstract: Ventilator-associated pneumonia and catheter-related bacteremia are the most common and severe infections caused by Acinetobacter baumannii. Besides the capsule, lipopolysaccharides, and the outer membrane porin OmpA, little is known about the contribution of secreted proteins to A. baumannii survival in vivo. Here we focus on CpaA, a potentially recently acquired virulence factor that inhibits blood coagulation in vitro. We identify coagulation factor XII as a target of CpaA, map the cleavage sites, and show that glycosylation is a prerequisite for CpaA-mediated inactivation of factor XII. We propose adding CpaA to a small, but growing list of bacterial proteases that are specific for highly glycosylated components of the host defense system., Antibiotic-resistant Acinetobacter baumannii is increasingly recognized as a cause of difficult-to-treat nosocomial infections, including pneumonia, wound infections, and bacteremia. Previous studies have demonstrated that the metalloprotease CpaA contributes to virulence and prolongs clotting time when added to human plasma as measured by the activated partial thromboplastin time (aPTT) assay. Here, we show that CpaA interferes with the intrinsic coagulation pathway, also called the contact activation system, in human as well as murine plasma, but has no discernible effect on the extrinsic pathway. By utilizing a modified aPTT assay, we demonstrate that coagulation factor XII (fXII) is a target of CpaA. In addition, we map the cleavage by CpaA to two positions, 279-280 and 308-309, within the highly glycosylated proline-rich region of human fXII, and show that cleavage at the 308-309 site is responsible for inactivation of fXII. At both sites, cleavage occurs between proline and an O-linked glycosylated threonine, and deglycosylation of fXII prevents cleavage by CpaA. Consistent with this, mutant fXII (fXII-Thr309Lys) from patients with hereditary angioedema type III (HAEIII) is protected from CpaA inactivation. This raises the possibility that individuals with HAEIII who harbor this mutation may be partially protected from A. baumannii infection if CpaA contributes to human disease. By inactivating fXII, CpaA may attenuate important antimicrobial defense mechanisms such as intravascular thrombus formation, thus allowing A. baumannii to disseminate.
Published: 2018

48. Tolerance and efficacy of anti-TNF currently used for severe non-infectious uveitis

Author: Laurence Bouillet, Florent Aptel, Alban Deroux, Nicolas Coste, Christophe Chiquet, Rachel Semecas, José Labarère, and Alexis Bocquet
Subjects: business.industry, Immunology, Adalimumab, medicine.disease, Infliximab, Uveitis, Infectious uveitis, Treatment Outcome, medicine, Humans, Immunology and Allergy, Tumor Necrosis Factor Inhibitors, Tumor necrosis factor alpha, business, medicine.drug
Published: 2021

49. Infliximab Versus Adalimumab in the Treatment of Refractory Inflammatory Uveitis: A Multicenter Study From the French Uveitis Network

Author: Damien Sène, Aude Rigolet, Patrice Cacoub, Sébastien Abad, Isabelle Marie, Pascal Sève, Alban Deroux, Laurent Perard, Matthieu Resche Rigon, Bahram Bodaghi, Phuc Le Hoang, David Saadoun, Lucie Biard, Sophie Rivière, Eric Hachulla, Gaëlle Clavel, Philip Bielefeld, Olivier Fain, Elodie Feurer, Boris Bienvenu, Antoinette Perlat, Grégory Pugnet, Pierre‐Alban Bouche, Julie Gueudry, Jean Baptiste Fraison, and H. Vallet
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, business.industry, Immunology, Arthritis, medicine.disease, Gastroenterology, Infliximab, 3. Good health, Surgery, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Refractory, Internal medicine, 030221 ophthalmology & optometry, medicine, Adalimumab, Immunology and Allergy, Sarcoidosis, Young adult, Adverse effect, business, Uveitis, medicine.drug
Abstract: OBJECTIVES: To analyze the factors associated with response to anti-TNFα and to compare the efficacy and safety of infliximab (IFX) and adalimumab (ADA) in patients with refractory non infectious uveitis. METHODS: Observational multicenter study including 160 patients [median age of 31 [21-42] years with 39% of men] with refractory uveitis treated with anti-TNFα [IFX 5mg/kg at weeks 0, 2, 6 and every 5-6 weeks (n=98) and ADA 40mg/14days (n=62)]. Factors associated to complete response were assessed in multivariate analysis. Comparison between efficacy and safety of IFX and ADA was performed using a propensity score approach accounting for baseline characteristics. RESULTS: Main etiologies of uveitis included Behcet's disease (36%), juvenile idiopathic arthritis (22%), spondylarthropathies (10%) and sarcoidosis (6%). The overall response rate at 6 and 12 months was of 87% (26% of complete response) and 93% (28% of complete response), respectively. The median time to complete response was 2 (0-12) months. In multivariate analysis, Behcet's disease (SHR= 2.52 [1.35-7.71], p=0.004) and a number of uveitis flares before anti-TNFα greater than 5 (HR=1.97 [1.02-3.84], p=0.045) were associated with complete response to anti-TNFα. Side effects were reported in 28% of patients, including 12% of serious adverse events. IFX and ADA did not differ significantly in terms of occurrence of complete response (SHR=0.65 [0.25;1.71], p=0.39), serious side effects (SHR= 0.22 [0.04-1.25], p=0.089) or event free survival (SHR=0.55 [0.28;1.08], p=0.083). CONCLUSIONS: Anti-TNFα are highly effective in refractory inflammatory uveitis. Behcet's disease is associated with increase odds of response. IFX and ADA seem equivalent in terms of efficacy. This article is protected by copyright. All rights reserved
Published: 2016

50. Prise en charge du purpura thrombotique thrombopénique dans deux centres français : à partir de 27 patients

Author: Paul Coppo, C. Barro, N. Daguindau, Alban Deroux, M. Sirodot, and Laurence Bouillet
Subjects: 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Gastroenterology, Internal Medicine, 030204 cardiovascular system & hematology
Abstract: Resume Introduction Le purpura thrombotique thrombocytopenique (PTT) est une forme de microangiopathie thrombotique caracterisee par l’association d’une anemie hemolytique mecanique, d’une thrombopenie peripherique et de defaillances d’organe de severite variable. Methodes Afin d’etudier la prise en charge du PTT, les caracteristiques cliniques, biologiques et therapeutiques de 27 patients consecutifs atteints de PTT ont ete analysees retrospectivement dans deux centres hospitaliers francais (Annecy et Grenoble). Resultats Tous les patients avaient une anemie hemolytique mecanique associee a une thrombopenie. Huit patients presentaient une fievre. Treize patients avaient une atteinte renale, caracterisee par une proteinurie ou une alteration de la fonction renale, et 18 avaient des anomalies neurologiques. L’association de ces 5 signes cardinaux du PTT n’etait que rarement presente (11 %) et ne doit pas retarder le diagnostic de cette pathologie. L’activite de la proteine de clivage du facteur de Willebrand (ADAMTS13) etait inferieure a 10 % chez les 27 patients. Un anticorps anti-ADAMTS13 etait detecte chez 20 des 27 patients. Apres echanges plasmatiques, glucocorticoides, et rituximab en deuxieme intention, le taux de survie etait de 85 % (23 survivants sur 27). Quatre patients decedaient, dont 2 dans un contexte de diagnostic tardif. Conclusion Le PTT est une microangiopathie thrombotique avec atteinte viscerale systemique dont la mortalite est elevee. Les traitements de sauvetage, bases sur l’experience de quelques etudes et discutes en concertation avec le Centre de reference, permettent d’obtenir des reponses dans les formes les plus graves dans une majorite des cas. La sensibilisation des praticiens a ce diagnostic represente une demarche importante permettant de limiter davantage tout retard dans la prise en charge, afin d’ameliorer encore le pronostic de ces patients.
Published: 2016

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Publication Type

Journal

Database

Publisher

127 results on '"Alban, Deroux"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources