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3. Echocardiographic phenotypes of patients with sickle cell disease. An unsupervised analysis based on etendard cohort

Author

F Lionnet, Thibaud Damy, S Deswarte, Marc Humbert, Pablo Bartolucci, L Savale, G. Loko, J Inamo, Geneviève Derumeaux, and T D\\'humieres

Subjects
Oncology, medicine.medical_specialty, business.industry, Cell, General Medicine, Disease, Phenotype, medicine.anatomical_structure, Internal medicine, Cohort, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business
Abstract

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): PHRC Backgroung Echocardiography is the cornerstone in the diagnosis of cardiopulmonary involvement in sickle cell disease (SCD). However, given the unique pathophysiology of SCD associating high cardiac output, and various degrees of peripheral vasculopathy, differentiate the pathological from the physiological using echocardiography can be particularly challenging. Purpose This study sought to link cardiac phenotypes in homozygous SCD patients with clinical profiles and outcomes using cluster analysis. Methods We analyzed data of 379 patients with a sufficient echographic dataset included in the French Etendard Cohort, a prospective cohort initially designed to assess the prevalence of pulmonary hypertension. A cluster analysis was performed on echocardiographic variables, and the association between clusters and clinical profiles and outcomes was assessed. Results Three clusters were identified. Cluster 1 (N = 122) patients had the lowest cardiac output, only mild left cavities remodeling, diastolic dysfunction, and high tricuspid regurgitation velocity (TRV). They were predominantly female, as old as cluster 2, and displayed the most severe functional limitation. Cluster 2 (N = 103) patients had the highest cardiac output, left ventricular mass and a severely dilated left atrium. Diastolic function and TRV were similar to cluster 1. These patients had a higher blood pressure and a severe hemolytic anemia. Cluster 3 (N = 154) patients had mild left cavities remodeling, the best diastolic function and the lowest TRV. They were younger patients with the highest hemoglobin and lowest hemolytic markers. Right heart catheterization was performed in 94 patients. Cluster 1 gathered the majority of precapillary PH while cluster 2 gathered postcapillary PH and no PH was found in cluster 3. After a follow-up of 9.9 years (IQR: 9.3 to 10.5 years) death occurred in 38 patients (10%). Clusters 2 had the worst prognosis with 18% mortality rate vs. 12% in cluster 2 and 5% in cluster 1 (P log-rank = 0,02). Results are summarized in the central illustration. Conclusions Cluster analysis of echocardiographic variables identified 3 phenotypes among SCD patients, each associated with different clinical features and outcome. These findings underlines the necessity to rethink echocardiographic evaluation of SCD patients, with an integrative approach based on simultaneous evaluation of TRV along with left cavities remodeling and diastolic parameters. Abstract Figure.

Published
2021
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4. New insights into the natural history of hepatitis E virus infection through a longitudinal study of multitransfused immunocompetent patients in France

Author

Jacques Izopet, F. Lionnet, A. Servant-Delmas, C. Hamon, Jean-Jacques Lefrère, Syria Laperche, and Florence Abravanel

Subjects
Adult, Male, Longitudinal study, Blood transfusion, Adolescent, medicine.medical_treatment, 030204 cardiovascular system & hematology, medicine.disease_cause, Virus, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Hepatitis E virus, Virology, Disease Transmission, Infectious, medicine, Humans, Hepatitis Antibodies, Longitudinal Studies, 030212 general & internal medicine, Seroconversion, Child, Aged, Aged, 80 and over, Hepatology, Transmission (medicine), business.industry, Transfusion Reaction, Middle Aged, Hepatitis E, medicine.disease, Natural history, Infectious Diseases, Immunology, RNA, Viral, Female, France, business
Abstract

Little is known about the natural history of Hepatitis E virus (HEV) infection in immunocompetent individuals. The prevalence, the course of infection and the occurrence of transmission by transfusion were investigated in multitransfused immunocompetent patients/blood donor pairs included in a longitudinal sample repository collection and followed up between 1988 and 2010. Ninety-eight subjects aged 6-89 years and suffering from acquired haemoglobinopathies were tested for HEV markers (IgM, IgG and RNA) in serial samples collected every 2 or 3 years. Eighteen patients (18.4%) were positive for HEV-IgG at baseline with a prevalence increasing from 12.5% below 26 years to 32% above 56 years. Nine patients remained IgG positive along the study and nine lost their antibodies after a mean follow-up of 7.4 years (1-22 years). One seropositive patient showed an increase of IgG level and RNA-HEV reappearance 1 year after inclusion, suggesting a reinfection and one seroconversion, probably acquired through blood transfusion was observed. This first longitudinal study including immunocompetent individuals confirms that HEV infection is common in Western Europe and that transfusion transmission occurs probably less frequently than expected. In addition, seroreversion and reinfection seem to be common. This suggests that the anti-HEV may not persist overtime naturally. However, repeat exposure to the virus related to the high prevalence of HEV infection may result in a sustainable specific IgG response.

Published
2016
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5. PF788 DATA FROM THE FRENCH REGISTRY FOR BETA-THALASSEMIA PATIENTS

Author

F. Lionnet, B. Pegourie, V. Brousse, C. Badens, I. Agouti, F. Galacteros, Jean-Antoine Ribeil, Christian Rose, A. Lambilliotte, A.D. Loundou, Arnaud Hot, I. Thuret, E. Bernit, D. Steschenko, and Y. Auguste

Subjects
Pediatrics, medicine.medical_specialty, business.industry, medicine, Beta thalassemia, Hematology, medicine.disease, business
Published
2019
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6. Peripheral autonomic impairment in sickle cell anaemia (SCA)

Author

Z. Affes, F. Lionnet, Jean-Pascal Lefaucheur, and Jean-Philippe Haymann

Subjects
medicine.medical_specialty, Bilirubin, business.industry, General Medicine, Ethnic origin, Overweight, Peripheral, chemistry.chemical_compound, Autonomic nervous system, Neurology, chemistry, Physiology (medical), Internal medicine, medicine, Neurology (clinical), medicine.symptom, business, reproductive and urinary physiology, Glomerular hyperfiltration, Skin conduction, Sudomotor dysfunction
Abstract

Background Impairment of autonomic nervous system seems underestimated in SCA. Objectives To assess the prevalence of sudomotor dysfunction in SCA patients, and to identify relevant associated clinical/biological phenotypes. Methods A total of 90 adult homozygous SCA patients–exclusively sub-Saharan-African-native–referred to our centre for a routine-follow-up were included. Clinical and biological data were collected as well as electrochemical skin conduction (ESC) measurements using Sudoscan®. A total of 34 healthy subjects with the same ethnic origin and matched for age, gender and BMI, were enrolled for ESC comparison. Results Among SCA patients, median age was 29.3 years, 51% were males. Neither overweight nor hypertension was reported. Mean Haemoglobin, reticulocyte-count, bilirubin and lactate-dehydrogenase was respectively of 8.9 ± 1.5 g/dL, 242 ± 122,109/L, 49.5 ± 34.7 μmol/L and 467 ± 169 IU/L. Percentage of glomerular hyperfiltration, micro and macroalbuminuria was respectively of 31.4%, 31% and 26.2%. ESC values for both hands (HESC) and feet (FESC) were significantly reduced in SCA patients compared to controls (P Conclusion Sudomotor dysfunction is an underdiagnosed frequent event in SCA patients. Its quantification could be of potential interest to assess the magnitude of peripheral autonomic impairment and/or microvascular lesions.

Published
2019
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7. L’anémie chez le patient drépanocytaire adulte

Author

Jean-Benoît Arlet, Jean-Antoine Ribeil, Pablo Bartolucci, F Lionnet, K Stankovic, and Anoosha Habibi

Subjects
Hemolytic anemia, Pediatrics, medicine.medical_specialty, Hemoglobinopathy, Transfusion reaction, business.industry, Anemia, Gastroenterology, Internal Medicine, Medicine, business, medicine.disease, Sickle cell anemia
Published
2009
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8. Recommandations pratiques de prise en charge de la drépanocytose de l’adulte

Author

Anoosha Habibi, Jean-Antoine Ribeil, Jean-Benoît Arlet, Pablo Bartolucci, F Lionnet, and Katia Stankovic

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Internal Medicine, medicine, Hidroxicarbamida, business
Abstract

Resume La drepanocytose chez l’adulte est une maladie systemique hematovasculaire, pouvant atteindre potentiellement tous les organes. La prevalence de la drepanocytose de l’adulte est en augmentation continue en France. Tout medecin peut donc actuellement etre conduit a prendre en charge un patient drepanocytaire. Les complications s’expriment de facon aigue ou chronique. La douleur represente le principal symptome qui doit etre traite rapidement et puissamment. Le syndrome thoracique aigu, parfois fatal, doit etre prevenu, depiste et precocement traite. Les complications chroniques, qui tiennent une place majeure chez l’adulte, doivent etre depistees, afin de tenter d’interrompre ou de retarder leur evolution. De nombreux organes peuvent etre touches par la maladie, notamment : les os, les reins, les yeux, les poumons… L’indication d’un traitement de fond (transfusion sanguine ou hydroxyuree) doit etre regulierement discutee. L’organisation de la prise en charge sur le territoire francais est tres importante pour permettre simultanement un suivi de proximite et un acces aux services specialises, associes a une coordination entre les differents intervenants. Nous presentons dans cet article les recommandations francaises du centre de reference de prise en charge de la drepanocytose adulte qui se veulent une aide pratique a la prise en charge quotidienne de cette veritable maladie systemique.

Published
2009
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9. [Issues and difficulties in the relationship between patients and caregivers in painful sickle cell vaso-occlusive crisis]

Author

N, Dzierzynski, K, Stankovic Stojanovic, S, Georgin-Lavialle, and F, Lionnet

Subjects
Physician-Patient Relations, Caregivers, Humans, Anemia, Sickle Cell, Acute Pain
Abstract

Sickle cell patients in acute pain situation experiment cognitive, behavioral and emotional changes that can accentuate their pain and disrupt communication with caregivers. On the other hand, caregivers have to face pain assessment difficulties and their own psychological reactions to their patient's pain. The gap between the patient's experience and caregiver's evaluation can lead to conflict and non-adherence treatment, and have a direct impact on the sickle cell disease prognosis. There is nothing inevitable about these phenomena, whose knowledge allows the action and opens up prospects for improving the management of sickle cell disease pain. This article is a narrative review updating the interactions between acute pain and some configurations, such as the inability to discern emotions, catastrophizing, post-traumatic stress or feeling ostracized. The overestimation of patient's addiction by caregivers also influences the pain itself. Open communication, as well as some treatments, medicated or not, a consistent institutional organization and a multidisciplinary approach altogether have an analgesic role by acting on pain cognitive and emotional components.

Published
2015

10. [French guidelines for the management of adult sickle cell disease: 2015 update]

Author

A, Habibi, J-B, Arlet, K, Stankovic, J, Gellen-Dautremer, J-A, Ribeil, P, Bartolucci, and F, Lionnet

Subjects
Adult, Disease Management, Humans, Anemia, Sickle Cell, France
Abstract

Sickle cell disease is a systemic genetic disorder, causing many functional and tissular modifications. As the prevalence of patients with sickle cell disease increases gradually in France, every physician can be potentially involved in the care of these patients. Complications of sickle cell disease can be acute and chronic. Pain is the main symptom and should be treated quickly and aggressively. In order to reduce the fatality rate associated with acute chest syndrome, it must be detected and treated early. Chronic complications are one of the main concerns in adults and should be identified as early as possible in order to prevent end organ damage. Many organs can be involved, including bones, kidneys, eyes, lungs, etc. The indications for a specific treatment (blood transfusion or hydroxyurea) should be regularly discussed. Coordinated health care should be carefully organized to allow a regular follow-up near the living place and access to specialized departments. We present in this article the French guidelines for the sickle cell disease management in adulthood.

Published
2015

11. [Anemia and splenomegaly in a 21-year-old woman]

Author

K, Stankovic Stojanovic, F, Lionnet, B, Thiolière, L, Selleret, E, Garandeau, and S, Mattioni

Subjects
Ovulation, Young Adult, C-Reactive Protein, Splenomegaly, Humans, Anemia, Female, Infertility, Female, Familial Mediterranean Fever
Published
2014

12. Unusual sites of Salmonella osteoarthritis in patients with sickle cell disease: two cases

Author

W. Ammouri, Claude Bachmeyer, L. Combescure, F. Lionnet, Gilles Grateau, P. M’Bappé, and Robert Girot

Subjects
Adult, Male, musculoskeletal diseases, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Sternoclavicular joint, Black People, Anemia, Sickle Cell, Osteoarthritis, Rheumatology, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Femur, Humerus, Tibia, Arthritis, Infectious, business.industry, Sacroiliitis, Sacroiliac Joint, General Medicine, musculoskeletal system, medicine.disease, Sternoclavicular Joint, Surgery, medicine.anatomical_structure, Rheumatoid arthritis, Salmonella Infections, Female, business
Abstract

Salmonella osteoarticular infections involve mainly long bones such as the femur, tibia, and humerus in patients with sickle cell disease (SCD). We report here two unusual cases of Salmonella osteoarthritis affecting sacroiliac and sternoclavicular joints in two patients with SCD, one patient also being followed for rheumatoid arthritis. Because of misleading presentation, diagnosis of septic osteoarthritis in patients with SCD requires a high index of suspicion and an early treatment.

Published
2006
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13. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain

Author

H. Hattig, C. Delli Pizzi, M. C. Addonizio, Michelle Davis, A. R. Giovagnoli, L. Florensa, M. Roth, J. de Kruijk, Francisco Lacruz, Ph. Dewailly, A. Toygar, C. Avendano, P.P. De Deyn, J. F. Hurtevent, F. Lomeila, T. W. Wong, Gordon T. Plant, M. Bud, H. J. Willison, DH Miller, D. W. Langdon, R. Cioni, J. Servan, A. Kaygisiz, E. Racadot, D. B. Schens, E. Picciola, L. Falip, C. Bouchard, J. Jotova, A. Jorge-Santamaria, P. Misra, A. Dufour, C. P. Panagopoulos, A. Venneri, B. Sredni, B. Angelard, M. Janelidze, M. Carreno, J. Obenberger, J. Pouget, H. W. Moser, R. Kaufmann, J. A. Molina, D. Linden, A. Martin Urda, E. Uvestad, A. Krone, J. P. Cochin, J. Mallecourt, A. Cambon-Thomsen, K. Violleau, P. Osschmann, A. M. Durocher, E. Bussaglia, D. M. Danielle, H. Efendi, C. Van Broeckhoven, K. G. Jordan, W. Rautenberg, C. Iniguez, J. M. Delgado, Graham Watson, M. Lawden, Gareth J. Barker, K. Stiasny, James T. Becker, G. Campanella, E. Peghi, A. Poli, A. Haddad, T. Yamawaki, Giacomo P. Comi, S. Sotgiu, B. Ersmark, A. Pomes, M. Ziegler, P. Ferrante, P. Ruppi, H. KuÇukoglu, R. Bouton, U. K. Rinne, P. Vieregge, M. Dary, P. Giunti, Peter J. Goadsby, S. Jung, E. Secor, A. Steinberg, N. Vila, M. A. Hernandez, M. Cursi, A. Enqelhardt, A. Engelhardt, J. Veitch, F. Di Silverio, F. Arnaud, B. Neundörfer, R. Brucher, Dominique Caparros-Lefebvre, B. Meyer, Marianne Dieterich, M. H. Snidaro, R. Gomez, R. Cerbo, M. Ragno, J. M. Vance, S. Nemni, A. Caliskan, F. Barros, I. Velcheva, D. Ceballos-Baumann, V. Barak, A. Avila, N. Antonova, F. Resche, S. Pappata, L. Varela, S. R. Silveira Santos, A. Cammarota, L. Naccache, Y. Nara, E. Tournier-Lasserves, R. Mobner, T. Chase, A. Ensenyat, J. Ulrich, G. Giegerich, M. Rother, M. Revilla, N. Nitschke, K. Honczarenko, E. Basart Tarrats, J. Blin, B. Jacob, J. Santamaria, S. Knezevic, J. L. Castillo, M. Antem, J. Colomer, O. Busse, Didier Hannequin, S. Carrier, J. B. Ruidavets, C. Rozman, J. Bogoussslavsky, J. Pascual Calvet, E. Monros, J. M. Polo, M. Zucconl, Javier Muruzabal, R. R. Allen, R. Rivolta, K. Haugaard, A. Nespolo, K. Hoang-Xuang, G. Bussone, T. Avramidis, E. Corsini, Christiana Franke, T. Vinogradova, H. Boot, K. Vestergaard, G. H. Jansen, N. Argentino, M. Raltzig, W. Linssen, Mark B. Pepys, P. Roblot, L. Lauritzen, E. Fainardi, D. Morin, T. X. Arbizu Urdiain, J. Wollenhaupt, S. Bostantjopoulou, G. Pavesi, A. D. Forman, Giovanni Fabbrini, D. Jean, J. J. Archelos, M. I. Blanchs, M. Del Gobbo, Anna Carla Turconi, Ch. Derouesné, Elio Scarpini, A. Visbeck, P. Castejon, J. P. Renou, F. Mounier-Vehier, G. Potagas, Ch. Duyckaerts, A. Filla, R. Schneider, G. Ronen, K. Nagata, J. P. Vedel, A. Henneberg, G. van Melle, C. Baratti, H. Knott, M. C. Prevett, A. Bes, B. Metin, Jos V. Reempts, L. Martorell, Mefkure Eraksoy, H. O. Handwerker, D. S. Younger, O. Oktem, D. Frongillo, C. Soriano-Soriano, L. Niehaus, F. Zipp, A. Tartaro, S Newman, R. H. Browne, P. Davous, R. Sanchez, M. Muros, M. E. Kornhuber, A. Lavarone, M. Mohr, M. R. Garcia, S. Russell, H. Kellar-Wood, M. R. Tola, B. Ostermeyer, Ch. Tzekov, K. Sartor, E. B. Ringelstein, P. P. Gazzaniga, Paul Krack, H. Fidaner, H. Rico, T. Dbaiss, F. Alameda, E. Torchiana, L. Rumbach, I. Charques, J. M. Bogaard, C. D. Frith, L. J. Rappelle, R. Brenner, A. Joutel, K. Fuxe, G. HÄcker, M. J. Blaser, J. Valls-SolÇ, G. Ulm, M. Alberdi, A. Bock, F. W. Bertelsmann, U. Wieshmann, J. Visa, J. R. Lupski, D. D'Amico, L. M. P. Ramos, A. A. Vanderbark, R. Horn, M. Warmuth, Dietmar Kühne, Mark S. Palmer, C. Ehrenheim, E. Canga, S. Viola, O. Scarpino, P. Naldi, R. Almeida, A. A. Raymond, J. Gamez, Stephan Arnold, A. DiGiovanni, J. Dalmau, C. C. Chari, H. F. Beer, J. C. Koetsier, J. Iriarte, E. Yunis, J. Casadevall, E. Le Guern, E. Stenager, S. R. Benbadis, J. M. Warter, F. Burklin, I. Theodorou, L. Johannesen, G. A. Graveland, X. Leclerc, I. Vecchio, L. Ozelius, G. Nicoletti, R. K. Gherardi, E. Esperet, M. L. Delodovici, F. Cattin, F. Paiau, Giorgio Sacilotto, C. A. J. Broere, D. Chavdarov, J. P. Willmer, C. H. Hawkes, Th. Naegele, E. Ellie, E. Dartigues, M. J. Guardiola, S. Hesse, Z. Levic, Marco Rovaris, P. Saugeir-Veber, B. A. Yaqub, H. F. Durwen, R. Larumbe, J. Ballabrina, M. Sendtner, J. Röther, M. Horstink, C. Kluglein, M.P. Montesi, H. Apaydin, J. Montoya, E. Waubant, Ch. Verellen-Dunoulin, A. Nicolai, J. Lopez-Delval, R. Lemon, G. Cantinho, E. Granieri, A. Zeviani, Wolfgang H. Oertel, U. Ficola, V. Di Piero, V. Fragola, K. Sabev, M. V. Guitera, I. Turki, F. Bolgert, P. Ingrand, J. M. Gobernado, L. M. E. Grimaldi, S. Baybas, B. Eymard, Y. Rolland, Y. Robitaille, Ta. Pampols, P. J. Koehler, A. Carroacedo, J. Vilchez, S. Di Vittorio, I. R. Rise, T. Nagy, M. Kuffner, E. Palazzini, A. Ott, J. Pruim, T. X. Arbizu, E. Manetti, C. Cervera, S. Felber, G. Gursoy, J. Scholz, G. A. Buscaino, M. S. Chen, A. Pascual, J. Hazan, J. U. Gajda, J. G. Cea, G. Bottini, G. Damalik, F. Le Doze, G. Bonaldi, J. M. Hew, C. Messina, A. M. Kennedy, J. M. Carney, N. M. F. Murray, M. Parent, M. Koepp, V. Dimova, D. De Leo, K. Jellinger, G. Salemi, S. Mientus, M. L. Hansen, F. Mazzucchelli, J. Vieth, M. Mauri, E. Bartels, L. Johannsen, C. Humphreys, J. Emile, D. N. Landon, E. Kansu, R. Sanchez-Pernaute, Rsj Frackowiak, M. Gonzalez Torres, L. Oller, C. Machedo, J. Kother, M. Billiard, H. Durak, T. Schindler, A. Frank, A. Uncini, A. Sbriccoli, C. Farinas, D. W. Paty, N. Fast, A. T. Zangaladze, A. Kerkhofs, J. M. Pino Garcia, I. De la Fuente, B. Marini, L. Gomez, I. Rubio, Alessandra Bardoni, C. Brodie, P. Acin, U. Sliwka, S. A. Hawkins, S. Tardieu, F. Vitullo, J. M. Pereira Monteino, R. Gagliardi, T. Jezewski, A. Cano, T. Lempert, F. Abad Alegria, G. Rotondo, D. Ince, C. Martinez Parra, Y. Huang, H. Luders, Y. Steinvil, F. G. A. Van Der Meche, R. Bianchi, A. Sanchez, T. Sevilla, J. M. Ketelslegers, A. Domzal-Stryga, M. Pandolfo, M. O. Josse, K. W. Neff, I. Blanco, G. W. Bruyn, O. W. Witte, J. L. Thibault, G. Andersen, J. Pariset, A. Marcone, R. J. M. Lane, A. Hofman, M. Verin, T. Matilla, P. Bedoucha, J. Roche, M. Lai, M. Collard, A. Ugarte, F. Gallecho, D. Silbersweig, C. Kennard, J. P. Azulay, T. W. Ho, P. L. I. Dellemijn, R. Girardello, F. Baas, B. Voss, F. Rozenberg, E. M. Brocker, V. Stanev, A. A. J. Soeterboek, A. Marra, A. Rey, E. Ertem, M. Sawradewicz-Rybak, J. De Keyser, P. Cavallari, F. Proust, Y. Chevalier, H. C. Hansen, D. Leys, C. A. Davie, K. Hoang-Xuan, C. Bairati, H. van Crevel, Thomas T. Warner, B. Bompais, A. Dobbeleir, T Campbell, C. Macko, C. J. M. Klijn, M. Dussallant, T. P. Berlit, W. Rozenbaum, M. J. van den Bent, W. A. Rocca, M. Muller, H. Hundemer, U. Zifko, M. Campera, F. Drislane, D. Ranoux, T. M. Kloss, Anil Kumar, I. Ruolt, C. Bargnani, B. Marescau, N. A. Losseff, S. Notermans, B. Kint, E. T. Burke, C. Aykut, J. Matias Guiu, P. Maquet, T. Drogendijk, M. Leone, K. von Ammon, M. Pepeliarska, C. Prados, L. DiGiamberardino, T. Logtenberg, G. Lenoir, I. Castaldo, Damhaut, M. Radionova, G. Sirabian, R. Navon, Giovanni Antonini, K. Al Moutaery, E. Chamas, R. Schönhuber, M. Giannini, B. Debilly, I. Labatut, H. Henon, J. A. Egido, M. Baudrimont, J. N. Lorenzo, J. E. C. Bromberg, R. Antonacci, J. J. Vilchez, T. Moulin, B. Rautenstrauss, Giovanni Meola, J. Noth, S Mammi, P. Laforet, F. Lopez, C. Gehring, S. Bort, G. Rancurel, D. Decamps, S. Kostadinova, Y. Shapira, B. Neundoerfer, D. Chavrot, M. Solimena, J. P. Salier, W. Deberdt, R. Hoff-Jörgensen, A. Messina, S. Meairs, G. Rosoklija, E. Nelis, I. Bertran, C. Ertekin, J. Lohmeyer, Mitermayer Galvao dos Reis, L. Calo, E. Maccagnano, A. P. Hays, J. Verlooy, M. G. Forno, T. Blanco, L. Bail, Gabriella Silvestri, J. Montero, F. Bertrand, R. T. Ghnassia, C. Besses, T. Sereghy, F. Shalit, G. Bogliun, S. Braghi, St. Baykouchev, C. Franke, A. Lasa, L. C. Archard, J. Kriebel, S. Shaunak, M. Nocito, Alexander Tsiskaridze, E. Manfredini, T. Seigal, David G. Gadian, M. Barlas, J. D. Degos, C. Seeber, J. Caemert, J. L. Mas, R. B. Pepinsky, M. G. D'Angelo, N. Baumann, S. Yorifuji, H. P. Endtz, M. A. Cassatella, R. A. C. Hughes, V. Golzi, A. Bittencourt, A. Ferreira, M. Sanson, C. Alper, M. Vermeulen, M. A. A. van Walderveen, E. Alexiou, C. H. Lucas, M. Fiorelli, Y. N. Debbink, R. Gil, S. Congia, T. Banerjee, J. M. Bouchard, A. N. Pinto, A. Ceballos-Baumann, G. Grollier, P. I. M. Schmitz, M. D. Catata, N. Lahat, N. S. Rao, P. Papathanasopoulos, J. Valls-Solé, D. Claus, G. Schroter, A. Castro, C. Videbaek, R. Martinez Dreke, A. D. Platts, M. Hermesl, A. C. PeÇanha-Martins, M. Cardoso Silva, P. Masnou, M. J. A. Tanner, Ch. Confavreux, B. Mishu, H. Rasmussen, L. Valenciano, Carlo Pozzilli, S. W. Li, V. Salzman, Y. Vashtang, Massimo Franceschi, M. Severo, G. Deuschl, S. Setien, G. Mariani, A. Protti, J. Castillo, M. J. B. Taphoorn, M. Frontali, I. Milonas, D. Decoq, J. A. Navarro, S. Castellvi-Pel, C. Ertikin, M. Urtasun, Y. Lajat, B. E. Kendall, E. Verdu, B. Gueguen, E. Boisen, R. Couderc, A Danek, JM Stevens, F. Nicoli, L. 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Brizioli, J. Calleja, L. Publio, M. Desi, R. Soffietti, P. Cortinovis-Tourniaire, E. F. Gonano, G. Cavaletti, S. Uselli, K. Westerlind, H. Betuel, C. O. Dhiver, H. Guggenheim, M. Hamon, R. Fazio, P. Lehikoinen, A. Esser, B. Sadzot, G. Fink, Angelo Antonini, D. Bendahan, V. Di Carlo, G. Galardi, A. F. Boller, M. Aksenova, Del Fiore, V. de la Sayette, H. Chabriat, A. Nicoletti, A. Dilouya, M. L. Harpin, E. Rouillet, J. Stam, A. Wolters, M. R. Delgado, Eduardo Tolosa, G. Said, A. J. Lees, L. Rinaldi, A. Schulze-Bonhage, MA Ron, C. Lefebvre, E. W. Radü, R. Alvarez, M. L. Bots, P. Reganati, S. Palazzi, A. Poggi, N. J. Scolding, V. Sazdovitch, T. Moreau, E. Maes, M. A. Estelies, P. Petkova, Jose-Felix Marti-Masso, G De La Meilleure, N. Mullatti, M. Rodegher, N. C. Notermans, T. A. T. Warner, S. Aktan, J. P. Louboutin, L. Volpe, C. Scheidt, W. Aust, C. M. Wiles, U. Schneider, S. K. Braekken, W. R. Willems, K. Usuku, Peter M. Rothwell, C. Talamon, M. L. Sacchetti, A. Codina, M. H. Marion, A. Santoro, J. Roda, A. Bordoni, D. J. Taylor, S. Ertas, H. H. Emmen, J. Vichez, V. BesanÇon, R. E. Passingham, M. L. Malosio, A. Vérier, M. Bamberg, A. W. Hansen, E. Mostacero, G. Gaudriault, Marie Vidailhet, B. Birebent, K. Strijckmans, F. Giannini, T. Kammer, I. Araujo, J. Nowicki, E. Nikolov, A. Hutzelmann, R. Gherardi, J. Verroust, L. Austoni, A. Scheller, A. Vazquez, S. Matheron, H. Holthausen, J. M. Gerard, M. Bataillard, S. Dethy, V. H. Patterson, V. Ivanez, N. P. Hirsch, F. Ozer, M. Sutter, C. Jacomet, M. Mora, Bruno Colombo, A. Sarropoulos, T. H. Papapetropoulos, M. Schwarz, D. S. Dinner, N. Acarin, B. Iandolo, J. O. Riis, P. R. J. Barnes, F. Taroni, J. Kazenwadel, L. Torre, A. Lugaresi, I. L. Henriques, S. Pauli, S. Alfonso, Pedro Quesada, A. S. T. Planting, J. M. Castilla, Thomas Gasser, M. Van der Linden, A. Alfaro, E. Nobile-Orazio, G. Popova, W. Vaalburg, F. G. A. van der Mech, L. Williams, F. Medina, J. P. Vernant, J. Yaouanq, B. Storch-Hagenlocher, A. Potemkowski, R. Riva, M. H. Mahagne, M. Ozturk, Ve. Drory, N. Konic, C. Jungreis, A. Pou Serradell, J. L. Gauvrit, G. J. Chelune, S. Hermandez, T. Dingus, L. Hewer, Ch. Koch, M. N. Metz-Lutz, G. Parlato, M. Sinaki, Charles Pierrot-Deseilligny, H. C. Diener, J. Broeckx, J. Weill-Fulazza, M. L. Villar, M. Rizzo, O. Ganslandt, C. Duran, N. A. Fletcher, G. Di Giovacchino, Susan T. Iannaccone, C. Kolig, N. Fabre, H. A. Crockard, Rita Bella, M. Tazir, E. Papagiannuli, K. Overgaard, Emma Ciafaloni, I. Lorenzetti, F. Viader, P. A. H. Millac, I. Montiel, L. H. Visser, M. Palomar, P. L. Murgia, H. Pedersen, Rafael Blesa, S. Seddigh, W. O. Renier, I. Lemahieu, H. M. L. Jansen, L. Rosin, J. Galofre, K. Mattos, M. Pondal, G. M. Hadjigeorgiou, D. Francis, L. Cantin, D. Stegeman, M. Rango, A. B. M. F. Karim, S. Schraff, B. Castellotti, I. Iriarte, E. Laborde, T. J. Tjan, R. Mutani, D. Toni, B. Bergaasco, J. G. Young, C. Klotzsch, A. Zincone, X. Ducrocq, M. Uchuya, O. J. Kolar, A. Quattrone, T. Bauermann, Nereo Bresolin, J. Vallée, B. C. Jacobs, A. Campos, Werner Poewe, J. A. Villanueva, A. W. Kornhuber, A. Malafosse, E. Diez-Tejedor, G. Jungreia, M. J. A. Puchner, A. Komiyama, O. Saribas, V. Volpini, L. Geremia, S. Bressi, A. Nibbio, Timothy E. Bates, T. z. Tzonev, E. Ideman, G. A. Damlacik, G. Martino, G. Crepaldi, T. Martino, Kjell Någren, E. Idiman, D. Samuel, J. M. Perez Trullen, Y. van der Graaf, J. O. Thorell, M. J. M. Dupuis, E. Sieber, R. D'Alessandro, C. Cazzaniga, J. Faiss, A. Tanguy, A. Schick, I. Hoksergen, A. Cardozo, R. Shakarishvili, G. K. Wennlng, J. L. Marti-Vilalta, J. Weissenbach, I. L. Simone, Amalia C. Bruni, Darius J. Adams, C. Weiller, A. Pietrangeli, F. Croria, C. Vigo-Pelfrey, Patricia Limousin, A. Ducros, G. Conti, O. Lindvall, E. Richter, M. Zuffi, A. Nappo, T. Riise, J. Wijdenes, M. J. Fernandez, J. Rosell, P. Vermersh, S. Servidei, M. S. C. Verdugo, F. Gouttiere, W. Solbach, M. Malbezin, I. S. Watanabe, A. Tumac, W. I. McDonald, D. A. Butterfield, P. P. Costa, F. deRino, F. Bamonti, J. M. Cesar, C. H. Lahoz, I. Mosely, M. Starck, M. H. Lemaitre, K. M. Stephan, S. Tex, R. Bokonjic, I. Mollee, L. Pastena, M. Gutierrez, F. Boiler, M. C. Martinez-Para, M. Velicogna, O. Obuz, A. Grinspan, M. Guarino, L. M. Cartier, E. Ruiz, D. Gambi, S. Messina, M. Villa, Michael G. Hanna, J. Valk, Leone Pascual, M. Clanet, Z. Argov, B. Ryniewicz, E. Magni, B. Berlanga, K. S. Wong, C. Gellera, C. Prevost, F. Gonzalez-Huix, R. Petraroli, J. E. G. Benedikz, I. Kojder, C. Bommelaer, L. Perusse, M. R. Bangioanni, Guy M. McKhann, A. Molina, C. Fresquet, E. Sindern, Florence Pasquier, M. J. Rosas, M. Altieri, O. Simoncini, M. Koutroumanidis, C. A. F. Tulleken, M. Dary-Auriol, S. Oueslati, H. Kruyer, I. Nishisho, C. R. Horning, A. Vital, G. V. Czettritz, J. Ph. Neau, B. Mihout, A. Ameri, M. Francis, S. Quasthoff, D. Taussig, S. Blunt, P. Valentin, C. Y. Gao, O. Heinzlef, H. d'Allens, C. Coudero, M. Erfas, G. Borghero, P. J. Modrego Pardo, M. C. Patrosso, N. L. Gershfeld, P. A. J. M. Boon, O. Sabouraud, M. Lara, J. Svennevig, G. L. Lenzi, A. Barrio, H. Villaroya, JosÇ M. Manubens, O. Boespflug-Tanguy, M. Carreras, D. A. Costiga, J. P. Breux, S. Lynn, C. Oliveras Ley, A. G. Herbaut, J. Nos, C. Tornali, Y. A. Hekster, J. L. Chopard, J. M. Manubens, P. Chemouilli, A. Jovicic, F. Dworzak, S. Smirne, S. E. Soudain, B. Gallano, D. Lubach, G. Masullo, G. Izquierdo, A. Pascual Leone Pascual, A. Sessa, V. Freitas, O. Crambes, L. Ouss, G. W. Van Dijk, P. Marchettini, P. Confalonieri, M. Donaghy, A. Munnich, M. Corbo, and M. E. L. van der Burg

Subjects
Neurology, business.industry, Media studies, Library science, Medicine, Neurology (clinical), business
Published
1994
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14. [Anemia in adult sickle cell disease]

Author

J-B, Arlet, P, Bartolucci, A, Habibi, J-A, Ribeil, K, Stankovic, and F, Lionnet

Subjects
Adult, Antisickling Agents, Humans, Transfusion Reaction, Anemia, Anemia, Sickle Cell, Chemoprevention
Published
2009

15. [Guidelines for management of adult sickle cell disease]

Author

F, Lionnet, J-B, Arlet, P, Bartolucci, A, Habibi, J-A, Ribeil, and K, Stankovic

Subjects
Adult, Humans, Anemia, Sickle Cell
Abstract

Sickle cell disease is a systemic disease that can potentially involve all organs. As the prevalence of patients with sickle cell disease increases gradually in France, every physician can be potentially involved in the care of these patients. Complications of sickle cell disease can be acute or chronic. Pain is the main symptom and should be treated quickly and aggressively. Acute chest syndrome is the leading cause of acute death and must be prevented, detected, and treated without delay. Chronic complications are one of the main concerns in adults and should be identified as early as possible in order to prevent sequels. Many organs can be involved, including the bones, kidneys, eyes, lungs... The indications for a specific treatment (blood transfusion or hydroxyurea) should be discussed. Health care should be carefully organized to allow both a regular follow-up near the living place and access to specialized departments. We present in this article the French guidelines for the sickle cell disease management in adulthood.

Published
2009

16. Prevalence and Mechanism of Pulmonary Hypertension in Sickle Cell Disease: A Prospective Multicentre French Study

Author

Laurent Savale, A Letierce, Florence Parent, F Lionnet, R Girot, G. Loko, F Galacteros, F. Driss, J Inamo, G Simonneau, D Bachir, and A Elmazouzi

Subjects
Pediatrics, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Mechanism (biology), Cell, medicine, Disease, medicine.disease, business, Pulmonary hypertension
Published
2009
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18. Risque diminué de carcinomes cutanés au cours de la drépanocytose ?

Author

Boutros Soutou, A. Habibi, Selim Aractingi, F. Lionnet, and P. Senet

Subjects
Dermatology
Abstract

Introduction Les malades ayant une drepanocytose ont deux circonstances de sur-risque de carcinomes cutanes. Il s’agit d’abord des ulceres, ce d’autant que la drepanocytose est responsable des pertes de substance dont la duree est la plus elevee, avec une moyenne de 1,5 ans et une limite superieure de 25 ans dans deux series recentes. Il existe en outre, chez un certain nombre de malades ayant une drepanocytose, une prescription d’hydroxyuree au long cours, molecule responsable de carcinogenese cutanee. Nous nous sommes donc pose la question du risque de cancers cutanes (CC) survenant sur les ulceres prolonges ou de CC induits par l’hydroxyuree (HU). Patients et methodes Il s’agit d’une analyse de cohorte transversale et descriptive. La population a compris tous les patients suivis pour drepanocytose dans deux centres de reference parisiens, Tenon et Henri-Mondor. Ont ete inclus les patients ayant un ulcere cutane evoluant depuis plus de 2 ans. Tous ont ete examines par un dermatologue a la recherche d’une suspicion de transformation maligne ; en cas de doute une biopsie etait realisee. Ont ete inclus egalement les patients traites avec HU pour au moins 2 ans. Leur nombre etant eleve et le risque d’omettre une lesion tumorale faible, une revue du seul dossier medical a ete faite a la recherche de CC ou de keratose actinique. Resultats Vingt-neuf patients avec 53 ulceres ont ete examines. La moyenne d’âge etait de 35 ± 8,4 ans. Tous etaient de phototype VI. Les ulceres se situaient aux jambes et aux pieds. Leur duree moyenne d’evolution etait de 9,2 ± 7 ans. Aucune zone suspecte de CC n’a ete identifiee ; aucune biopsie n’a donc ete faite. En outre, les dossiers de 187 patients drepanocytaires traites par HU ont ete revus. La moyenne d’âge etait de 31,3 ± 9,9 ans. Quatre-vingt-douze pour cent etaient de phototype VI. La duree moyenne du traitement avec HU etait de 6 ± 3,2 ans. Aucun cas de CC ni de keratose actinique n’a ete rapporte. Discussion Le risque de carcinome sur ulcere prolonge ou sous HU est nul dans nos series. De meme, aucune publication jusqu’a present ne rapporte cette complication. Pourtant, des ulceres de jambe prolonges peuvent, quelle que soit la cause, se transformer en CC avec une prevalence pouvant atteindre 10 %. De meme, la prevalence des CC et des keratoses actiniques chez les patients ayant un syndrome myeloproliferatif traite avec HU atteint dans certaines series 31 % et 11 % respectivement. L’absence de cancer observee dans notre etude peut faire discuter deux causes : soit une vraie reduction/resistance au risque carcinologique chez ces malades, soit un biais lie : – a l’âge, jeune dans la drepanocytose et eleve dans les ulceres vasculaires et les syndromes myeloproliferatifs ; – au phototype, VI dans la drepanocytose. Conclusion Certains facteurs carcinogenes cutanes, tels l’HU ou un ulcere chronique, n’auraient pas les memes effets dans la drepanocytose.

Published
2015
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19. Recommandations françaises de prise en charge de la drépanocytose de l'adulte : actualisation 2015

Author

Anoosha Habibi, F Lionnet, K Stankovic, Jean-Antoine Ribeil, Justine Gellen-Dautremer, Jean-Benoît Arlet, and Pablo Bartolucci

Subjects
Gastroenterology, Internal Medicine
Abstract

Resume La drepanocytose est une pathologie genetique du globule rouge, qui provoque des atteintes fonctionnelles et tissulaires de facon systemique. La prevalence de la drepanocytose de l'adulte est en augmentation continue en France. Tout medecin peut etre conduit a prendre en charge un patient drepanocytaire. Les complications s'expriment de facon aigue ou chronique. La douleur represente le principal symptome qui doit etre traite rapidement et puissamment. Pour reduire la mortalite associee au syndrome thoracique aigu, il faut le depister et le traiter precocement. Les complications chroniques, qui tiennent une place majeure chez l'adulte, doivent etre depistees, afin de tenter d'interrompre ou de retarder leur evolution. De nombreux organes peuvent etre touches par la maladie, notamment : les os, les reins, les yeux, les poumons, etc. L'indication d'un traitement de fond (transfusion sanguine ou hydroxyuree) doit etre regulierement discutee. L'organisation de la prise en charge sur le territoire francais est tres importante pour permettre simultanement un suivi de proximite et un acces aux services specialises, associes a une coordination entre les differents intervenants. Nous presentons dans cet article les recommandations francaises du centre de reference de prise en charge de la drepanocytose adulte qui se veulent une aide pratique a la prise en charge quotidienne de cette veritable maladie systemique.

Published
2015
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20. Acute myocardial ischemia after high-dose therapy with BEAM regimen

Author

B Gallet, P Genet, T. Touahri, K Laribi, M Pulik, K Jondeau, and F Lionnet

Subjects
Melphalan, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Ischemia, Myocardial Ischemia, Antimetabolite, Transplantation, Autologous, Disease-Free Survival, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Etoposide, Transplantation, Chemotherapy, Carmustine, Peripheral Blood Stem Cell Transplantation, business.industry, Vascular disease, Cytarabine, Hematology, Middle Aged, medicine.disease, Surgery, Immunoblastic Lymphadenopathy, Cardiology, Female, Complication, business, medicine.drug
Abstract

We describe a case of acute myocardial ischemia following carmustine treatment during the BEAM regimen. Despite this, full completion of the autologous peripheral stem-cell transplant was possible.

Published
2001

21. Neurological complications of varicella-zoster virus infection in adults with human immunodeficiency virus infection

Author

Eric Caumes, J Livartowski, F Lionnet, Pierre Lebon, O Picard, A De La Blanchardiere, D. Sicard, D. Salmon-Ceron, F. Rozenberg, and J. Coste

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Pathology, Herpesvirus 3, Human, Opportunistic infection, viruses, Myelitis, HIV Infections, medicine.disease_cause, Gastroenterology, Herpes Zoster, Polymerase Chain Reaction, Central Nervous System Infections, Internal medicine, medicine, Humans, CSF albumin, Retrospective Studies, General Immunology and Microbiology, business.industry, Varicella zoster virus, virus diseases, General Medicine, Middle Aged, medicine.disease, Prognosis, Magnetic Resonance Imaging, CD4 Lymphocyte Count, Infectious Diseases, Disease Progression, Female, Acute retinal necrosis, business, Tomography, X-Ray Computed, Meningitis, Encephalitis, Shingles
Abstract

This multicentre retrospective study describes the clinical features and prognostic significance of Varicella-zoster virus (VZV)-associated neurological complications. The study was performed in patients with human immunodeficiency virus (HIV) infection, hospitalized for VZV neurological complications, confirmed in every case by positive VZV polymerase chain reaction (PCR) in cerebrospinal fluid (CSF). Between 1990 and 1995, 34 HIV-infected patients were included in the study. At diagnosis, 59% had AIDS, with a median CD4 count of 11 x 10(9)/l. A past history of zoster was noted in 35% of cases. A concomitant herpes zoster rash and/or acute retinal necrosis were noted in 71% and 12% of patients, respectively. The predominant neurological manifestations were encephalitis (13), myelitis (8), radiculitis (7) and meningitis (6). The mean CSF white blood cell count was 126/mm3 and the mean CSF protein concentration was 2.3 g/l. Interferon-alpha level was increased in 36% of patients. VZV was isolated from CSF cultures in 2/6 cases. Magnetic resonance imaging was abnormal, demonstrating encephalitis lesions. After intravenous antiviral therapy, complete recovery was obtained in 18 cases (53%), serious sequelae were observed in 10 cases (29%) and 6 patients died (18%). Severe symptoms and a low CD4 cell count appeared to be associated with death or sequelae. In conclusion, VZV should be considered as a possible cause of encephalitis, myelitis, radiculitis or meningitis in HIV-infected patients, especially in patients with a history of or concomitant herpes zoster or acute retinal necrosis. VZV-PCR in the CSF may allow rapid diagnosis and early specific antiviral treatment.

Published
2000

24. [Acute myelocytic leukemia in immunodeficiency virus infection]

Author

M, Pulik, F, Lionnet, P, Genet, L, Jary, and K, Jondeau

Subjects
Leukemia, Myeloid, Acute, Humans, HIV Infections, Prognosis
Abstract

B lineage-derived malignant proliferation is a well recognized complication of HIV infection. Acute myeloid leukemias have been reported but no complete review of these cases has been performed. The Medline database was reviewed for the years 1980-1997. Eighteen cases of AML have been reported. When previously known, HIV infection was present for 40 months. In 7 patients HIV infection and AML were diagnosed simultaneously. According to the FAB classification, 5 cases were M2, 8 M4, 5 M5. Extramedullary localizations (skin, testis, spleen) were noticed in 10 patients. Non-treated patients had a survival of 2.7 weeks versus 9.8 months in patients treated with chemotherapy. Pathophysiologic studies were performed in 3 cases: reverse transcriptase activity and p24 antigen were noted in tumoral cultured cells in 1 case; absence of viral particules in culture in another one; absence of cloned DNA provirus integration in blasts cells in a third patient. Based on the observed high rate of M4/M5 (72%) versus 19-36% expected in a non HIV-infected population, we postulate that the association of AML and HIV is not coincidental. The monocytotropism of HIV, the chronic cytokines-mediated activation of monocyte/macrophages, the immunodeficiency may explain this association.

Published
1999

25. La drépanocytose: de l'enfance à l'âge adulte

Author

R Girot and F Lionnet

Subjects
Hemolytic anemia, Pediatrics, medicine.medical_specialty, Hemoglobinopathy, business.industry, Public health, Pediatrics, Perinatology and Child Health, medicine, medicine.disease, business, Sickle cell anemia
Published
2007
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29. Immune-complex glomerulonephritis associated with Staphylococcus aureus infection of a totally implantable venous device

Author

Genet P, F. Lionnet, B. Vacher, C. Petitdidier, and Pulik M

Subjects
medicine.medical_specialty, Pathology, Catheterization, Central Venous, Acute diffuse proliferative glomerulonephritis, Immunofluorescence, medicine.disease_cause, Kidney, Catheters, Indwelling, Glomerulonephritis, medicine, Endocarditis, Humans, Immune Complex Diseases, Percutaneous Renal Biopsy, Immune complex glomerulonephritis, Aged, medicine.diagnostic_test, business.industry, Complement C3, Staphylococcal Infections, medicine.disease, Surgery, Oncology, Staphylococcus aureus, Immunoglobulin G, Female, Complication, business
Abstract

We report a previously unrecognized complication of totally implanted subcutaneous ports. A patient with a totally implantable central venous device developed a septic syndrome. Blood and injection-reservoir cultures grew Staphylococcus aureus. There was no evidence of endocarditis. The port was removed but acute oliguric renal failure developed. A percutaneous renal biopsy showed acute diffuse proliferative glomerulonephritis. There was no extracapillary crescent. On immunofluorescence study, capillary wall granular deposits stained brightly for IgG and C3. These findings were thought to be consistent with infection-associated immune-complex glomerulonephritis.

Published
1995

30. [Varicella-zoster virus pancreatitis in hematologic diseases]

Author

M, Pulik, F, Teillet, F, Teillet-Thiebaud, F, Lionnet, P, Genet, and C, Petitdidier

Subjects
Adult, Male, Immunocompromised Host, Pancreatitis, Humans, Middle Aged, Hematologic Diseases, Herpes Zoster, Retrospective Studies
Abstract

We report four cases of varicella-zoster pancreatitis in immunocompromised hosts. All 4 patients presented a severe immunodeficiency because of chronic lymphoproliferative disorders (mainly lymphoma and Hodgkin disease) and long-term immunosuppressive therapy. Varicella zoster pancreatitis is a very unusual presentation of varicella-zoster infection. Few cases of pancreatitis occurring after bone marrow transplantation have been reported. All 4 patients presented with acute epigastric pain associated with transient elevation of serum amylase. The vesicular rash followed the presenting symptoms of severe abdominal pain by 8 days. This clinical presentation, occurring in immunocompromised patients, defines a set of symptoms which should lead the physician to suspect varicella-zoster pancreatitis, even in the initial absence of the characteristic skin vesicular eruption. Early institution of antiviral therapy seems mandatory.

Published
1995

31. Skeletal muscle toxoplasmosis in patients with acquired immunodeficiency syndrome: a clinical and pathological study

Author

M. Baudrimont, M. Wolff, F. Lionnet, C. Michon, C. Marche, J.‐M. Salord, Romain K. Gherardi, and C. Duvivier

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Biopsy, Antibodies, Protozoan, Biology, Polymyositis, Necrosis, Muscular Diseases, medicine, Animals, Humans, Myopathy, Acquired Immunodeficiency Syndrome, Muscle biopsy, medicine.diagnostic_test, Macrophages, Toxoplasma gondii, Skeletal muscle, Brain, Middle Aged, medicine.disease, biology.organism_classification, Pancytopenia, Toxoplasmosis, Microscopy, Electron, medicine.anatomical_structure, Neurology, Neurology (clinical), medicine.symptom, Toxoplasma, Encephalitis
Abstract

The present article describes the clinical and pathological findings in 5 human immunodeficiency virus (HIV)-infected patients with muscle toxoplasmosis. The patients had marked lymphopenia (5/5), with less than five CD4+ cells/mm3 (3/3), when they developed fever (5/5), and multiorgan failure (5/5), including diffuse encephalitis, pneumonia, pancytopenia, and myopathy. Muscle involvement included weakness and wasting (4/5), myalgias (3/5), and high serum creatine kinase levels (3/3). Serology for toxoplasmosis showed high IgG titers in 3 patients (3/4). Anti-Toxoplasma therapy resulted in complete recovery in 2 patients. Muscle toxoplasmosis was detected by biopsy (3/5) or postmortem evaluation (2/5), and was identified using immunocytochemistry and electron microscopy. Toxoplasma cysts were detected in 0.5 to 4% of muscle fibers close to or remote from necrotic fibers and inflammatory infiltrates. Muscle fibers strongly expressed the major histocompatibility complex class I antigen (2/2) as in polymyositis. We suggest that Toxoplasma gondii should be sought by muscle biopsy in patients who have acquired immunodeficiency syndrome with fever, encephalitis, multiorgan dysfunction, and elevated serum creatine kinase levels of obscure origin.

Published
1992

32. [AIDS-related progressive multifocal leukoencephalopathy limited to U fibers, responsible for subacute encephalopathy with normal CT scan findings]

Author

F, Gray, C, Geny, M C, Lescs, F, Lionnet, P, Brugières, J, Mikol, and A, Sobel

Subjects
Adult, Male, Acquired Immunodeficiency Syndrome, AIDS-Related Opportunistic Infections, Leukoencephalopathy, Progressive Multifocal, Nucleic Acid Hybridization, Immunohistochemistry, Tumor Virus Infections, DNA, Viral, Humans, Polyomaviridae, Tomography, X-Ray Computed, Papillomaviridae, In Situ Hybridization
Abstract

A 41-year-old male homosexual with AIDS was hospitalized for temperature elevation to 40 degrees C with confusion. Neurologic evaluation found psychomotor slowing and temporospatial disorientation with no focal signs. The CD4 count was 100/mm3. CSF analysis and the CT scan were normal. Despite antiviral treatment the patient died fifteen days after admission. Gross appearance of the brain was normal. Histologic examination disclosed multiple, small foci of demyelination characteristic of progressive multifocal leukoencephalopathy. These foci were disseminated among the U fibers. In situ hybridization and immunocytochemical studies demonstrated papovavirus particles in oligodendrocytes and a few astrocytes. This case shows that papovavirus infection in AIDS patients may be responsible for a diffuse febrile encephalopathy with normal CT scan findings and a rapidly progressive course.

Published
1992

34. Multifocal multinucleated giant cell myelitis in an AIDS patient

Author

Françoise Gray, F. Lionnet, C. Geny, P. Boudes, Romain K. Gherardi, and P. Cesaro

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Histology, Myelitis, Neurological examination, Pathology and Forensic Medicine, White matter, Myelopathy, Physiology (medical), medicine, Humans, Substance Abuse, Intravenous, Acquired Immunodeficiency Syndrome, medicine.diagnostic_test, business.industry, Brain, medicine.disease, Spinal cord, Immunohistochemistry, medicine.anatomical_structure, Neurology, Spinal Cord, Giant cell, Neurology (clinical), business, Myelography, Encephalitis, Toxoplasmosis
Abstract

A 19-year-old male intravenous drug abuser, was admitted to hospital with a one-week history of lower limb weakness and urinary retention. He was known to have been HIV-seropositive for 3 years and had been treated for cerebral toxoplasmosis. Neurological examination confirmed flaccid paraparesis with weak ankle jerks and bilateral extensor plantar responses. There was no obvious sensory deficit. Neurological examination was otherwise normal. CSF contained 63 mg/dl protein and 10 leucocytes/mm3. Myelography was normal. He died 1 month later from septic peritonitis. Neuropathological examination showed chronic lesions of toxoplasmosis in brain. Small necrotic foci with myelin loss, proliferation of microglia, macrophages and multinucleated giant cells (MGC) were disseminated in the whole spinal cord, mostly in the white matter, but the brain was spared. Immunohistochemistry demonstrated p24 and p17 HIV antigens in macrophages, MGC and microglial cells. These lesions resemble those of so called ‘multifocal giant cell encephalitis'. The present case demonstrates that HIV-related multifocal inflammatory changes may be restricted to the spinal cord and may be a cause of myelopathy in AIDS patients.

Published
1991

35. [Neuropathologic study of 135 adult cases of acquired immunodeficiency syndrome (AIDS)]

Author

F, Gray, C, Geny, F, Lionnet, E, Dournon, G, Fenelon, R, Gherardi, and J, Poirier

Subjects
Adult, Aged, 80 and over, Inflammation, Male, Acquired Immunodeficiency Syndrome, Lymphoma, Non-Hodgkin, Middle Aged, Opportunistic Infections, Central Nervous System Diseases, Virus Diseases, Ganglia, Spinal, Encephalitis, Humans, Female, Aged, Retrospective Studies
Abstract

The central nervous system was examined in 135 adult AIDS patients who died between August 1982 and December 1990. Twenty two brains showed non-diagnostic changes including microglial nodules, discrete myelin pallor with reactive astrocytosis, mineralization of blood vessels and granular ependymitis. In 105 brains with specific changes, toxoplasmosis was the most frequent finding (55 cases) manifested by multifocal necrotic lesions or diffuse pseudo-encephalitic process. Other opportunists included cytomegalovirus (21 case), progressive multifocal leukoencephalopathy (1 cases), cryptococcosis (6 cases), mycobacterium avium intracellulaire (2 cases), varicella-zoster virus (2 cases), aspergillosis (1 case) and multiple bacterial microabscesses (1 case). Multinucleated giant cells were found in 52 cases. In 40 cases, they were widely disseminated throughout the brain and in 39 cases, they were associated with diffuse or multifocal white matter changes. Fifteen cases had a cerebral lymphoma, 9 hepatic encephalopathy, 1 centropontine myelinolysis and 1 focal pontine leukoencephalopathy. Three cases had a cerebral haemorrhage due to disseminated intravascular coagulation, antithrombin therapy and amyloid angiopathy. Spinal changes in 13 cases included vacuolar myelopathy (7 cases), HIV myelitis (1 case) and ganglio-radiculitis (1 cases), cytomegalovirus myelo-radiculitis (1 case) secondary spread from a lymphoma (1 case) and spinal infarcts due to disseminated intravascular coagulation (1 case). These lesions were frequently atypical and various combinations of all these pathologies were encountered in the same brain, sometimes in the same area and occasionally in the same cell. Chronological variations in the incidence of some complications could be related to changes in treatment.

Published
1991

37. Assessment of antacid characteristics of drugs containing a combination of aluminium and magnesium salts using the 'artificial stomach' model

Author

J, Vatier, M T, Vitre, F, Lionnet, C, Poitevin, and M, Mignon

Subjects
Drug Combinations, Gastric Juice, Magnesium Hydroxide, Meat, Gastric Emptying, Stomach, Animals, Aluminum Hydroxide, Magnesium, Antacids, Hydrochloric Acid, Hydrogen-Ion Concentration, Models, Biological
Abstract

Antacid characteristics of three drugs containing aluminium and magnesium salts (combination of clay with aluminium and magnesium hydroxides, aluminium and magnesium hydroxide mixture and hydrotalcite) have been studied in a dynamic situation simulated by the "artificial stomach" model, simultaneously taking into account both gastric fluxes, a constant secretory flux and variable emptying fluxes. Therapeutic doses of the drugs were added 1. to 100 ml of 0.1 N HCl, without or with 1% or 5% meat extract, and 2. 100 ml of pooled human gastric juice (96 mmol/l, pH 1.1). In addition, antacid activity of 0.5 g aluminium and magnesium hydroxides, taken alone or in combination, were evaluated when added to 100 ml of 0.1 N HCl. In aqueous HCl solution or in human gastric juice, the three antacid drugs exhibited 1. a neutralising activity characterised by pH-rise and 2. a buffering capacity close to pH 3.8. In addition, hydrotalcite exhibited also buffering capacity at pH 1.2. The antacid-induced capacity, expressed as H+ mmol, to recover initial pH were very similar, indicating that antacid physiochemical properties are similar in HCl solution or in gastric juice. H+ consumption depended upon emptying fluxes. The same antacid characteristics were observed when antacids were mixed with 1% meat extract while 5% meat extract resulted in a modification of antacid characteristics. Therefore the antacid capacities of respective mixtures were of smaller magnitude (50-60%) than the sum of the activities of antacids plus meat extracts.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1990

38. Bilateral tibial chronic osteomyelitis due to Pantoea agglomerans in a patient with sickle cell disease

Author

C Bachmeyer, G. Arlet, F Jacquot, Gilles Grateau, H. Entressengle, M Gibeault, F. Lionnet, Pauline M’Bappé, F. Delisle, and G Nédellec

Subjects
Adult, Male, Hemolytic anemia, medicine.medical_specialty, Anemia, Sickle Cell, Rheumatology, medicine, Humans, Pharmacology (medical), Tibia, biology, Pantoea, business.industry, Osteomyelitis, biology.organism_classification, medicine.disease, Magnetic Resonance Imaging, Pantoea agglomerans, Sickle cell anemia, Surgery, Hemoglobinopathy, Chronic Disease, Osteitis, Gram-Negative Bacterial Infections, Tomography, X-Ray Computed, business
Published
2007
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41. Severe Candida krusei infection in an AIDS patient receiving long-term treatment with fluconazole

Author

M. Pulik, T. Touahri, C. Petitdidier, Philippe Genet, F. Lionnet, and B. De Jonghe

Subjects
medicine.medical_specialty, Long term treatment, biology, business.industry, Immunology, medicine.disease, biology.organism_classification, Infectious Diseases, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Candida krusei, Immunology and Allergy, Medicine, business, Fluconazole, medicine.drug
Published
1995
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44. COGAN'S SYNDROME AND PEYRONIE'S DISEASE: A NON-FORTUITOUS ASSOCIATION

Author

J.L. Lejonc, Bertrand Godeau, F. Lionnet, L. Ollivaud, C. C. Abbou, and A. Schaeffer

Subjects
Adult, Male, Vasculitis, Systemic disease, medicine.medical_specialty, Pathology, Cochlear Diseases, Cogan syndrome, Eye disease, Labyrinth Diseases, Penile Induration, Peyronie disease, Rheumatology, medicine, Humans, Pharmacology (medical), Keratitis, Autoimmune disease, S syndrome, business.industry, Syndrome, medicine.disease, Dermatology, Peyronie's disease, business
Published
1993
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45. Syndrome drépanocytaire majeur et infection par le VIH. À propos de 8 observations

Author

A Schaeffer, D. Bachir, F. Lionnet, I. Billy, Bertrand Godeau, J.L. Portos, and Frédéric Galactéros

Subjects
Pediatrics, medicine.medical_specialty, Pneumococcal infections, business.industry, Gastroenterology, Internal Medicine, medicine, Disease, Penicillin prophylaxis, business, medicine.disease
Abstract

The aim of the study was to specify the influence of sickle cell disease on HIV-infection. Our results suggest that, in this situation, pneumococcal infections are frequent and severe. At our opinion, oral penicillin prophylaxis should be interesting in these patients.

Published
1991
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46. Photo-onycholyse associée à la prise de doxycycline

Author

A Schaeffer, F. Guibal, J.L. Portos, J.C. Roujeau, and F. Lionnet

Subjects
medicine.medical_specialty, integumentary system, business.industry, Gastroenterology, Internal Medicine, Medicine, business, Phototoxicity, Dermatology, Surgery
Abstract

We report a case emphasizing the fact that doxycycline-induced phototoxicity may involve the nails as well as the skin.

Published
1990
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47. [Antacid action of the aluminum cation: comparison of the in vitro effect of hydroxide and phosphate in open and closed systems]

Author

J, Vatier, F, Lionnet, and M T, Vitre

Subjects
Gastric Acid, Dose-Response Relationship, Drug, Gastric Emptying, Humans, Aluminum Hydroxide, Antacids, Hydrogen-Ion Concentration, In Vitro Techniques, Aluminum Compounds, Aluminum, Phosphates
Abstract

Antacid capacity of two aluminium containing-antacid drugs was evaluated in vitro; the first drug contained aluminium hydroxide (Alternagel), the second, aluminium phosphate (Phosphalugel). The antacid evaluation was performed 1) in a closed system by measuring antacid activity by down titration, 2) by a dynamic evaluation simulating acid secretion and gastric emptying. The results were reported both to the recommended therapeutical dose and to 100 mg aluminium. In static conditions, without gastric emptying, it was shown that aluminium hydroxide and phosphate acted by their buffer capacity in pH range less than or equal to pH 1.5. The therapeutical dose of aluminium phosphate displayed greater antacid activity than aluminium hydroxide, this fact being due to the empiric choice of the doses. With regard to aluminium content, aluminium phosphate activity remained greater than that of aluminium hydroxide although the difference decreased with decreasing pH values. The antacid capacities were related to the emptying outputs. Antacid activity corresponding to 100 mg aluminium was similar in both antacids less than pH 1.5. This effect was dependent on emptying rates. It can be suggested that Al was responsible for antacid activity in both preparations, and that the buffering capacity was supported by the change of aluminium cation in hydrolysis intermediary compounds.

Published
1987

48. [Home thrombolysis for myocardial infarction. A multicenter study of the feasibility and evaluation of short-term prognosis]

Author

C, Hervé, M, Gaillard, J L, Dubois-Rande, C, Boesch, A M, Duval, F, Lionnet, M, Gouault, C, Prehu, D, Lellouche, and F, Jan

Subjects
Male, Random Allocation, Time Factors, Double-Blind Method, Fibrinolytic Agents, Myocardial Infarction, Humans, Female, Emergencies, Middle Aged, Prognosis, Home Care Services
Abstract

It has been proven since 1986 that in myocardial infarction the sooner thrombolysis is performed the better. Forty-four patients were selected to enter a double-blind randomized trial in which they received either an acylated plasminogen streptokinase activator complex or a placebo. The injections were given intravenously at home within the first 3 hours (within the first 2 hours in 26 of them), by doctors from Mobile care units. This home treatment in the acute phase made it possible to gain 75 minutes on average, and up to 90 minutes when it was performed by an anaesthetist trained in emergency management. No serious complication, such as haemorrhagic or allergic reaction, occurred, and arrhythmia was no more frequent in the treated group than in the placebo group. Home thrombolysis did not delay admission to a cardiology Intensive Care unit (66 min. versus 64 min). Mean coronary patency was 75 per cent, and up to 82 per cent, in patients treated within 2 hours of the first symptoms. There was no significant difference between areas of reperfused or not reperfused patients in relation to time (P less than 0.08). Diagnosis sensitivity was 100 per cent. Thus, home thrombolysis is feasible and safe when performed by trained emergency medical teams and when criteria for inclusion and exclusion are fulfilled.

Published
1988

49. [Evaluation of the antacid properties of Gelox in a dynamic milieu using the artificial stomach apparatus]

Author

J, Vatier, M T, Vitre, F, Lionnet, and M, Mignon

Subjects
Stomach, Methods, Drug Evaluation, Humans, Antacids, Hydrogen-Ion Concentration, Models, Biological
Abstract

Gelox antacid activity has been evaluated in a dynamic procedure by using the "artificial stomach" model that mimics both gastric fluxes, gastric secretion and gastric emptying. At time 0, the gastric reservoir has been filled by 100 ml of 0.1 N hydrochloric acid solution without or with protein, or by 100 ml of human gastric juice (pH 1.1). Gastric secretion was simulated by a constant 3 ml/min flux of HCl solution or of human gastric juice. Gastric emptying fluxes varied from 1.5 to 4.5 ml/min. Gelox addition to 100 ml of 0.1 N HCl or of human gastric juice induced 1) a pH-rise from 1.0 to 4.5-5.8, 2) a buffering capacity close to pH 3.6-4.0 and 3) the consumption of an acid amount between 25 and 50 mmol according to emptying fluxes, for recovering initial pH. In a mixture of HCl 0.1 N and protein extract 1 or 5%, Gelox induced 1) a pH-rise related to the protein concentrations, 2) a buffering capacity close to pH 3.2-3.9 when 1% protein extract has been used, and close to pH 5.0-5.9 with 5% protein extract and 3) a greater acid consumption with 1% than with 5% protein extract. For both protein concentrations, the resistance for recovering the initial pH, expressed as the amount of consumed mmol H+, was therefore less than the sum of individual capacities of proteins and Gelox.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1989

50. Combined use of respiratory multiplex PCR and procalcitonin to reduce antibiotic exposure in sickle-cell adult patients with acute chest syndrome (The ANTIBIO-STA study): a randomised, controlled, open-label trial.

Author

Sabaté-Elabbadi A, Mekontso-Dessap A, Lionnet F, Santin A, Verdet C, Woerther PL, Lopinto J, Turpin M, Rousseau A, Lacoste-Badie R, Razazi K, Voiriot G, and Fartoukh M

Abstract

Background: Respiratory infection may account for 30% of acute chest syndrome (ACS) aetiologies. However, antimicrobials are routinely prescribed, and de-escalation and/or discontinuation are challenging. Multiplex Polymerase Chain Reaction (mPCR) with an enlarged respiratory panel might support antimicrobial stewardship, and procalcitonin (PCT) measurements help reduce duration of antibiotic therapy. We hypothesized that a strategy combining the use of mPCR with repeated PCT measurements would reduce antibiotic exposure during ACS., Methods: We conducted a randomised, controlled, parallel group, open-label study in two French hospitals. Consecutive adult patients with ACS were randomly assigned to the conventional or interventional strategy, where antibiotic therapy was targeted on the results of mPCR performed on lower respiratory tract secretions (LRTS) samples, and antibiotic discontinuation based on PCT values and kinetics at Day 1 (D1), D3 and D7. The primary outcome was the number of days of antibiotic exposure at D28 after randomisation. This trial was registered on ClinicalTrial.gov (NCT03919266) and is closed to recruitment., Findings: From June 2020 to September 2022, 72 patients were assigned to the interventional (n = 37) or conventional strategy (n = 35). Despite a higher rate of microbiological documentation with the intervention (n = 25; 67.6% versus n = 13; 37.1%; difference, 30.4%; 95% CI 6.7%-51.5%), antibiotic exposure at D28 was similar between the two strategies (6 days [4.0-8.0] versus 6 days [5.0-9.0], respectively; difference, 0.0 day; 95% CI, -2.1 to 2.1). The time to clinical stability, and ICU and hospital lengths of stay did not differ., Interpretation: As compared with conventional tests, an enlarged respiratory panel mPCR combined with a PCT-guided algorithm did not reduce antibiotic exposure at D28 in adults with ACS., Funding: Assistance Publique-Hôpitaux de Paris, AP-HP (CRC180159). A financial support for the multiplex PCR kits used in this study was partially provided by bioMérieux., Competing Interests: ASE reports support for attending meeting from SOS Oxygène and LVL Medical outside the submitted work. MF reports grants from bioMérieux and personal fees from bioMérieux, Pfizer, SOS Oxygène and Fisher and Paykel outside the submitted work. AMD reports grants and personal fees from Addmedica, all outside the submitted work. GV reports research grants from bioMérieux and travel grants from SOS Oxygène and Oxyvie, all outside the submitted work. KR reports lecture fees from MSD, Shionogi and a travel grant from Pfizer outside the submitted work. PLW reports consulting fees from MSD and personal fees from Pfizer, outside the submitted work. MT reports support for attending meeting from Fresenius outside the submitted work. FL, AS, CV, JL, RLB and AR have no competing interests to declare., (© 2025 The Author(s).)

Published
2025
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