69 results on '"Gilles Blaison"'
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2. Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus
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Laurent Arnaud, Thierry Martin, Matteo Piga, Anne-Sophie Korganow, Vincent Poindron, Jean Sibilia, Bernard Bonnotte, Philippe Mertz, Andreas Schwarting, Hanns-Martin Lorenz, Reinhard E Voll, Gilles Blaison, Elisabetta Chessa, and Christoph Fiehn
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Medicine - Abstract
Objectives To analyse whether reported fatigue, one of the most challenging manifestations of systemic lupus erythematosus (SLE), may bias the assessment of disease activity in SLE according to the Physician Global Assessment (PGA).Methods Patients from the Lupus BioBank of the upper Rhein database, a cross-sectional multicentre collection of detailed clinical and biological data from patients with SLE, were included. Patients had to fulfil the 1997 American College of Rheumatology criteria for SLE and the PGA (0–3 scale) at the time of inclusion had to be available. Fatigue was assessed according to the Fatigue Scale for Motor and Cognitive Functions. Univariate and multivariate regression models were built to determine which variables were associated with the PGA.Results A total of 350 patients (89% female; median age: 42 years, IQR: 34–52) were included. The median Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score was 4 (IQR: 2–6). Of these 350 patients, 257 (73%) reported significant fatigue. The PGA (p=0.004) but not the SELENA-SLEDAI (p=0.43) was significantly associated with fatigue. Both fatigue and SELENA-SLEDAI were independently associated with the PGA in two different multivariate models.Conclusion Fatigue is independently associated with disease activity assessed using the PGA but not the SLEDAI. These findings highlight the fact that the PGA should capture only objectively active disease manifestations in order to improve its reliability.
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- 2022
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3. Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study
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Laurent Arnaud, Thierry Martin, Christelle Sordet, Jean Sibilia, Gilles Blaison, María González, Laurent Messer, Aurélien Schlencker, Julia Walther, Olivier Hinschberger, Marc Ardizzone, Etienne Dahan, Anne Dory, Stéphanie Kleinlogel, Aurélia Bramont-Nachman, Lionel Barrand, and Isabelle Payen-Revol
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Objective Among the most significant challenges in SLE are the excessive diagnosis delay and the lack of coordinated care. The aim of the study was to investigate patient pathways in SLE in order to improve clinical and organisational challenges in the management of those with suspected and confirmed SLE.Methods We conducted a cross-sectional study of patients with SLE, healthcare providers and other representative stakeholders. Focus groups were conducted, and based on the collected data the most impactful disruption points in SLE patient pathways were identified. A novel framework to improve individual patient pathways in SLE was developed, discussed and validated during a consensus meeting with representative stakeholders.Results Six thematic clusters regarding disruption in optimal patient pathways in SLE were identified: appropriate and timely referral strategy for SLE diagnosis; the need for a dedicated consultation during which the diagnosis of SLE would be announced, and following which clarifications and psychological support offered; individualised patient pathways with coordinated care based on organ involvement, disease severity and patient preference; improved therapeutic patient education; prevention of complications such as infections, osteoporosis and cancer; and additional patient support. During the consensus meeting, the broader panel of stakeholders achieved consensus on these attributes and a framework for optimising SLE patient pathways was developed.Conclusions We have identified significant disruption points and developed a novel conceptual framework to improve individual patient pathways in SLE. These data may be of valuable interest to patients with SLE, their physicians, health organisations as well as policy makers.
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- 2022
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4. Absence of Anti-Glomerular Basement Membrane Antibodies in 200 Patients With Systemic Lupus Erythematosus With or Without Lupus Nephritis: Results of the GOODLUPUS Study
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Nellie Bourse Chalvon, Pauline Orquevaux, Delphine Giusti, Gregory Gatouillat, Thierry Tabary, Marcelle Tonye Libyh, Jan Chrusciel, Moustapha Drame, Grace Stockton-Bliard, Zahir Amoura, Laurent Arnaud, Hanns-Martin Lorenz, Gilles Blaison, Bernard Bonnotte, Nadine Magy-Bertrand, Sabine Revuz, Reinhard Edmund Voll, Oliver Hinschberger, Andreas Schwarting, Bach Nga Pham, Thierry Martin, Jean-Loup Pennaforte, and Amelie Servettaz
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anti-glomerular basement membrane antibodies ,lupus nephritis ,Goodpasture disease ,anti-GBM antibodies ,anti-GBM glomerulonephritis ,systemic lupus erythematosus ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionAnti-glomerular basement membrane (GBM) antibodies are pathogenic antibodies first detected in renal-limited anti-GBM disease and in Goodpasture disease, the latter characterized by rapidly progressive crescentic glomerulonephritis combined with intra-alveolar hemorrhage. Studies have suggested that anti-GBM antibody positivity may be of interest in lupus nephritis (LN). Moreover, severe anti-GBM vasculitis cases in patients with systemic lupus erythematosus (SLE) have been described in the literature, but few studies have assessed the incidence of anti-GBM antibodies in SLE patients.ObjectiveThe main study objective was to determine if positive anti-GBM antibodies were present in the serum of SLE patients with or without proliferative renal damage and compared to a healthy control group.MethodologyThis retrospective study was performed on SLE patients’ sera from a Franco-German European biobank, developed between 2011 and 2014, from 17 hospital centers in the Haut-Rhin region. Patients were selected according to their renal involvement, and matched by age and gender. The serum from healthy voluntary blood donors was also tested. Anti-GBM were screened by fluorescence enzyme immunoassay (FEIA), and then by indirect immunofluorescence (IIF) in case of low reactivity detection (titer >6 U/ml).ResultsThe cohort was composed of 100 SLE patients with proliferative LN (27% with class III, 67% with class IV, and 6% with class V), compared to 100 SLE patients without LN and 100 controls. Patients were mostly Caucasian and met the ACR 1997 criteria and/or the SLICC 2012 criteria. Among the 300 tested sera, no significant levels of anti-GBM antibodies were detected (>10 U/ml) by the automated technique, three sera were found “ambivalent” (>7 U/ml): one in the SLE with LN group and two in the SLE without LN group. Subsequent IIF assays did not detect anti-GBM antibodies.ConclusionAnti-GBM antibodies were not detected in the serum of Caucasian patients with SLE, even in case of renal involvement, a situation favoring the antigenic exposure of glomerular basement membranes. Our results reaffirm the central role of anti-GBM antibodies as a specific diagnostic biomarker for Goodpasture vasculitis and therefore confirm that anti-GBM antibody must not be carried out in patients with SLE (with or without LN) in the absence of disease-suggestive symptoms.
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- 2020
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5. Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults
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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
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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.
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- 2018
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6. Characteristics of Adult Patients with Idiopathic Retroperitoneal Fibrosis and Assessment of Risk of Relapse at Diagnosis
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Jerome Razanamahery, Bastien Bouldoires, Sebastien Humbert, Philip Bielefeld, Veronique Fournier, Bernard Bonnotte, Gilles Blaison, and Nadine Magy-Bertrand
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idiopathic retroperitoneal fibrosis ,risk of relapse ,smoking cessation ,Medicine - Abstract
Objectives: To compare adult patients’ characteristics suffering from idiopathic retroperitoneal fibrosis between “relapse-free” and relapsing patients at the diagnosis and identify factors associated with relapse at initial presentation. Methods: We conducted a retrospective multicentric study in four hospitals in Eastern France, from 1993 to 2020, of adult patients suffering from idiopathic retroperitoneal fibrosis. We analyzed clinical, biological, and radiological features at diagnosis and during a forty-month follow-up. Results: Of 47 patients suffering from retroperitoneal fibrosis, 21 patients had idiopathic retroperitoneal fibrosis. Among them, 13 experienced one or more relapses during follow-up. At diagnosis, clinical characteristics, relevant comorbidities, biological and radiological features were similar between groups. Smoking cessation seems associated with decreased relapse risk (p: 0.0624). A total of 8 patients developed chronic renal failure during follow-up. Ureteral infiltration at diagnosis was associated with evolution to chronic renal failure (p: 0.0091). Conclusion: No clinical, biological, or radiological features could predict relapse at retroperitoneal fibrosis diagnosis, but smoking cessation may prevent relapse.
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- 2021
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7. Idiopathic pulmonary embolism in a case of severe family ANKRD26 thrombocytopenia
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Jérôme Guison, Gilles Blaison, Oana Stoica, Remy Hurstel, Marie Favier, and Remi Favier
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Ankyrin repeat domain 26 protein ,Blood platelets ,Platelet disorder, familial, with associated myeloid malignancy ,Pulmonary embolism ,Thrombocytopenia. ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Venous thrombosis affecting thrombocytopenic patients is challenging. We report the case of a thrombocytopenic woman affected by deep vein thrombosis and pulmonary embolism leading to the discovery of a heterozygous mutation in the gene encoding ankyrin repeat domain 26 (ANKRD26) associated with a heterozygous factor V (FV) Leiden mutation. This woman was diagnosed with left lower-limb deep vein thrombosis complicated by pulmonary embolism. Severe thrombocytopenia was observed. The genetic study evidenced a heterozygous FV Leiden mutation. Molecular study sequencing was performed after learning that her family had a history of thrombocytopenia. Previously described heterozygous mutation c-127C>A in the 5′ untranslated region (5′UTR) of the ANKRD26 gene was detected in the patient, her aunt, and her grandmother. ANKRD26-related thrombocytopenia and thrombosis are rare. This is, to our knowledge, the first case reported in the medical literature. This mutation should be screened in patients with a family history of thrombocytopenia.
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- 2017
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8. B cell signature during inactive systemic lupus is heterogeneous: toward a biological dissection of lupus.
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Jean-Claude Garaud, Jean-Nicolas Schickel, Gilles Blaison, Anne-Marie Knapp, Doulaye Dembele, Julie Ruer-Laventie, Anne-Sophie Korganow, Thierry Martin, Pauline Soulas-Sprauel, and Jean-Louis Pasquali
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Medicine ,Science - Abstract
Systemic lupus erythematosous (SLE) is an autoimmune disease with an important clinical and biological heterogeneity. B lymphocytes appear central to the development of SLE which is characterized by the production of a large variety of autoantibodies and hypergammaglobulinemia. In mice, immature B cells from spontaneous lupus prone animals are able to produce autoantibodies when transferred into immunodeficient mice, strongly suggesting the existence of intrinsic B cell defects during lupus. In order to approach these defects in humans, we compared the peripheral B cell transcriptomas of quiescent lupus patients to normal B cell transcriptomas. When the statistical analysis is performed on the entire group of patients, the differences between patients and controls appear quite weak with only 14 mRNA genes having a false discovery rate ranging between 11 and 17%, with 6 underexpressed genes (PMEPA1, TLR10, TRAF3IP2, LDOC1L, CD1C and EGR1). However, unforced hierarchical clustering of the microarrays reveals a subgroup of lupus patients distinct from both the controls and the other lupus patients. This subgroup has no detectable clinical or immunological phenotypic peculiarity compared to the other patients, but is characterized by 1/an IL-4 signature and 2/the abnormal expression of a large set of genes with an extremely low false discovery rate, mainly pointing to the biological function of the endoplasmic reticulum, and more precisely to genes implicated in the Unfolded Protein Response, suggesting that B cells entered an incomplete BLIMP1 dependent plasmacytic differentiation which was undetectable by immunophenotyping. Thus, this microarray analysis of B cells during quiescent lupus suggests that, despite a similar lupus phenotype, different biological roads can lead to human lupus.
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- 2011
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9. Patterns of fatigue and association with disease activity and clinical manifestations in systemic lupus erythematosus
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Jean Sibilia, Reinhard E. Voll, Hanns-Martin Lorenz, Thierry Martin, Bernard Bonnotte, Gilles Blaison, Zahir Amoura, Anne-Sophie Korganow, Andreas Schwarting, Laurent Arnaud, Vincent Poindron, Philippe Mertz, François Maurier, and Christoph Fiehn
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Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,Mixed anxiety-depressive disorder ,Anxiety ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Interquartile range ,Internal medicine ,Prevalence ,medicine ,Cluster Analysis ,Humans ,Lupus Erythematosus, Systemic ,Pharmacology (medical) ,030212 general & internal medicine ,Fatigue ,Depression (differential diagnoses) ,030203 arthritis & rheumatology ,Systemic lupus erythematosus ,Lupus erythematosus ,Depression ,business.industry ,Middle Aged ,medicine.disease ,Latent class model ,Patient Outcome Assessment ,Cohort ,Female ,medicine.symptom ,business - Abstract
Objective The prevalence of fatigue is high in patients with systemic lupus erythematosus (SLE). In this study, we used latent class analysis to reveal patterns of fatigue, anxiety, depression and organ involvement in a large international cohort of SLE patients. Methods We used the Lupus BioBank of the upper Rhein to analyse patterns of fatigue using latent class analysis (LCA). After determining the optimal number of latent classes, patients were assigned according to model generated probabilities, and characteristics of classes were compared. Results A total of 502 patients were included. Significant fatigue, anxiety and depression were reported by 341 (67.9%), 159 (31.7%) and 52 (10.4%) patients, respectively. LCA revealed a first cluster (67.5% of patients) with low disease activity [median (25th–75th percentile interquartile range) Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI: 2 (0–4)], significant fatigue (55.5%, P Conclusion LCA revealed three patterns of fatigue with important practical implications. Based on these, it is crucial to distinguish patients with active disease (in whom remission will be achieved) from those with no or mild activity but high levels of fatigue, depression and anxiety, for whom psychological counselling should be prioritized.
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- 2020
10. Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus
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Philippe Mertz, Matteo Piga, Elisabetta Chessa, Zahir Amoura, Reinhard E Voll, Andreas Schwarting, Francois Maurier, Gilles Blaison, Bernard Bonnotte, Vincent Poindron, Christoph Fiehn, Hanns-Martin Lorenz, Anne-Sophie Korganow, Jean Sibilia, Thierry Martin, and Laurent Arnaud
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Adult ,Male ,Immunology ,Reproducibility of Results ,Estrogens ,Middle Aged ,Severity of Illness Index ,United States ,Cross-Sectional Studies ,Rheumatology ,Physicians ,Immunology and Allergy ,Humans ,Lupus Erythematosus, Systemic ,Female ,Fatigue - Abstract
ObjectivesTo analyse whether reported fatigue, one of the most challenging manifestations of systemic lupus erythematosus (SLE), may bias the assessment of disease activity in SLE according to the Physician Global Assessment (PGA).MethodsPatients from the Lupus BioBank of the upper Rhein database, a cross-sectional multicentre collection of detailed clinical and biological data from patients with SLE, were included. Patients had to fulfil the 1997 American College of Rheumatology criteria for SLE and the PGA (0–3 scale) at the time of inclusion had to be available. Fatigue was assessed according to the Fatigue Scale for Motor and Cognitive Functions. Univariate and multivariate regression models were built to determine which variables were associated with the PGA.ResultsA total of 350 patients (89% female; median age: 42 years, IQR: 34–52) were included. The median Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score was 4 (IQR: 2–6). Of these 350 patients, 257 (73%) reported significant fatigue. The PGA (p=0.004) but not the SELENA-SLEDAI (p=0.43) was significantly associated with fatigue. Both fatigue and SELENA-SLEDAI were independently associated with the PGA in two different multivariate models.ConclusionFatigue is independently associated with disease activity assessed using the PGA but not the SLEDAI. These findings highlight the fact that the PGA should capture only objectively active disease manifestations in order to improve its reliability.
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- 2022
11. Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study
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Aurelien Schlencker, Laurent Messer, Marc Ardizzone, Gilles Blaison, Olivier Hinschberger, Etienne Dahan, Christelle Sordet, Julia Walther, Anne Dory, Maria Gonzalez, Stéphanie Kleinlogel, Aurélia Bramont-Nachman, Lionel Barrand, Isabelle Payen-Revol, Jean Sibilia, Thierry Martin, and Laurent Arnaud
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Cross-Sectional Studies ,Immunology ,Humans ,Lupus Erythematosus, Systemic ,General Medicine ,Focus Groups ,Severity of Illness Index - Abstract
ObjectiveAmong the most significant challenges in SLE are the excessive diagnosis delay and the lack of coordinated care. The aim of the study was to investigate patient pathways in SLE in order to improve clinical and organisational challenges in the management of those with suspected and confirmed SLE.MethodsWe conducted a cross-sectional study of patients with SLE, healthcare providers and other representative stakeholders. Focus groups were conducted, and based on the collected data the most impactful disruption points in SLE patient pathways were identified. A novel framework to improve individual patient pathways in SLE was developed, discussed and validated during a consensus meeting with representative stakeholders.ResultsSix thematic clusters regarding disruption in optimal patient pathways in SLE were identified: appropriate and timely referral strategy for SLE diagnosis; the need for a dedicated consultation during which the diagnosis of SLE would be announced, and following which clarifications and psychological support offered; individualised patient pathways with coordinated care based on organ involvement, disease severity and patient preference; improved therapeutic patient education; prevention of complications such as infections, osteoporosis and cancer; and additional patient support. During the consensus meeting, the broader panel of stakeholders achieved consensus on these attributes and a framework for optimising SLE patient pathways was developed.ConclusionsWe have identified significant disruption points and developed a novel conceptual framework to improve individual patient pathways in SLE. These data may be of valuable interest to patients with SLE, their physicians, health organisations as well as policy makers.
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- 2022
12. Intravenous Immunoglobulins Tapering and Withdrawal in Systemic Capillary Leak Syndrome (Clarkson Disease)
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Quentin Moyon, Marc Pineton de Chambrun, Marie Gousseff, Alexis Mathian, Miguel Hie, Geoffrey Urbanski, Franco Verlicchi, Stanislas Faguer, Antoine Dossier, Jean-Christophe Lega, Sophie Riviere, David Saadoun, Julie Graveleau, Marie-Josée Lucchini-Lecomte, Christine Christides, Sylvie Le Moal, Béatrice Bibes, Giuseppe Malizia, Marc Ruivard, Gilles Blaison, Laurent Alric, Christian Agard, Martin Soubrier, Jean-François Viallard, Hervé Levesque, Georges-Etienne Rivard, Nathalie Tieulie, Arnaud Hot, Pierre-Yves Lovey, Thomas Hanslik, François Lhote, Vincent Eble, Jorge Álvarez Troncoso, Avinash Aujayeb, Paul Quentric, Dov Taieb, Fleur Cohen-Aubart, Marc Lambert, Zahir Amoura, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), 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], 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), Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Institut des Maladies Métaboliques et Casdiovasculaires (UPS/Inserm U1297 - I2MC), 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), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière] (I3), CHU Charles Foix [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 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)-Sorbonne Université (SU), Centre hospitalier de Saint-Nazaire, Centre Hospitalier Henri Duffaut (Avignon), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Hôpital pasteur [Colmar], Université de Toulouse (UT), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre de recherche du CHU Sainte-Justine / Research Center of the Sainte-Justine University Hospital [Montreal, Canada], Université de Montréal (UdeM)-CHU Sainte Justine [Montréal], Hôpital Pasteur [Nice] (CHU), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de médecine interne [CHU Ambroise Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier Eure-Seine - Hôpital d'Evreux - Vernon (Evreux), CHU Lille, SNFMI-2021, This clinical research was supported by a grant from Octapharma to the Association pour la Recherche, l'Enseignement et la Thérapeutique en Médecine Interne (ARTHEMI) but all treatment decisions, including intravenous immunoglobulin (IVIG) type, were left at physician's discretion. Conflicts of interest: M. Pineton de Chambrun was supported for this study by a grant from La Société Française Nationale de Médecine Interne (SNFMI-2021). The rest of the authors declare that they have no relevant conflicts of interest., Conflicts of interest: M. Pineton de Chambrun was supported for this study by a grant from La Société Française Nationale de Médecine Interne (SNFMI-2021). The rest of the authors declare that they have no relevant conflicts of interest., and This clinical research was supported by a grant from Octapharma to the Association pour la Recherche, l’Enseignement et la Thérapeutique en Médecine Interne (ARTHEMI) but all treatment decisions, including intravenous immunoglobulin (IVIG) type, were left at physician’s discretion.
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Adult ,Incidence ,[SDV]Life Sciences [q-bio] ,Paraproteinemias ,Immunoglobulins, Intravenous ,Tapering ,Intravenous immunoglobulins ,Middle Aged ,Withdrawal ,Systemic capillary leak syndrome ,Humans ,Immunology and Allergy ,Capillary Leak Syndrome ,Clarkson disease ,Retrospective Studies - Abstract
International audience; Background: The systemic capillary leak syndrome (SCLS), also known as Clarkson disease, is a very rare condition characterized by recurrent life-threatening episodes of vascular hyperpermeability in the presence of a monoclonal gammopathy. Extended intravenous immunoglobulin (IVIG) treatment is associated with fewer recurrences and improved survival, but the optimal treatment dosage and duration remain unknown. Objective: We aim to evaluate the safety of IVIG tapering and withdrawal in patients with SCLS. Methods: We conducted a retrospective multicenter study including all adult patients with monoclonal gammopathy–associated SCLS from the EurêClark registry who received at least 1 course of IVIG. The primary end point was overall survival according to IVIG withdrawal. Results: Fifty-nine patients of mean ± SD age 51 ± 13 years were included. Overall cumulative probabilities of 2-, 5-, 10- and 15-year survival were 100%, 85%, 72%, 44%, respectively. The IVIG was withdrawn at least once in 18 patients (31%; W+ group) and never in 41 patients (69%; W– group). Cumulative probabilities of 10-year survival in W+ versus W– groups were 50% and 83% (log rank test, P = .02), respectively. Relapse rate and the median number of relapses in the W+ versus the W– groups were 72% versus 58% (P = 0.3) and 2.5 (0.3–4) versus 1 (0–2) (P = .03), respectively. The IVIG tapering was not statistically associated with increased person-year incidence of attacks using a mixed linear model. Conclusions: The IVIG withdrawal was associated with increased mortality and higher rate of recurrence in SCLS patients. The IVIG tapering might be cautiously considered in stable SCLS patients.
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- 2022
13. The consequences of COVID-19 pandemic on patients with monoclonal gammopathy-associated systemic capillary leak syndrome (Clarkson disease)
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Marc Pineton de Chambrun, Quentin Moyon, Stanislas Faguer, Geoffrey Urbanski, Alexis Mathian, Noémie Zucman, Marie Werner, Charles-Edouard Luyt, Franco Verlicchi, Zahir Amoura, Marie Gousseff, Wladimir Mauhin, Arnaud Hot, Jean-Christophe Lega, Marc Lambert, Sophie Riviere, Antoine Dossier, Marc Ruivard, François Lhote, Gilles Blaison, Sybille Merceron, Nathalie Zapella, Laurent Alric, Christian Agard, Mathieu Lacout, David Saadoun, Julie Graveleau, Martin Soubrier, Julien Haroche, Julien Boileau, Marie-Josee Lucchini-Lecomte, Thomas Hanslik, Christine Christides, Hervé Levesque, Aline Talasczka, Caroline Bulte, Eric Hachulla, Olivier Decaux, Romain Sonneville, Florent Ibouanga, Bertrand Arnulf, Marcel Benedit, Jean François Viallard, Nathalie Tieulie, Fadi Haddad, Bruno Moulin, Fleur Cohen-Aubert, Pierre-Yves Lovey, Sylvie le Moal, Béatrice Bibes, Georges-Etienne Rivard, Eric Rondeau, Giuseppe Malizia, Philippe Debourdeau, Pierre Abgueguen, Annick Bosseray, Jérôme Devaquet, Claire Presne, François Liferman, Nicolas Limal, Laurent Argaud, Romain Hernu, Sylvie de la Salle, Jorge Álvarez Troncoso, John Harty, Pascal Godmer, Miguel Hie, Thomas Papo, and Pierre-Yves Hatron
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SARS-CoV-2 ,systemic capillary-leak syndrome ,Paraproteinemias ,Immunology and Allergy ,COVID-19 ,Humans ,Clinical Communications ,Clarkson’s disease ,vaccination ,Pandemics ,Capillary Leak Syndrome - Published
- 2021
14. Disease-specific quality of life following a flare in systemic lupus erythematosus: an item response theory analysis of the French EQUAL cohort
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Nadine Magy-Bertrand, Gilles Blaison, Pascal Sève, Thierry Martin, Marie Corneloup, Sabine Berthier, Jean-Loup Pennaforte, Géraldine Muller, Abderrahmane Bourredjem, François Maurier, Hervé Devilliers, Zahir Amoura, Denis Wahl, Olivier Aumaître, and Laurent Arnaud
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Adult ,Male ,medicine.medical_specialty ,Logistic regression ,law.invention ,Disease activity ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Quality of life ,law ,Item response theory ,Humans ,Lupus Erythematosus, Systemic ,Medicine ,Pharmacology (medical) ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,030203 arthritis & rheumatology ,business.industry ,Physical health ,Middle Aged ,Symptom Flare Up ,Clinical trial ,Logistic Models ,Latent Class Analysis ,Cohort ,Quality of Life ,Physical therapy ,Female ,France ,business ,Flare - Abstract
Objective To explore, at an item-level, the effect of disease activity (DA) on specific health-related quality of life (HRQoL) in SLE patients using an item response theory longitudinal model. Methods This prospective longitudinal multicentre French cohort EQUAL followed SLE patients over 2 years. Specific HRQoL according to LupusQoL and SLEQOL was collected every 3 months. DA according to SELENA-SLEDAI flare index (SFI) and revised SELENA-SLEDAI flare index (SFI-R) was evaluated every 6 months. Regarding DA according to SFI and each SFI-R type of flare, specific HRQoL of remitting patients was compared with non-flaring patients fitting a linear logistic model with relaxed assumptions for each domain of the questionnaires. Results Between December 2011 and July 2015, 336 patients were included (89.9% female). LupusQoL and SLEQOL items related to physical HRQoL (physical health, physical functioning, pain) were most affected by musculoskeletal and cutaneous flares. Cutaneous flares had significant influence on self-image. Neurological or psychiatric flares had a more severe impact on specific HRQoL. Patient HRQoL was impacted up to 18 months after a flare. Conclusion Item response theory analysis is able to pinpoint items that are influenced by a given patient group in terms of a latent trait change. Item-level analysis provides a new way of interpreting HRQoL variation in SLE patients, permitting a better understanding of DA impact on HRQoL. This kind of analysis could be easily implemented for the comparison of groups in a clinical trial. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov, NCT01904812.
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- 2019
15. Evaluation of Rituximab for Induction and Maintenance Therapy in Patients 75 Years and Older With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis
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Sara, Thietart, Alexandre, Karras, Jean-François, Augusto, Carole, Philipponnet, Pierre-Louis, Carron, Xavier, Delbrel, Rafik, Mesbah, Gilles, Blaison, Pierre, Duffau, Khalil, El Karoui, Perrine, Smets, Jonathan, London, Luc, Mouthon, Loïc, Guillevin, Benjamin, Terrier, Xavier, Puéchal, and Stéphane, Vinzio
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Cohort Studies ,Treatment Outcome ,Recurrence ,Humans ,Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ,Female ,General Medicine ,Rituximab ,Glucocorticoids ,Aged ,Antibodies, Antineutrophil Cytoplasmic - Abstract
Older patients are underrepresented in studies of rituximab for the treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Little is known about outcomes and adverse events associated with the use of rituximab therapy among patients 75 years and older with ANCA-associated vasculitis.To examine outcomes and adverse events associated with the use of rituximab therapy in patients 75 years and older with ANCA-associated vasculitis, specifically granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA).This multicenter cohort study involved 93 patients 75 years and older with ANCA-associated vasculitis from 36 university and nonuniversity hospitals in France. Data were obtained from the French Vasculitis Study Group database between January 1, 2000, and July 1, 2018, and a call for observation sent to French Vasculitis Study Group members on June 6, 2019. Data analysis was performed from November 15 to December 31, 2021. Inclusion criteria included a diagnosis of GPA or MPA according to European Medicines Agency classification criteria and receipt of treatment with rituximab after age 75 years. Patients were excluded if they were missing relevant clinical or biological data. Data on race and ethnicity were not reported because inclusion of this information was not authorized by the ethics committee.At least 1 infusion of rituximab as induction or maintenance therapy.Occurrence of remission, relapse, drug discontinuation, death, and serious infections (including types of serious infections).Of 238 patients screened, 93 were included (median [IQR] age, 79.4 [76.7-83.1] years; 51 women [54.8%]); 52 patients (55.9%) had a diagnosis of GPA, and 41 (44.1%) had a diagnosis of MPA. Thirty patients (32.3%) received rituximab as induction therapy in combination with high-dose glucocorticoid regimens, 27 (29.0%) received rituximab as maintenance therapy, and 36 (38.7%) received rituximab as both induction and maintenance therapy. The median (IQR) follow-up was 2.3 (1.1-4.0) years. Among 66 patients who received rituximab as induction therapy, 57 (86.4%) achieved remission, and 2 (3.0%) experienced relapses. The incidence of serious infection was significantly higher when rituximab was used as induction therapy vs maintenance therapy (46.6 [95% CI, 24.8-79.7] per 100 patient-years vs 8.4 [95% CI, 3.8-15.9] per 100 patient-years; P = .004). Most infections (12 of 22 [54.5%]) were gram-negative bacterial infections. The incidence of death was 19.7 (95% CI, 7.2-42.9) per 100 patient-years among those who received rituximab as induction therapy and 5.3 (95% CI, 1.9-11.6) per 100 patient-years among those who received rituximab as maintenance therapy.In this cohort study, rituximab therapy was associated with achievement and maintenance of remission in most patients 75 years and older with ANCA-associated vasculitis. The incidence of serious infections and death was high when rituximab was used as induction therapy in combination with high-dose glucocorticoid regimens but not when rituximab was used as maintenance therapy. Efforts might focus on reducing serious infections during the first months of therapy.
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- 2022
16. COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study
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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)
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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.
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- 2021
17. Characteristics of Adult Patients with Idiopathic Retroperitoneal Fibrosis and Assessment of Risk of Relapse at Diagnosis
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Sébastien Humbert, Philip Bielefeld, Nadine Magy-Bertrand, Bastien Bouldoires, Bernard Bonnotte, Veronique Fournier, Jerome Razanamahery, and Gilles Blaison
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medicine.medical_specialty ,medicine.medical_treatment ,risk of relapse ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Retroperitoneal fibrosis ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,idiopathic retroperitoneal fibrosis ,medicine ,Relapse risk ,Idiopathic Retroperitoneal Fibrosis ,030203 arthritis & rheumatology ,Adult patients ,business.industry ,lcsh:R ,General Medicine ,medicine.disease ,smoking cessation ,Radiological weapon ,Smoking cessation ,Chronic renal failure ,medicine.symptom ,business ,Infiltration (medical) - Abstract
Objectives: To compare adult patients’ characteristics suffering from idiopathic retroperitoneal fibrosis between “relapse-free” and relapsing patients at the diagnosis and identify factors associated with relapse at initial presentation. Methods: We conducted a retrospective multicentric study in four hospitals in Eastern France, from 1993 to 2020, of adult patients suffering from idiopathic retroperitoneal fibrosis. We analyzed clinical, biological, and radiological features at diagnosis and during a forty-month follow-up. Results: Of 47 patients suffering from retroperitoneal fibrosis, 21 patients had idiopathic retroperitoneal fibrosis. Among them, 13 experienced one or more relapses during follow-up. At diagnosis, clinical characteristics, relevant comorbidities, biological and radiological features were similar between groups. Smoking cessation seems associated with decreased relapse risk (p: 0.0624). A total of 8 patients developed chronic renal failure during follow-up. Ureteral infiltration at diagnosis was associated with evolution to chronic renal failure (p: 0.0091). Conclusion: No clinical, biological, or radiological features could predict relapse at retroperitoneal fibrosis diagnosis, but smoking cessation may prevent relapse.
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- 2021
18. Interleukin 6 receptor inhibition in primary Sjögren syndrome: a multicentre double-blind randomised placebo-controlled trial
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Christophe Richez, S. Rist, Christelle Sordet, Valérie Devauchelle-Pensec, Aleth Perdriger, Jacques Morel, Azeddine Dellal, Claire Larroche, Alain Saraux, Carine Salliot, Arsène Mekinian, Raphaèle Seror, Philippe Dieudé, Jean Sibilia, David Saadoun, Thierry Martin, Renaud Felten, Eric Hachulla, Charles Zarnitsky, Emanuelle Dernis, A. Contis, P. Kieffer, Patrice Cacoub, Jean-Marie Berthelot, Mira Y Tawk, Olivier Vittecoq, Lise Holterbach, Ouafaa Aberkane, Véronique Le Guern, Gilles Blaison, Nicolas Meyer, Cécile Arnold, Emmanuel Chatelus, François Maurier, Hatron Pierre Yves, Emmanuel Andrès, Pierre Duffau, Xavier Mariette, Jacques-Eric Gottenberg, Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Rhumatologie [CHU Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional d'Orléans (CHRO), CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Génétique Moléculaire de Montpellier (IGMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Interne [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Service de rhumatologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de rhumatologie [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Rhumatologie [CH Le Mans], Centre Hospitalier Le Mans (CH Le Mans), Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Service de médecine interne [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, CHU Strasbourg, Groupe Hospitalier du Havre Hôpital Jacques Monod (MONTIVILLIERS) (GHH), CH Colmar, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hôpital Sainte Blandine, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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medicine.medical_specialty ,Immunology ,Population ,Placebo-controlled study ,Placebo ,Severity of Illness Index ,General Biochemistry, Genetics and Molecular Biology ,Double blind ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Double-Blind Method ,Rheumatology ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,10. No inequality ,education ,Primary Sjögren Syndrome ,030203 arthritis & rheumatology ,education.field_of_study ,business.industry ,Middle Aged ,Receptors, Interleukin-6 ,cytokines ,3. Good health ,chemistry ,[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,Sjogren's syndrome ,biological therapy ,Interleukin-6 receptor ,Female ,business - Abstract
ObjectivesNo immunomodulatory drug has been approved for primary Sjögren’s syndrome, a systemic autoimmune disease affecting 0.1% of the population. To demonstrate the efficacy of targeting interleukin 6 receptor in patients with Sjögren’s syndrome-related systemic complications.MethodsMulticentre double-blind randomised placebo-controlled trial between 24 July 2013 and 16 July 2018, with a follow-up of 44 weeks, involving 17 referral centres. Inclusion criteria were primary Sjögren’s syndrome according to American European Consensus Group criteria and score ≥5 for the EULAR Sjögren’s Syndrome Disease activity Index (ESSDAI, score of systemic complications). Patients were randomised to receive either 6 monthly infusions of tocilizumab or placebo. The primary endpoint was response to treatment at week 24. Response to treatment was defined by the combination of (1) a decrease of at least 3 points in the ESSDAI, (2) no occurrence of moderate or severe activity in any new domain of the ESSDAI and (3) lack of worsening in physician’s global assessment on a Visual Numeric Scale ≥1/10, all as compared with enrolment.Results110 patients were randomised, 55 patients to tocilizumab (mean (SD) age: 50.9 (12.4) years; women: 98.2%) and 55 patients to placebo (54.8 (10.7) years; 90.9%). At 24 weeks, the proportion of patients meeting the primary endpoint was 52.7% (29/55) in the tocilizumab group and 63.6% (35/55) in the placebo group, for a difference of −11.4% (95% credible interval −30.6 to 9.0) (Pr[Toc >Pla]=0.14).ConclusionAmong patients with primary Sjögren’s syndrome, the use of tocilizumab did not improve systemic involvement and symptoms over 24 weeks of treatment compared with placebo.Trial registration numberNCT01782235.
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- 2021
19. Prevalence of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and Spatial Association With Quarries in a Region of Northeastern France: A Capture-Recapture and Geospatial Analysis
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P.E. Gavand, Y. Dimitrov, Frédéric de Blay, Christian Debry, Dan Lipsker, Gilles Blaison, Yves Hansmann, Jean-Christophe Weber, Olivier Imhoff, Emmanuel Andrès, Benoit Nespola, Hanta Nirina Rakotoarivelo, François Chantrel, Bruno Moulin, Thierry Hannedouche, Yannick Dieudonné, Jacques-Eric Gottenberg, Caroline Lohmann, Olivier Hinschberger, Stéphane Giorgiutti, Anne-Sophie Korganow, Thierry Martin, J. Campagne, Aurélien Guffroy, Laurent Arnaud, François Mathiaux, Alexandre Klein, Marie-Caroline Dalmas, and Vincent Poindron
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Immunology ,Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Rheumatology ,Proteinase 3 ,Internal medicine ,medicine ,Prevalence ,Immunology and Allergy ,Humans ,10. No inequality ,Child ,030304 developmental biology ,Anti-neutrophil cytoplasmic antibody ,Aged ,030203 arthritis & rheumatology ,Aged, 80 and over ,0303 health sciences ,business.industry ,Odds ratio ,Environmental Exposure ,Middle Aged ,medicine.disease ,Confidence interval ,3. Good health ,Female ,France ,Vasculitis ,Microscopic polyangiitis ,Granulomatosis with polyangiitis ,business - Abstract
OBJECTIVE Silica is an environmental substance strongly linked with autoimmunity. The aim of this study was to assess the prevalence of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and renal limited vasculitis, in a northeastern region of France and to evaluate whether there was a geospatial association between the localization of quarries in the region and the prevalence of these AAVs. METHODS Potential AAV patients were identified using 3 sources: hospital records, immunology laboratories, and the French National Health Insurance System. Patients who resided in the Alsace region of France as of January 1, 2016 and who fulfilled the American College of Rheumatology criteria for GPA or the 2012 Chapel Hill Consensus Conference definitions for GPA or MPA were included. Incomplete case ascertainment was corrected using a capture-recapture analysis. The spatial association between the number of cases and the presence of quarries in each administrative entity was assessed using regression analyses weighted for geographic region. RESULTS Among 910 potential AAV patients, we identified 185 patients fulfilling inclusion criteria: 120 patients with GPA, 35 patients with MPA, and 30 patients with renal limited vasculitis. The number of cases missed by any source as estimated by capture-recapture analysis was 6.4 (95% confidence interval [95% CI] 3.6-11.5). Accordingly, the estimated prevalence in Alsace in 2016 was 65.5 GPA cases per million inhabitants (95% CI 47.3-93.0), 19.1 MPA cases per million inhabitants (95% CI 11.3-34.3), and 16.8 renal limited vasculitis cases per million inhabitants (95% CI 8.7-35.2). The risk of AAV was significantly increased in communities with quarries (odds ratio 2.51 [95% CI 1.66-3.80]), and geographic-weighted regression analyses revealed a significant spatial association between the proximity to quarries and the number of GPA cases (P = 0.039). In analyses stratifying the AAV patients by ANCA serotype, a significant association between the presence of quarries and positivity for both proteinase 3 ANCAs (P = 0.04) and myeloperoxidase ANCAs (P = 0.03) was observed. CONCLUSION In a region with a high density of quarries, the spatial association between the presence of and proximity to quarries and the prevalence of AAVs supports the idea that silica may have a role as a specific environmental factor in this disease.
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- 2020
20. Absence of Anti-Glomerular Basement Membrane Antibodies in 200 Patients With Systemic Lupus Erythematosus With or Without Lupus Nephritis: Results of the GOODLUPUS Study
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Bernard Bonnotte, P. Orquevaux, Bach Nga Pham, Zahir Amoura, S. Revuz, Delphine Giusti, Laurent Arnaud, Moustapha Dramé, Gilles Blaison, Marcelle Tonye Libyh, Thierry Martin, Hanns-Martin Lorenz, Nadine Magy-Bertrand, Grace Stockton-Bliard, Reinhard E. Voll, Amélie Servettaz, Grégory Gatouillat, Jan Chrusciel, Nellie Bourse Chalvon, Jean-Loup Pennaforte, Andreas Schwarting, Thierry Tabary, Oliver Hinschberger, Centre Hospitalier Universitaire de Reims (CHU Reims), Immuno-Régulation dans les Maladies Auto-Immunes Inflammatoires et le Cancer - EA 7509 (IRMAIC), and Université de Reims Champagne-Ardenne (URCA)
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Male ,Anti-Glomerular Basement Membrane Disease ,[SDV]Life Sciences [q-bio] ,Lupus nephritis ,Aucun ,urologic and male genital diseases ,Severity of Illness Index ,Gastroenterology ,anti-glomerular basement membrane antibodies ,0302 clinical medicine ,systemic lupus erythematosus ,Lupus Erythematosus, Systemic ,Immunology and Allergy ,030212 general & internal medicine ,Original Research ,medicine.diagnostic_test ,biology ,anti-GBM glomerulonephritis ,Glomerular basement membrane ,IIf ,Middle Aged ,3. Good health ,Titer ,medicine.anatomical_structure ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Female ,Antibody ,Vasculitis ,Adult ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Immunology ,03 medical and health sciences ,Antigen ,Internal medicine ,anti-GBM antibodies ,medicine ,Humans ,Autoantibodies ,Retrospective Studies ,030203 arthritis & rheumatology ,lupus nephritis ,business.industry ,Goodpasture disease ,medicine.disease ,Case-Control Studies ,Immunoassay ,biology.protein ,business ,lcsh:RC581-607 ,Biomarkers - Abstract
IntroductionAnti-glomerular basement membrane (GBM) antibodies are pathogenic antibodies first detected in renal-limited anti-GBM disease and in Goodpasture disease, the latter characterized by rapidly progressive crescentic glomerulonephritis combined with intra-alveolar hemorrhage. Studies have suggested that anti-GBM antibody positivity may be of interest in lupus nephritis (LN). Moreover, severe anti-GBM vasculitis cases in patients with systemic lupus erythematosus (SLE) have been described in the literature, but few studies have assessed the incidence of anti-GBM antibodies in SLE patients.ObjectiveThe main study objective was to determine if positive anti-GBM antibodies were present in the serum of SLE patients with or withoutproliferativerenal damage and compared to a healthy control group.MethodologyThis retrospective study was performed on SLE patients’ sera from a Franco-German European biobank, developed between 2011 and 2014, from 17 hospital centers in the Haut-Rhin region. Patients were selected according to their renal involvement, and matched by age and gender. The serum from healthy voluntary blood donors was also tested. Anti-GBM were screened by fluorescence enzyme immunoassay (FEIA), and then by indirect immunofluorescence (IIF) in case of low reactivity detection (titer >6 U/ml).ResultsThe cohort was composed of 100 SLE patients withproliferativeLN (27% with class III, 67% with class IV, and 6% with class V), compared to 100 SLE patients without LN and 100 controls. Patients were mostly Caucasian and met the ACR 1997 criteria and/or the SLICC 2012 criteria. Among the 300 tested sera, no significant levels of anti-GBM antibodies were detected (>10 U/ml) by the automated technique, three sera were found “ambivalent” (>7 U/ml): one in the SLE with LN group and two in the SLE without LN group. Subsequent IIF assays did not detect anti-GBM antibodies.ConclusionAnti-GBM antibodies were not detected in the serum of Caucasian patients with SLE, even in case of renal involvement, a situation favoring the antigenic exposure of glomerular basement membranes. Our results reaffirm the central role of anti-GBM antibodies as a specific diagnostic biomarker for Goodpasture vasculitis and therefore confirm that anti-GBM antibody must not be carried out in patients with SLE (with or without LN) in the absence of disease-suggestive symptoms.
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- 2020
21. The value of screening for asymptomatic relatives of an index patient affected by symptomatic hereditary thrombophilia
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Gilles Blaison, Florence Durr, and Emmanuel Andrès
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Pediatrics ,medicine.medical_specialty ,Index (economics) ,Patient affected ,business.industry ,medicine ,Hereditary thrombophilia ,Hematology ,medicine.symptom ,business ,Asymptomatic ,Value (mathematics) - Abstract
La maladie thromboembolique veineuse etant relativement frequente et source d’une morbi-mortalite importante, la question du depistage des thrombophilies hereditaires se pose, d’autant que des moyens potentiels de prevention existent. Cette question reste controversee et debattue chez les apparentes asymptomatiques d’un cas-index porteur d’une thrombophilie hereditaire symptomatique. Les recommandations actuelles reposent sur de faibles niveaux de preuves. Theoriquement, ce depistage pourrait aboutir a une diminution du nombre d’evenements thromboemboliques veineux sous reserve de la mise en place d’une thromboprophylaxie. Toutefois, dans cette population, le benefice sur la mortalite de cette thromboprophylaxie n’est pas, a ce jour, clairement etabli, cette derniere exposant en outre a un risque hemorragique en cas d’utilisation d’antiagregants plaquettaires et/ou d’anticoagulants. Dans ce cadre, la mise a disposition des anticoagulants oraux directs va peut-etre bousculer ces certitudes et dans tous les cas donner lieu a de nouvelles etudes. Dans tous les cas, cela nous amene a reevaluer cette question au regard de la litterature factuelle (etudes prospectives).
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- 2018
22. Prognostic factors of survival in patients with non-infectious mixed cryoglobulinaemia vasculitis: data from 242 cases included in the CryoVas survey
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Terrier, Benjamin, Carrat, Fabrice, Krastinova, Evguenia, Marie, Isabelle, Launay, David, Lacraz, Adeline, Belenotti, Pauline, de Saint Martin, Luc, Quemeneur, Thomas, Huart, Antoine, Bonnet, Fabrice, Le Guenno, Guillaume, Kahn, Jean-Emmanuel, Hinschberger, Olivier, Rullier, Patricia, Hummel, Aurelie, Diot, Elisabeth, Pagnoux, Christian, Lzaro, Estibaliz, Bridoux, Frank, Zenone, Thierry, Hermine, Olivier, Leger, Jean-Marc, Mariette, Xavier, Senet, Patricia, Plaisier, Emmanuelle, Cacoub, Patrice, Laurent, Aaron, Sébastien, Abad, Redouane, Bakir, Pauline, Belenotti, Lucas, Benarous, Nathalie, Beneton, Gilles, Blaison, Claire, Blanchard-Delaunay, Fabrice, Bonnet, Frank, Bridoux, Patrice, Cacoub, Pascal, Cathébras, Fabrice, Carrat, Laurent, Chiche, Olivier, Chosidow, Bernard, Combe, Christian, Combe, Nathalie, Costedoat-Chalumeau, Pierre, Cougoul, Bernard, Cribier, Gilles, Defuentes, Elisabeth, Diot, Isabelle, Durieu, Philippe, Evon, Thibault, Fraisse, Camille, Francès, Hélène, Francois, Thierry, Frouget, Loik, Geffray, Helder, Gil, Jean, Gutnecht, Eric, Hachulla, Olivier, Hermine, Olivier, Hinschberger, Arnaud, Hot, Antoine, Huart, Aurélie, Hummel, Jean-Emmanuel, Kahn, Gilles, Kaplanski, Alexandre, Karras, Evguenia, Krastinova, Adeline, Lacraz, Claire, Larroche, David, Launay, Estibaliz, Lazaro, Guillaume, Le Guenno, Véronique, Leblond, Jean-Marc, Léger, Nicolas, Limal, Eric, Liozon, Catherine, Lok, Véronique, Loustau-Ratti, Kim, Ly, Hervé, Maillard, Raifah, Makdassi, Isabelle, Marie, Xavier, Mariette, Olivier, Meyer, Catherine, Michel, Philippe, Modiano, David, Noel, Raphaele, Nove-Josserand, Céline, Onno, Christian, Pagnoux, Caroline, Pajot, Géraldine, Perceau, Antoinette, Perlat, Anne-Marie, Piette, Emmanuelle, Plaisier, Jean-François, Pouget-Abadie, Thomas, Quemeneur, Viviane, Queyrel, Joseph, Rivalan, Eric, Rondeau, Patricia, Rullier, Luc, de Saint-Martin, Elisabeth, Salles-Thomasson, Françoise, Sarrot-Reynauld, Thierry, Schaeverbeke, Gwendoline, Sebille, Patricia, Senet, Raphaele, Seror, Jacques, Serratrice, Alexandre, Somogyi, Pascale, Soria, Benjamin, Terrier, Marie-Francoise, Thiercelin-Legrand, François, Truchetet, Jean-Paul, Vagneur, Philippe, Vanhille, Bérengère, Vivet, Pierre-Jean, Weiller, Bernadette, Woehl-Kremer, Jean-Marie, Woehl, and Thierry, Zénone
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- 2013
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23. Étude rétrospective monocentrique visant à mettre en évidence une valeur seuil significativement différente de cryoglobulinémie entre les patients présentant des symptômes cliniques liés à la cryoglobulinémie et ceux chez qui elle est asymptomatique
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X. Parent, M. Bach-Bunner, B. Bouldoires, Gilles Blaison, and N. Aubertin
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Gastroenterology ,Internal Medicine - Abstract
Introduction Les cryoglobulines (CG) sont des immunoglobulines seriques ayant la faculte de precipiter a une temperature inferieure a 37 °C. Leur presence est associee a diverses pathologies: infectieuses, auto-immunes et hematologiques. Les CG peuvent etre symptomatiques. La recherche de CG necessite des mesures strictes de prelevement, de conditionnement, plusieurs etapes d’analyse et un resultat rendu tardivement. Le dosage de CG peut etre realise par plusieurs methodes avec une precision croissante. Dans notre etablissement, le seuil de rendu positif a ete fixe arbitrairement a 20 mg/l mais une augmentation de ce seuil est envisagee pour reduire le nombre d’immunofixations realisees pour les prelevements positifs. L’objectif de ce travail est d’evaluer les implications de la modification du seuil de positivite en decrivant une cohorte de patients avec CG positives, et de comparer les dosages de CG chez les patients consideres symptomatiques versus patients asymptomatiques. Patients et methodes Nous avons mene une etude retrospective unicentrique de l’ensemble des dossiers des patients avec CG positives dosees dans notre hopital entre mai 2015 et avril 2019. Un dosage de CG positif permettait l’inclusion dans notre etude. Nous avons recueilli les donnees cliniques, biologiques, radiologiques, anatomopathologiques et therapeutiques. Les services prescripteurs ont ete recueillis. Le caractere symptomatique de la CG etait determine par le praticien en charge du patient aumoment du dosage. Resultats Nous avons inclus 166 patients, avec un taux moyen de CG de 124 mg/l. 90 femmes (54 %) et 76 hommes (46 %), dont l’âge moyen au diagnostic est de 64 ans . Seize patients presentaient une CG type 1 (10 %), 77 une CG de type 2 (46 %), et 63 une CG de type 3 (38 %), 10 CG etaient non-typees (6 %). Pour 3 dosages de CG positifs, aucune donnee clinique n’etait disponible, ces prelevements etaient issus d’un autre etablissement, ces dossiers n’ont pas ete retenus pour les analyses. Les diagnostics etiologiques etaient pour 23 % auto-immuns (14 polyarthrites rhumatoides, 7 Gougerot-Sjogren, 4 lupus, 4 vascularites a IgA); 23 % infectieux (23 lies au VHC, 5 bacteriemies a Staphylocoque); 22 % hematologiques (24 lymphomes, 9 gammapathies monoclonales). Les principales manifestations cliniques etaient des manifestations cutanees (54 %) dont un purpura (18 %) et un syndrome de Raynaud (13 %), des arthralgies (16 %) et une asthenie (26 %). Trente et une biopsies cutanees et 7 biopsies renales etaient realisees. La majorite des dosages etaient prescrits par des internistes (53 %), des dermatologues (10 %), des gastrohepatologues (7 %) et des rhumatologues(7 %). Parmi les 163 patients, 30 avaient une CG consideree symptomatique (groupe 1) contre 133 non symptomatique (groupe 2). La repartition homme/femme, l’âge et la repartition des types de CG etaient equivalentes selon les groupes. Les patients du groupe 1 presentaient significativement plus d’atteintes cutanees (77 % vs 31 %), de purpura (46 % vs 11 %), de syndrome de Raynaud (26 % vs 10 %), de vascularites leucocytoclasiques a l’histologie (83 % vs 21 %) mais pas de difference significative sur l’asthenie (23 % vs 27 %), les arthrites (16 % vs 16 %), la fievre (3 % vs 12 %), ni de difference d’antecedents d’infection au VHC (13 % vs 13 %). Les principaux diagnostics retenus au sein du groupe 1 etaient: une infection au VHC (13 %), un Lymphome B non Hodgkiniens (13 %), une maladie de Waldenstrom (10 %) et dans le groupe 2: une infection au VHC (13 %), une polyarthrite rhumatoide (9 %), une gammapathie monoclonale (7 %). Le taux deCG essentielle etait equivalent dans les deux groupes (27 % vs 28 %). Le taux moyen de CG dans le groupe 1 etait de 319 mg/L et de 82 mg/L dans le groupe 2 (p = 0,106). Le seuil de rendu positif de CG a 20 mg/L actuellement utilise a dans notre effectif une specificite de 3 % et une sensibilite de 100 %. Un seuil de 50 mg/L aurait une sensibilite de 50 % et une specificite de 65,4 %. En cas de seuil a 50 mg/l, 14 patients (46,6 % des patients) ayant une CG symptomatique auraient eu un resultat rendu negatif. Discussion Saisir le texte. Conclusion Dans les limites de notre effectif et de notre methodologie, cette etude permet d’evaluer l’impact d’une modification du seuil de positivite du dosage des cryoglobulinemie. La determination d’un seuil de positivite reste difficile a etablir. Il parait preferable de maintenir le seuil bas afin de ne pas meconnaitre des patients symptomatiques avec un faible taux de CG.
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- 2020
24. Un tableau clinique complexe révélant une encéphalite à DPPX
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B. Bouldoires, S. Coito, N.Y. Dupré, F. Sellal, and Gilles Blaison
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0301 basic medicine ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Gastroenterology ,Internal Medicine ,030217 neurology & neurosurgery - Abstract
Introduction Les anticorps anti-DPPX (dipeptidyl-peptidase-like protein-6) ont ete decrits en 2013 [1] , chez des patients presentant des troubles psychiatriques, digestifs et neurologiques. Cette description a fait suite a une decennie de decouverte de nouveaux anticorps (anti-NMDAR, AMPAR, GABA(B), LGI1, Caspr2, GlyR, et mGluR5) ayant differentes cibles au sein du systeme nerveux central et etant responsables d’encephalite dysimmunitaire associees a des signes cliniques polymorphes. Nous en rapportons une observation. Observation En 2008, une patiente de 53 ans est adressee pour un tableau complexe et polymorphe evoluant depuis plusieurs mois. Ces antecedents sont : un asthme allergique, une hypothyroidie substituee et un fibrome uterin. Depuis le mois de septembre 2007, la patiente rapporte une perte de poids de 18 kg associe a une diarrhee chronique sans vomissement ni anorexie avec endoscopie haute et basse normale, des sensations ebrieuses, sans vrai vertige et des difficultes a la lecture en lien avec des oscillopsies. L’examen clinique ne revele ni desorientation ni signe meninge, les reflexes osteotendineux sont percus de maniere bilaterale et symetrique, le reflexe cutaneo-plantaire est en flexion bilaterale, il existe un trouble de la marche avec elargissement du polygone de sustentation et une danse des tendons sans adiadococinesie ni dysmetrie. L’examen des paires crâniennes met en evidence un nystagmus inepuisable. Differents examens d’imageries sont realises : une TDM TAP met en evidence volumineuse masse de 13 cm pelvienne fibromateuse, la TEP TDM montre la masse ovarienne ou pelvienne sans hypermetabolisme, et une IRM cerebrale est sans anomalie. Des examens biologiques sont effectues : NFS, ionogramme sanguin, bilan hepatique, electrophorese des proteines plasmatique sont sans particularite, serologie de lyme negative, AAN positifs au 1/160 sans specificite, ANCA negatifs, anticorps anti-TPO, anti-transglutaminase et anti-GAD negatifs, anticorps anti-neurones positifs mais sans possibilites de typage, serologies VIH, VHB, et VHC negatives. L’analyse du LCR : 1 leucocyte, 2 hematies, proteinorachie a 0,26 et glycorachie normale. Un syndrome paraneoplasique est evoque mais la chirurgie gynecologique ne diagnostique aucune neoplasie. Un traitement par immunoglobuline polyvalente est efficace permettant a la patiente de lire a nouveau. La surveillance clinique de la patiente met en evidence une proteinurie. Une ponction biopsie renale revele une glomerulopathie avec depots d’IgG au niveau de la membrane basale glomerulaire. Les perfusions d’immunoglobulines sont interrompues et il est decide de realiser des seances de plasmapherese (4) puis un traitement par rituximab (octobre 2008). En decembre 2008 on note une nette amelioration du syndrome cerebelleux. De meme les troubles oculomoteurs sont en cours d’amelioration. Le diagnostic de syndrome cerebelleux auto immun associe une glomerulopathie est retenue ; un traitement d’entretien par CELLCEPT est poursuivi. En octobre 2009, devant l’aggravation des saccades oculaires et une majoration du syndrome cerebelleux, le traitement par rituximab est repris en association avec le CELLCEPT. Une amelioration clinique est observee, il est decide de poursuite le traitement par rituximab en entretien. Le traitement est ainsi poursuivi avec un bilan annuel a la recherche de neoplasie. Sous traitement l’etat clinique de la patiente reste stable, les recherches pour une pathologie neoplasique restent negatives et des imageries cerebrales, IRM notamment, ne montrent pas d’evolution. Les anticorps anti-neurones restent positifs mais ne presentent aucune specificite. Le traitement ne sera pas modifie jusqu’au printemps 2018, et l’arret du CELLCEPT. Le bilan est repris a l’ete 2018 devant l’apparition de troubles digestifs a type de selles liquides, d’une part, avec la recherche de pathologie infectieuse en lien avec l’immunodepression, et d’autres part, avec la recherche d’anticorps anti-neuropiles : presence d’anticorps anti-DPPX confirmee a deux reprises. Conclusion Les manifestations neurologiques des encephalites a DPPX sont diverses, multifocales et parfois intermittentes. Les manifestations les plus frequentes comprennent une perte de poids, des troubles neuropsychiatriques et une dysautonomie. Les patients semblent bien reagir aux debuts precoces d’une immunotherapie. Un traitement immunosuppresseur semble necessaire a long terme [2] . Ce cas clinique permet de rappeler le polymorphisme des encephalites, et l’interet de reevaluer regulierement des situations cliniques complexes.
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- 2019
25. Association of antiphospholipid antibodies with active digital ulceration in systemic sclerosis
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Jean-Christophe Weber, Vincent Poindron, Jean-Loup Pennaforte, Gilles Blaison, Denis Wahl, C. Martinez, Nadine Magy-Bertrand, Philip Bielefeld, Pierre Kieffer, Bernard Bonnotte, Hervé Devilliers, Sabine Berthier, Thierry Martin, Laurent Arnaud, Mickael Martin, François Maurier, Médecine interne [ Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Médecine interne [Hôpitaux civils de Colmar], Hôpitaux Civils de Colmar, Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Centre National de Référence pour les Maladies Auto-immunes Rares [CHU Strasbourg] (RESO), CHU Strasbourg, Médecine interne [CHU Strasbourg], Département de Médecine Interne et Immunologie Clinique (DMIIC - STRASBOURG), Médecine interne [CH Emile Muller, Mulhouse], Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA)-Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Service de médecine interne et immunologie clinique (SOC 1) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Interne et Vasculaire [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre régional de compétence des Maladies systémiques et auto-immunes rares de l'adulte et Maladies vasculaires rares, Faculté de Médecine [Nancy], Université de Lorraine (UL), Service de Médecine Interne [CHR Metz-Thionville], Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Service de Rhumatologie [Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Service de médecine interne (Med Int - BESANCON), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and WEBER, JEAN-CHRISTOPHE
- Subjects
Male ,Raynaud’s phenomenon ,0302 clinical medicine ,Risk Factors ,Informed consent ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,skin and connective tissue diseases ,ComputingMilieux_MISCELLANEOUS ,Gangrene ,[SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,integumentary system ,biology ,antiphospholipid antibodies ,Interstitial lung disease ,Middle Aged ,Pathophysiology ,3. Good health ,[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,Antibodies, Antiphospholipid ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Female ,Disease Susceptibility ,Antibody ,Adult ,medicine.medical_specialty ,[SDV.IMM] Life Sciences [q-bio]/Immunology ,Immunology ,digital ulcer ,Systemic Sclerosis ,Fingers ,03 medical and health sciences ,Rheumatology ,Antiphospholipid syndrome ,Internal medicine ,Skin Ulcer ,Humans ,Aged ,Autoantibodies ,030203 arthritis & rheumatology ,Autoimmune disease ,Scleroderma, Systemic ,business.industry ,medicine.disease ,Cross-Sectional Studies ,biology.protein ,business ,antiphospholipid syndrome ,Biomarkers - Abstract
Key messages #### What is already known about this subject? #### What does this study add? #### How might this impact on clinical practice? Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) can be severe with active digital ulceration (ADU) and gangrene. RP physiopathology includes early endothelial cell injury, vascular dysfunction and sometimes microvascular thrombosis.1 Antiphospholipid antibodies (aPL) activate endothelial cells and platelets by complexes of beta-2 glycoprotein 1 (β2GP1) and anti-β2GP12 and could therefore contribute to the initiation of and/or aggravate SSc-related RP. aPL prevalence seems increased in patients with SSc compared with controls,3 but aPL-associated clinical features are often contradictory. The aims of this study were to assess aPL and antiphospholipid syndrome (APS) prevalence in patients with SSc and their association with ADU. Consecutive patients aged more than 18 years, fulfilling the American College of Rheumatology/EULAR classification criteria for SSc4 and followed in seven French expert centres for autoimmune diseases labelled by the French national network for autoimmune disease care, were enrolled prospectively during 8 months. Patients with other associated autoimmune disease were excluded. All patients provided written informed consent. SSc subtype was classified based on LeRoy and Medsger’s criteria,5 and skin involvement was assessed according to the modified Rodnan skin score (mRSS).6 Interstitial lung disease …
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- 2019
26. FRI0337 INCIDENCE AND PREVALENCE OF MYOSITIS ASSESSED BY MULTI-SOURCES CAPTURE-RECAPTURE METHODOLOGY
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Alain Meyer, Léa Debrut, Thierry Martin, Gilles Blaison, Lionel Spielmann, Jean Sibilia, and Pierre Kieffer
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medicine.medical_specialty ,business.industry ,Medical record ,Incidence (epidemiology) ,Prevalence ,medicine.disease ,Mark and recapture ,Family medicine ,Health care ,Epidemiology ,medicine ,Referral center ,business ,Myositis - Abstract
Background Precise epidemiology of myositis epidemiology remains largely unknown (1). Surveys based solely on administrative claims benefit from large case ascertainment but may be influenced by miscoding and misdiagnosing. The use of medical records with charts review benefit from accurate diagnosis but exhaustive ascertainment is difficult to achieve because numerous specialists are involved and cases may concern both inpatients and outpatients. To overcome these difficulties we undertook a capture–recapture survey that takes advantage of a multi-sources case ascertainment to estimate the number of cases missed by any one source and to correct the prevalence rate (2). Objectives To assess the incidence and prevalence of myositis in Alsace, a region of eastern France. Methods Alsace, region of eastern France, is home to about 2 million inhabitants benefiting from high access to healthcare and a labialized referral center for myositis. Seeking care outside is uneasy because of peculiar geography. Myositis patients were retrieved through three separate sources: i) all general practitioners and community specialist ii) Muscle pathology center records, iii) all public and private hospitals records, vi) all public and private laboratory records. Incident and prevalent cases fulfilling the ACR/EULAR criteria for myositis were included. Results The responses to the questionnaires sent to the physicians (n=3452), yielded 105 potential myositis cases. All hospital centres contacted (n=13) participated in the study and 1335 potential myositis patients were recorded by this source. 263 potential myositis cases were identified through muscle pathology center records. 13 laboratories participate in the studies and 324 potential myositis patients were recorded by this source. We thus received 1863 records of suspected myositis after excluding duplicates within each sources. The thorough review of the corresponding medical charts is currently ongoing and at this stage 10% of the potential cases fulfilled the ACR/EULAR criteria for myositis. Conclusion This first study based on a multi-sources capture-recapture methodology and ACR/EULAR criteria is very likely to provide an accurate estimation of myositis epidemiology. References [1] Incidence and prevalence of inflammatory myopathies: a systematic review. [2] Meyer A, Meyer N, Schaeffer M, Gottenberg JE, Geny B, Sibilia J. [3] Rheumatology (Oxford). 2015;54:50-63. [4] Brief Report: Spatial Heterogeneity of Systemic Sclerosis in France: High Prevalence in the Northeast Region. [5] Meyer A, Chifflot H, Chatelus E, Kleinmann JF, Ronde-Ousteau C, Klein D, Jegu J, Geny B, Hirshi S, Canuet M, Blaison G, Kieffer P, Lipsker D, Martin T, Sauleau E, Velten M, Sibilia J. Arthritis Rheumatol. 2016;68:1731-7. Disclosure of Interests None declared
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- 2019
27. Brief Report: Spatial Heterogeneity of Systemic Sclerosis in France: High Prevalence in the Northeast Region
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Erik Sauleau, Pierre Kieffer, J.F. Kleinmann, Gilles Blaison, Jérémy Jégu, Hélène Chifflot, Bernard Geny, Emmanuel Chatelus, Sandrine Hirshi, Thierry Martin, Alain Meyer, Cécile Ronde-Ousteau, Jean Sibilia, Michel Velten, Dan Lipsker, Delphine Klein, and Matthieu Canuet
- Subjects
030203 arthritis & rheumatology ,medicine.medical_specialty ,Pathology ,education.field_of_study ,business.industry ,Immunology ,Population ,Prevalence ,Confidence interval ,Spatial heterogeneity ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Statistical significance ,Health care ,Epidemiology ,medicine ,Immunology and Allergy ,030212 general & internal medicine ,Young adult ,business ,education ,Demography - Abstract
Objective Alsace is a region in eastern France with a population of ∼2 million. All residents have high access to health care and an accredited referral center for SSc. Seeking care outside of this region is difficult because of the peculiar geography. The aim of this study was to assess the prevalence and spatial variation of systemic sclerosis (SSc) in eastern France. Methods Data for SSc patients were obtained from 3 sources (all general practitioners and community specialists, capillaroscopy centers, and all public and private hospital records) and were used to estimate the prevalence of SSc. Surviving patients who resided in Alsace on January 1, 2008 and fulfilled the American College of Rheumatology and/or the LeRoy and Medsger criteria were included in this study. The clinical characteristics of the patients were also assessed. Potentially incomplete case ascertainment was corrected by capture–recapture analyses. Geographic disparities were assessed by spatial cluster analysis and by comparing our results with those for other geographic areas in the world for which data derived using similar methodology were available. Results The review of 499 potential cases identified a total of 244 SSc patients. A trend toward a west-to-east gradient was observed but did not reach statistical significance. According to log-linear modeling, an estimated 83.87 additional cases were missed. Thus, the SSc prevalence was 228.42 cases per million adult inhabitants of Alsace (95% confidence interval 203.70–253.14); this prevalence was significantly higher than that in 2 other regions of France and comparable with the reported prevalence in Detroit, Michigan. Conclusion The stringent methodology used in the current study is very likely to provide an accurate estimation of the prevalence of SSc. Design similarity with 3 other surveys extends the scope of the results by identifying geographic disparities that were previously indistinguishable due to methodologic differences.
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- 2016
28. Description of 214 cases of autoimmune congenital heart block: Results of the French neonatal lupus syndrome
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Kateri Levesque, Nathalie Morel, Alice Maltret, Gabriel Baron, Agathe Masseau, Pauline Orquevaux, Jean-Charles Piette, Francois Barriere, Jérome Le Bidois, Laurent Fermont, Olivier Fain, Arnaud Theulin, Francois Sassolas, Philippe Pezard, Zahir Amoura, Gaëlle Guettrot-Imbert, Delphine Le Mercier, Sophie Georgin-Lavialle, Christophe Deligny, Eric Hachulla, Luc Mouthon, Philippe Ravaud, Elisabeth Villain, Damien Bonnet, Nathalie Costedoat-Chalumeau, Holy Bezanahary, Boris Bienvenu, Gilles Blaison, Philippe Blanche, Bernard Bonnotte, Pascal Cathebras, Christine Christides, Fleur Cohen, Laurence Cohen, Edouard Devaud, Elisabeth Diot, Pierre Duhaut, Yves Dulac, Bertrand Godeau, Véronique Gournay, Céline Gronier, Loïc Guillevin, Mohamed Hamidou, Julien Haroche, Gilles Hayem, François Heitz, Richard Isnard, Moez Jallouli, Anne-Sophie Korganow, Claire Le Jeunne, François Lhote, Hugues Lucron, Jean-René Lusson, Suzel Magnier, Jacques Ninet, Nicolas Pangaud, Thomas Papo, Jean-Luc Pellegrin, Jean Loup Pennaforte, Jacques Pouchot, Françoise Sarrot-Reynauld, Nicolas Schleinitz, Pascal Seve, Bertrand Stos, Denis Vital-Durand, and Bertrand Wechsler
- Subjects
Pacemaker, Artificial ,medicine.medical_specialty ,Pediatrics ,Fetus ,Pregnancy ,Multivariate analysis ,Heart block ,business.industry ,Immunology ,Retrospective cohort study ,Dilated cardiomyopathy ,medicine.disease ,Prosthesis Implantation ,Heart Block ,Treatment Outcome ,In utero ,Internal medicine ,medicine ,Cardiology ,Humans ,Lupus Erythematosus, Systemic ,Immunology and Allergy ,Gestation ,business - Abstract
Cardiac neonatal lupus syndrome is due to anti-SSA or SSB antibodies and mainly includes congenital heart block (CHB) and dilated cardiomyopathy (DCM). Its optimal management is still debated. We report a large series of autoimmune high degree CHB.Inclusion criteria in this retrospective study were fetuses or neonates with high-degree CHB associated with maternal anti-SSA/SSB antibodies.214 CHB were included: 202 detected in utero at a median term of 23 weeks' gestation (WG) [range 16 to 39 WG] and 12 neonatal cases diagnosed at a median age of 0 days [range birth to 8 days]. The 214 cases of CHB included 202 (94.4%) third-degree CHB, 8 (3.7%) second-degree CHB, and 4 (1.9%) intermittent CHB. In multivariate analysis, the factors associated with feto-neonatal deaths (15.7%) were hydrops (p0.001; hazard ratio [HR] 12.4 [95% confidence interval (95%CI) 4.7-32.7]) and prematurity (p=0.002; HR 17.1 [95%CI 2.8-103.1]). During a median follow-up of 7 years [birth to 36 years], 148 of 187 children born alive (79.1%) had a pacemaker, 35 (18.8%, one missing data) had DCM, and 22 (11.8%) died. In multivariate analysis, factors associated with child death were in utero DCM (p=0.0157; HR 6.37 [95%CI: 1.25-32.44]), postnatal DCM (p0.0001; HR 227.58[95%CI: 24.33-2128.46]) and pacemaker implantation (p=0.0035; HR 0.11[95%CI: 0.02-0.51]). The use of fluorinated steroids was neither associated with survival nor with regression of 2nd degree CHB.In this second largest series of CHB, we confirm some of the previous results. We were unable to find data supporting the routine use of in utero fluorinated steroids.
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- 2015
29. Systemic lupus erythematosus and neutropaenia: a hallmark of haematological manifestations
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Aurore, Meyer, Aurélien, Guffroy, Gilles, Blaison, Yannick, Dieudonne, Zahir, Amoura, Bernard, Bonnotte, Christoph, Fiehn, Pierre, Kieffer, Hannes Martin, Lorenz, Nadine, Magy-Bertrand, François, Maurier, Jean-Louis, Pennaforte, Hans-Hartmut, Peter, Andreas, Schwarting, Jean, Sibilia, Laurent, Arnaud, Thierry, Martin, Reinhard Edmund, Voll, Anne-Sophie, Korganow, R, Voll, CHU Strasbourg, Université de Strasbourg (UNISTRA), Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Médecine interne [Hôpitaux civils de Colmar], Hôpitaux Civils de Colmar, Institut E3M [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], 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 Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Heidelberg University Hospital [Heidelberg], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpitaux Privés de Metz (HPMetz), Centre Hospitalier Universitaire de Reims (CHU Reims), University of Freiburg [Freiburg], Les Hôpitaux Universitaires de Strasbourg (HUS), and LBBR/Rarenet group: Z Amoura, L Arnaud, G Blaison, B Bonnotte, E Chatelus, E Ciobanu, F Duchene, J P Faller, A Gorse, J E Gottenberg, O Hinschberger, F Jaeger, P Kieffer, M Kilifa, N Magy-Bertrand, T Martin, L Martzolff, F Maurier, A Meyer, J-L Pasquali, J-L Pennaforte, V Poindron, S Revuz, M Samson, J Sibilia, C Sordet, A Theulin, D Wahl, J C Weber, M Bartsch, N Bartholomä, C Fiehn, S Finzel, A Funkert, M Hausberg, H Lorenz, R Max, H-H Peter, M Rizzi, A Schwarting, J Thiel, N Venhoff, R Voll
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Neutropenia ,autoantibodies ,Immunology ,Disease ,Sciences du Vivant [q-bio]/Médecine humaine et pathologie ,Autoimmune Diseases ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Lymphopenia ,lupus erythematosus, systemic ,Internal medicine ,medicine ,Humans ,Oral ulcers ,030203 arthritis & rheumatology ,Autoimmune disease ,Systemic lupus erythematosus ,Genetic heterogeneity ,business.industry ,Autoantibody ,Complement C3 ,General Medicine ,systemic ,medicine.disease ,Thrombocytopenia ,Epidemiology and Outcomes ,3. Good health ,Cross-Sectional Studies ,Sjogren's Syndrome ,030104 developmental biology ,Antibodies, Antinuclear ,Case-Control Studies ,Cohort ,Absolute neutrophil count ,Female ,France ,business ,lupus erythematosus ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
ObjectiveSystemic lupus is a chronic autoimmune disease characterised by its phenotypic heterogeneity. Neutropaenia is a frequent event in SLE occurring in 20%–40% of patients depending on the threshold value of neutrophil count. On a daily basis, the management of neutropaenia in SLE is difficult with several possible causes. Moreover, the infectious consequences of neutropaenia in SLE remain not well defined.Methods998 patients from the Lupus BioBank of the upper Rhein (LBBR), a large German and French cohort of patients with SLE, mostly of Caucasian origin (83%), were included in this study. Neutropaenia was considered when neutrophil count was below 1800×106/L. An additional analysis of detailed medical records was done for 65 LBBR patients with neutropaenia.Results208 patients with neutropaenia (21%) were compared with 779 SLE patients without neutropaenia. Neutropaenia in SLE was significantly associated with thrombocytopaenia (OR 4.11 (2.57–10.3)), lymphopaenia (OR 4.41 (2.51–11.5)) and low C3 (OR 1.91 (1.03–4.37)) in multivariate analysis. 65 representative patients with neutropaenia were analysed. Neutropaenia was moderate to severe in 38%, chronic in 31%, and both severe and chronic in 23% of cases. Moderate to severe and chronic neutropaenia were both associated with lymphopaenia and thrombopaenia. Chronic neutropaenia was also associated anti-Ro/SSA antibodies and moderate to severe neutropaenia with oral ulcers.ConclusionThis study is to date the largest cohort to describe neutropaenia in SLE. Neutropaenia displays a strong association with other cytopaenias, suggesting a common mechanism. Chronic neutropaenia is associated with anti-Ro/SSA antibodies with or without identified Sjögren’s disease.
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- 2020
30. Predictors of fatigue and severe fatigue in a large international cohort of patients with systemic lupus erythematosus and a systematic review of the literature
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Rheinardt Voll, Hannes M. Lorenz, Gilles Blaison, Pierre Kieffer, Bernard Bonnotte, Laurent Arnaud, Zahir Amoura, Vincent Poindron, Jean-Loup Pennaforte, Jean Sibilia, Thierry Martin, Pierre Edouard Gavand, Nadine Magy-Bertrand, Hans-Harmut Peter, François Maurier, Andreas Schwarting, and Christoph Fiehn
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Adult ,Male ,medicine.medical_specialty ,Anxiety ,Logistic regression ,Severity of Illness Index ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Rheumatology ,Interquartile range ,Risk Factors ,Internal medicine ,medicine ,Humans ,Lupus Erythematosus, Systemic ,Pharmacology (medical) ,030212 general & internal medicine ,Depression (differential diagnoses) ,Fatigue ,Aged ,030203 arthritis & rheumatology ,Systemic lupus erythematosus ,Lupus erythematosus ,business.industry ,Depression ,Odds ratio ,Middle Aged ,medicine.disease ,Cohort ,Quality of Life ,Female ,medicine.symptom ,business - Abstract
OBJECTIVE Fatigue is reported in up to 90% of patients with SLE. This study was conducted to identify the determinants associated with fatigue in a large cohort of patients with SLE, as well as to provide a systematic review of the literature. METHODS Patients from the Lupus BioBank of the upper Rhein, a large German-French cohort of SLE patients, were included in the FATILUP study if they fulfilled the 1997 ACR criteria for SLE and had Fatigue Scale for Motor and Cognitive Functions scores collected. Multivariate logistic regression analyses were performed to assess the determinants of fatigue and severe fatigue. RESULTS A total of 570 patients were included (89.1% female). The median age was 42 years (interquartile range 25-75: 34-52). The median value of the SAfety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI was 2 (0-4). Fatigue was reported by 386 patients (67.7%) and severe fatigue by 209 (36.7%). In multivariate analyses, fatigue was associated with depression [odds ratio (OR): 4.72 (95% CI: 1.39-16.05), P = 0.01], anxiety [OR: 4.49 (95% CI: 2.60-7.77), P < 0.0001], glucocorticoid treatment [OR: 1.59 (95% CI 1.05-2.41), P = 0.04], SELENA-SLEDAI scores [OR: 1.05 (95% CI: 1.00-1.12) per 1 point increase, P = 0.043] and age at sampling [OR: 1.01 (95% CI: 1.00-1.03) per 1 year increase, P = 0.03]. Severe fatigue was independently associated with anxiety (P < 0.0001), depression (P < 0.0001), glucocorticoid treatment (P = 0.047) and age at sampling (P = 0.03). CONCLUSION Both fatigue and severe fatigue are common symptoms in SLE, and are strongly associated with depression and anxiety. Disease activity and the use of glucocorticoids were also independently associated with fatigue, although more weakly.
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- 2018
31. AB0593 Predictors of fatigue and severe fatigue in a large multicenter international cohort of patients with systemic lupus erythematosus: the fatilup study
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J. Sibilia, Reinhard E. Voll, Z. Amoura, Gilles Blaison, A. Schwartzing, Christoph Fiehn, François Maurier, Thierry Martin, P.E. Gavand, N. Magy Bertrand, Laurent Arnaud, H.-M. Lorenz, Pierre Kieffer, B. Bonnote, Vincent Poindron, and Jean-Loup Pennaforte
- Subjects
030203 arthritis & rheumatology ,0301 basic medicine ,medicine.medical_specialty ,Univariate analysis ,Multivariate analysis ,Systemic lupus erythematosus ,business.industry ,medicine.disease ,Hospital Anxiety and Depression Scale ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Quality of life ,Internal medicine ,Cohort ,medicine ,Anxiety ,medicine.symptom ,skin and connective tissue diseases ,business ,Depression (differential diagnoses) - Abstract
Background Fatigue is an important issue in systemic lupus and has a major impact on quality of life of the patients. Data are controversial about the factors associated with this complex symptom.1 Objectives To identify the factors associated with fatigue and severe fatigue in patients with systemic lupus erythematosus (SLE) in a large cohort using a multivariate model to precise the importance of each parameter in this multidimensional symptom. Methods We used the LBBR data base, a German French data base of SLE patients. All patients fulfilled the 1997 ACR criteria for SLE. The Fatigue Scale for Motor and Cognitive Functions (FSMC) was used to assess fatigue and severe fatigue. The depression and anxiety were measured with Hospital Anxiety and Depression Scale (HADS). Tests were performed at sampling. Results A total of 570 patients were included (89.1% female). The median age was 42 years (QR25–75: 34–52). The median value of the SELENA-SLEDAI was 2 (QR25–75: 0–4) and 136 patients had a SELENA-SLEDAI score >6. Fatigue was reported by 386 patients (67.7%) including severe fatigue by 209 (36.7%). In univariate analysis among the individual components of the SLEDAI arthritis (p=0.003) and oral ulcers (p=0.002) were associated with severe fatigue. In multivariate analysis fatigue was strongly associated with anxiety (OR: 4.49 [95%CI: 2.60–7.77], p Severe fatigue was strongly associated with depression (OR:6.87 [95%CI: 3.12–15.11], p Conclusions Fatigue is a common symptom in SLE patients and is strongly associated with anxiety and depression. While remission remains an important therapeutic target, these manifestations should also be taken care of with psychological counselling and pharmacological intervention, when needed. Reference [1] Cleanthous S, Tyagi M, Isenberg DA, Newman SP. What do we know about self-reported fatigue in systemic lupus erythematosus?Lupus. 2012Apr;21(5):465–76 Disclosure of Interest None declared
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- 2018
32. Extra-haematological manifestations related to human parvovirus B19 infection: retrospective study in 25 adults
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Gilles Blaison, Laurent Chiche, Luc Mouthon, Alban Deroux, Marion Dollat, Emmanuelle Dernis, Nicolas Dupin, Luc de Saint-Martin, Benjamin Chaigne, Olivier Lambotte, Benjamin Terrier, François Lifermann, Grégoire Cormier, Emilie Berthoux, Jérémie Sellam, Nathalie Costedoat-Chalumeau, Thomas Sené, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Service de Médecine Interne [Dax], Centre Hospitalier de Dax, Centre Hospitalier Universitaire [Grenoble] (CHU), Centre hospitalier Saint Joseph - Saint Luc [Lyon], Le Mans Université (UM), Hôpital Foch [Suresnes], Centre Hospitalier Louis Pasteur [Dole], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Saint-Antoine [AP-HP], Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), 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), Service de Dermatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Centre National de Référence Maladies auto-immunes Systémiques Rares [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre Hospitalier Départemental Vendée, Service de rhumatologie [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), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]
- Subjects
Adult ,Male ,Vasculitis ,medicine.medical_specialty ,Peripheral neuropathy ,Pleural effusion ,Arthritis ,lcsh:Infectious and parasitic diseases ,Intravenous immunoglobulin, lupus ,Arthritis, Rheumatoid ,Parvoviridae Infections ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Focal segmental glomerulosclerosis ,Glomerulonephritis ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Pregnancy ,Internal medicine ,Membranoproliferative glomerulonephritis ,medicine ,Parvovirus B19, Human ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Prospective Studies ,Pregnancy Complications, Infectious ,Intravenous immunoglobulin lupus ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Aged, 80 and over ,Hemophagocytic lymphohistiocytosis ,business.industry ,Mononeuritis Multiplex ,Immunoglobulins, Intravenous ,Middle Aged ,medicine.disease ,3. Good health ,Infectious Diseases ,Female ,business ,Human parvovirus B19 ,Myopericarditis ,Research Article - Abstract
International audience; Background: 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.
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- 2018
33. Facteurs associés à la fatigue au cours du lupus érythémateux systémique dans une étude prospective multicentrique française
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O. Aumaître, N. Magy-Bertrand, Hervé Devilliers, Thierry Martin, Z. Amoura, D. Wahl, Sylvain Audia, Jean-Loup Pennaforte, Gilles Blaison, Christiane Broussolle, R. Bouvet, and François Maurier
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Gastroenterology ,Internal Medicine - Abstract
Introduction Cette etude avait pour objectif d’etudier les facteurs associes a la fatigue chez des patients atteints de lupus erythemateux systemique (LES) francais a l’aide de 3 questionnaires de fatigue differents. Patients et methodes Nous avons conduit une etude de cohorte prospective multicentrique et recrute des patients dans 10 hopitaux francais entre 2010 et 2014. A partir des donnees recueillies lors du suivi de 336 patients nous avons analyse les donnees de 3 questionnaires auto-administres de fatigue : le domaine fatigue du questionnaire specifique LupusQoL, le domaine vitalite du questionnaire generique SF-36 et le questionnaire generique de fatigue MFI-20. Les donnees demographiques, socioprofessionnelles et cliniques en rapport avec le LES etaient recueillies a l’inclusion. La precarite etait mesuree par le questionnaire EPICES et la depression par le questionnaire CES-D. Les poussees du lupus etaient mesurees par le SELENA-SLEDAI Flare Index-Revised (SFI-R). Les analyses multivariees, sans et avec ajout du facteur depression, ont porte sur les variables significatives en analyse bivariee. Les scores de fatigue utilises variaient de 100 (pas de fatigue) a 0 (plus forte fatigue imaginable) pour les 2 premiers questionnaires et inversement pour le questionnaire MFI-20. Resultats Trois-cent trente-six patients ont ete inclus dont 302 (90 %) femmes. L’âge moyen ± DS (deviation standard) etait de 41 ± 12 ans, la duree d’evolution du LES de 12 ± 9 ans, l’IMC etait de 24,4 ± 5,1 kg/m2. 114 (34 %) patients avaient un niveau d’etude inferieur au baccalaureat, 103 (31 %) etaient sans emploi et 64 (19 %) etaient en situation de precarite selon le score EPICES. Selon le score CES-D, 99 (29 %) patients presentaient un etat depressif avere. Le score de sequelles SLICC/ACR-DI (SDI) etait de 1 ± 1. Les scores de fatigue moyens etaient a 66 ± 25 pour le LupusQoL et 46 ± 21 pour le SF-36. Concernant les domaines du MFI-20, la fatigue etait mesuree a 50 ± 26 pour le domaine fatigue generale/physique (GPF), 35 ± 26 pour le domaine fatigue mentale (MF), 31 ± 28 pour le domaine reduction des activites (RA) et 27 ± 27 pour le domaine reduction de la motivation (RM) du MFI-20. Les facteurs associes a une fatigue plus importante en analyse bivariee et dans les 6 domaines des questionnaires utilises etaient : la precarite, le niveau d’etude bas, le statut sans emploi et un etat depressif avere. Les autres variables significativement associees a des scores de fatigue eleves selon le questionnaire utilise etaient : le sexe feminin, l’âge ≥ 40 ans, le tabagisme actif, l’obesite, une poussee clinique osteoarticulaire, neurologique ou avec des signes generaux, le SDI ≥ 1 et la prise de corticoides ≥ 10 mg/j. L’analyse multivariee, sans inclusion de la depression identifiait la precarite comme facteur significativement associe a la fatigue dans les 6 questionnaires utilises. Les autres facteurs significativement associes aux scores eleves de fatigue etaient le sexe feminin, l’absence d’emploi, l’obesite et les poussees dans les systemes osteoarticulaire et neuropsychiatrique du SFI-R. L’analyse multivariee, en incluant la depression retrouvait celle-ci comme facteur significativement associe a la fatigue dans tous les questionnaires. La precarite n’etait plus significativement associee a la fatigue que dans 2 questionnaires. L’absence d’emploi, l’obesite, les poussees dans les systemes osteoarticulaire et neuropsychiatrique du SFI-R restaient significativement associes a la fatigue selon le questionnaire utilise mais il existait des differences entre les 2 analyses en nombre de questionnaires significativement associes a la fatigue. Conclusion Les facteurs associes a la fatigue dans le LES sont multiples et sujets a de grandes variations selon les questionnaires et la methodologie employee, comme en temoigne la litterature. L’utilisation de questionnaires de fatigue multidimensionnels semble permettre une analyse plus fine de ces facteurs dans le cadre d’etudes epidemiologiques, mais le choix du questionnaire doit etre guide par les objectifs de l’etude. Dans le cadre de notre travail les facteurs associes a la fatigue dans le LES sont sociodemographiques : le sexe feminin ; socioprofessionnels : la precarite et l’absence d’emploi ; certaines comorbidites : la depression et l’obesite ; des facteurs specifiques du LES : les poussees osteoarticulaire et neuropsychiatrique selon le SFI-R. L’effet de la precarite sur la fatigue pourrait etre due a la plus forte intensite des symptomes depressifs chez les patients precaires. La mise en place de strategies interventionnelles visant a corriger les facteurs identifies comme etant associee a la fatigue chez les patients atteints de LES et l’evaluation de leur efficacite devrait etre l’objectif de prochaines etudes.
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- 2018
34. Central nervous system involvement in eosinophilic granulomatosis with polyangiitis (Churg-Strauss): Report of 26 patients and review of the literature
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David Launay, Valentine Loustau, Nathalie Costedoat-Chalumeau, Robin Dhote, François Maurier, Vincent Cottin, Edouard Pertuiset, Xavier Puéchal, Luc Mouthon, Aurélie Foucher, Jorg Dieter Seebach, Raphaël André, H. Gil, Boris Bienvenu, Jean-Luc Saraux, Thierry Zenone, Loïc Guillevin, Gilles Blaison, Pascal Cathébras, Joëlle Lapoirie, and Benjamin Terrier
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Subarachnoid hemorrhage ,Retinal Artery Occlusion ,Immunology ,03 medical and health sciences ,0302 clinical medicine ,Eosinophilia ,medicine ,Immunology and Allergy ,Humans ,Optic neuritis ,Stroke ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Intracerebral hemorrhage ,ddc:616 ,business.industry ,Cortical blindness ,Cranial nerves ,Granulomatosis with Polyangiitis ,Brain ,Middle Aged ,medicine.disease ,Prognosis ,Dermatology ,Asthma ,Peripheral neuropathy ,Treatment Outcome ,Female ,business ,Granulomatosis with polyangiitis ,030217 neurology & neurosurgery - Abstract
Background Although peripheral nervous system involvement is common in eosinophilic granulomatosis with polyangiitis (EGPA), central nervous system (CNS) manifestations are poorly described. This study aimed to describe CNS involvement in EGPA. Patients and methods This retrospective, observational, multicenter study included patients with EGPA and CNS involvement affecting cranial nerves, brain and/or spinal cord. We also undertook a systematic literature review. Results We analyzed 26 personal cases and 62 previously reported cases. At EGPA diagnosis, asthma was noted in 97%, eosinophilia in 98%, peripheral neuropathy in 55% and cardiac involvement in 41%. 38/71 (54%) were ANCA-positive, with a perinuclear-labeling pattern and/or anti-MPO specificity. CNS was involved in 86% at EGPA diagnosis, preceded EGPA in 2%, and occurred during follow-up in 12% after a median of 24 months. Main neurological manifestations were ischemic cerebrovascular lesions in 46 (52%), intracerebral hemorrhage and/or subarachnoid hemorrhage in 21 (24%), loss of visual acuity in 28 (33%) (15 with optic neuritis, 9 with central retinal artery occlusion, 4 with cortical blindness), and cranial nerves palsies in 18 (21%), with 25 patients having ≥ 1 of these clinical CNS manifestations. Among the 81 patients with assessable neurological responses, 43% had complete responses without sequelae, 43% had partial responses with long-term sequelae and 14% refractory disease. After a mean follow-up of 36 months, 11 patients died including 5 from intracerebral hemorrhages. Conclusion EGPA-related CNS manifestations form 4 distinct neurological pictures: ischemic lesions, intracerebral hemorrhages, cranial nerve palsies and loss of visual acuity. Such manifestation should prompt practitioners to consider EGPA in such conditions. Long-term neurological sequelae were common, and intracerebral hemorrhages had the worst prognostic impact.
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- 2017
35. Idiopathic Pulmonary Embolism in a case of Severe Family ANKRD26 Thrombocytopenia
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Remy Hurstel, Gilles Blaison, Rémi Favier, Oana Stoica, Marie Favier, Jérôme Guison, Hôpitaux Civils Colmar, Aix Marseille Université (AMU), CHU Trousseau [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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familial platelet disorder ,medicine.medical_specialty ,pulmonary embolism ,Ankyrin repeat domain 26 ,Deep vein ,Platelet disorder ,Médecine humaine et pathologie ,Context (language use) ,Platelet disorder, familial, with associated myeloid malignancy ,thrombocytopenia ,Case Reports ,030204 cardiovascular system & hematology ,Gastroenterology ,03 medical and health sciences ,Thrombocytopenia ,0302 clinical medicine ,Blood platelets ,associated myeloid malignancy ,Internal medicine ,hemic and lymphatic diseases ,Medicine ,Family history ,Ankyrin repeat domain 26 protein ,biology ,business.industry ,lcsh:RC633-647.5 ,Factor V ,Hematology ,lcsh:Diseases of the blood and blood-forming organs ,medicine.disease ,Thrombosis ,3. Good health ,Pulmonary embolism ,Surgery ,Venous thrombosis ,Infectious Diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,biology.protein ,Human health and pathology ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Venous thrombosis affecting thrombocytopenic patients is challenging. We report the case of a woman affected by deep vein thrombosis and pulmonary embolism in a thrombocytopenic context leading to the discovery of a heterozygous mutation in the gene encoding ankyrin repeat domain 26 (ANKRD26) associated with a heterozygous factor V (FV) Leiden mutation. This woman was diagnosed with lower-limb deep vein thrombosis complicated by pulmonary embolism. Severe thrombocytopenia was observed. The genetic study evidenced a heterozygous FV Leiden mutation. Molecular study sequencing was performed after learning that her family had a history of thrombocytopenia. Previously described heterozygous mutation c-127C>A in the 5'untranslated region (5'UTR) of the ANKRD26 gene was detected in the patient, her aunt, and her grandmother. ANKRD26-related thrombocytopenia and thrombosis are rare. This is, to our knowledge, the first case reported in the medical literature. This mutation should be screened in patients with a family history of thrombocytopenia.
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- 2017
36. Intravenous Immunoglobulins Improve Survival in Monoclonal Gammopathy-Associated Systemic Capillary-Leak Syndrome
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Marc Pineton de Chambrun, Marie Gousseff, Wladimir Mauhin, Jean-Christophe Lega, Marc Lambert, Sophie Rivière, Antoine Dossier, Marc Ruivard, François Lhote, Gilles Blaison, Laurent Alric, Christian Agard, David Saadoun, Julie Graveleau, Martin Soubrier, Marie-Josée Lucchini-Lecomte, Christine Christides, Annick Bosseray, Hervé Levesque, Jean-François Viallard, Nathalie Tieulie, Pierre-Yves Lovey, Sylvie Le Moal, Béatrice Bibes, Giuseppe Malizia, Pierre Abgueguen, François Lifermann, Jacques Ninet, Pierre-Yves Hatron, Zahir Amoura, Arnaud Hot, Laurent Argaud, Romain Hernu, Sylvie de la Salle, Stanislas Ledochowski, Anne-Sophie Moreau, Thomas Papo, Romain Sonneville, Bruno Verdière, Sybille Merceron, Nathalie Zappella, Mickael Landais, Nicolas Limal, Damien Contou, Thomas Similowski, Alexandre Demoule, Bertrand Souweine, Julien Haroche, Julien Boileau, Bernard Lecomte, Thomas Hanslik, Antoine Vieillard-Baron, Nicolas Terzi, Caroline Bulte, Aline Talasczka, Eric Hachulla, Olivier Decaux, Florent Ibouanga, Bertrand Arnulf, Matthieu Groh, Elie Azoulay, Marcel Benedit, Assaad Maalouf, Bruno Moulin, Fleur Cohen-Aubart, Raymond Friolet, Sylvie le Moal, Micheline Pha, Georges-Etienne Rivard, Eric Rondeau, Philippe Debourdeau, Marc Puidupin, François Beloncle, Jérôme Devaquet, Claire Presne, François Liferman, Jean-Marc Mazou, Maude Andrieu, Sylvie Paulus, Yannick Fedun, Jean-Paul Mira, Jean-Herlé Raphalen, Oscar Len Abad, Hervé Devilliers, Alister Rogers, Pascal Godmer, Charles-Edouard Luyt, Alain Combes, Miguel Hie, Alexis Mathian, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre d'Immunologie et de Maladies Infectieuses (CIMI), 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 Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Department of Internal Medicine, Hôpital pasteur [Colmar], CHU Toulouse [Toulouse], Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Immunologie - Immunopathologie - Immunothérapeutique (I3), Centre hospitalier de Saint-Nazaire, CHU Clermont-Ferrand, Centre hospitalier d'Ajaccio, Centre Hospitalier Henri Duffaut (Avignon), Clinique de médecine interne, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Service de Médecine Interne [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Hôpital l'Archet, Centre Hospitalier du Valais Romand [Sion, Switzerland], CHU de Saint-Brieuc, CHP Saint Grégoire, Service des maladies infectieuses et tropicales [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Médecine Interne Dax (MEDECINE INTERNE), Hopital, Service de Médecine Interne, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de médecine interne [Lille], Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Analyse Comparée des Pouvoirs (ACP), Université Paris-Est Marne-la-Vallée (UPEM), Université Paris Diderot - Paris 7 (UPD7), Hôpital Bichat - Claude Bernard, Service de soins intensifs, Centre Hospitalier de Versailles André Mignot (CHV), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neurophysiologie Respiratoire Expérimentale et Clinique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS), Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Department of Clinical Immunology, CHU Strasbourg, Médecine générale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de réanimation medico-chirurgicale [CHU Raymond-Poincaré], Service de réanimation médicale [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), CHU Pontchaillou [Rennes], Service d'hématologie biologique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service des maladies infectieuses et tropicales, 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)-Université Paris Diderot - Paris 7 (UPD7), Medical ICU, Service de néphrologie, Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Service d'Hématologie-Oncologie, Hôpital Ste-Justine, Département d'Oncologie (Dep Oncol - AVIGNON), Institut Ste Catherine, Service de Réanimation Médicale et de Médecine Hyperbare [Angers], Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], Service de Néphrologie - Médecine Interne, CHU Amiens-Picardie-hôpital Sud, Institut Cochin (UMR_S567 / UMR 8104), 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 Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de médecine interne [CHU Bretagnes Atlantique], CHU Bretagnes Atlantique, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-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 de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Medecine Interne, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC), 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 National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), and Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière]
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Male ,medicine.medical_specialty ,Paraproteinemias ,Context (language use) ,Intravenous immunoglobulins ,Monoclonal gammopathy-associated systemic capillary-leak syndrome ,Systemic capillary-leak syndrome ,030204 cardiovascular system & hematology ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Theophylline ,Interquartile range ,Internal medicine ,medicine ,Terbutaline ,Systemic capillary leak syndrome ,Humans ,030212 general & internal medicine ,Multiple myeloma ,Clarkson disease ,business.industry ,Hazard ratio ,Immunoglobulins, Intravenous ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Survival Analysis ,3. Good health ,Surgery ,Cohort ,Monoclonal ,Female ,business ,Capillary Leak Syndrome ,Cohort study - Abstract
International audience; Background: Monoclonal gammopathy-associated systemic capillary-leak syndrome, also known as Clarkson disease, is a rare condition characterized by recurrent life-threatening episodes of capillary hyperpermeability in the context of a monoclonal gammopathy. This study was conducted to better describe the clinical characteristics, natural history, and long-term outcome of monoclonal gammopathy-associated systemic capillary-leak syndrome.Methods: We conducted a cohort analysis of all patients included in the European Clarkson disease (EurêClark) registry between January 1997 and March 2016. From diagnosis to last follow-up, studied outcomes (eg, the frequency and severity of attacks, death, and evolution toward multiple myeloma) and the type of preventive treatments administered were monitored every 6 months.Results: Sixty-nine patients (M/F sex ratio 1:1; mean ± SD age at disease onset 52 ± 12 years) were included in the study. All patients had monoclonal gammopathy of immunoglobulin G type, with kappa light chains in 47 (68%). Median (interquartile range) follow-up duration was 5.1 (2.5-9.7) years. Twenty-four patients (35%) died after 3.3 (0.9-8) years. Fifty-seven (86%) patients received at least one preventive treatment, including intravenous immunoglobulins (IVIg) n = 48 (73.8%), theophylline n = 22 (33.8%), terbutaline n = 22 (33.8%), and thalidomide n = 5 (7.7%). In the 65 patients with follow-up, 5- and 10-year survival rates were 78% (n = 35) and 69% (n = 17), respectively. Multivariate analysis found preventive treatment with IVIg (hazard ratio 0.27; 95% confidence interval, 0.10-0.70; P = .007) and terbutaline (hazard ratio 0.35; 95% confidence interval, 0.13-0.96; P = .041) to be independent predictors of mortality.Conclusions: We describe the largest cohort to date of patients with well-defined monoclonal gammopathy-associated systemic capillary-leak syndrome. Preventive treatment with IVIg was the strongest factor associated with survival, suggesting the use of IVIg as the first line in prevention therapy.
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- 2016
37. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study
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Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. Berger, Jean-Daniel Lelièvre, Dominique Perotin, Abdelkader Bemrah, Alain Lozniewski, Bernard Borstein, Hanna Eid, Diana Suatean, Virginie Mignaut, Jean-Claude N'guyen, Valérie Le Goff, Laurent Teillet, Christophe Rolland, Gwenaël Alfonsi, Florence Lachenal, Philippe Bossi, Yves Botreau, Florence Doucet Populaire, Henry Jardel, Nicolas Gallo, Elias Jabre-Sikias, Michel Dupon, Hélène Brihier, Isabelle Patry, Alexandre Leclercq, Bernadette Tourrand, Christophe Roussel, Jean-Emmanuel Kurtz, Bénédicte Paindaveine, Simon Elhadad, Richard Sanchez, Eric Sgro, Pierre Berger, Valérie Murbach, Anne Holstein, Florence Martin, Taoufik Merabet, Amélie Benbara, Milagros Ferreyra, Laure Esposito, Pierre Delobel, Antoine Andremont, Marc Bourlière, Carole-Anne Boudy, Jean-Baptiste Gaulthier, Laurent Tacchini, Olivier Marpeau, Sonia Tesseydre, Marie-Pierre Coulhon, Nathalie Hodee, Marie-Chrsitine Conroy, Pierre Weinbreck, Roland Leclercq, Laurent Souply, Christian Bidault, Annie Elbez, Marie-Annick Lebreton, Patrick Brisou, Agnès Ferroni, Jean-Louis Pourriat, Nadia Anguel, Christian Noel, Philippe Jouvencel, Eric Pichard, Xavier Martin, Mathieu Coste, Pierre Zuber, Catherine Neuwirth, Jean-Pierre Hacot, Paul Aye, Jérôme Guinard, Yves Pean, Jean-Christophe Dengo, Fabrice Petassou, Didier Viole, Thierry Messiaen, Jean Beytout, Philippe Petitjean, Ferdinand Savare, Patrice Cuvillier, Sophie Coignard, Hélène Anglaret, Nassim Kamar, Elisabeth Chachaty, Karine Guimard, Louis Braem, Hacene Fezoui, Pierre Martin, Jean-Paul Viard, Claire Larroche, Nicolai Claudiu-Plesa, Thierry Benoit-Cattin, Olivier Moquet, Thierry Pasdeloup, David Rosay, Rodolphe Jean, Jean-Bernard Mariette, Marc Debouverie, Hervé Peltier, Mustapha Terki, Jacques Daleas, Valérie Dattin-Dorrière, Michel Vergnaud, Emmanuel Grimprel, Sylvène Rosselli, Jean-Marc Didier, Pierre Faurie, Luc Frimat, Aziza Mandjee, Sabine Etchemendy, Pierre Tissières, Jean Nakhleh, Sylvie Mariette, Christian Perronne, Bruno Carbonne, Nathalie Houssiaux-Maisonneuve, Tristan Ferry, S Beague, Anthony Sebban, Marie-Thérèse Hili, Jean-Michel De Kermadec, Lucien Brasme, Gilles Blaison, Caroline Garandeau, Jean-Pierre Sollet, Laurent Tronchon, Thierry Samson, Julien Gesquière, Nicolas Ettahar, Alain Créange, Etienne Laurens, Véronique Equy, Fréderic Bart, Bernard Bouffandeau, Christine Vaillant, Valerie Pesque, Jean-Marc Lalot, Marc Levy, Michel Kaidomar, Mihaela Saplacan, Sterenn Yvenou, Marie-Isabelle Steibach, Emmanuelle Cambau, Agnès Riche, François Fourrier, François Raffi, Mélissa Lalu, Henri Bérard, Danielle Clave, Jean-Claude Mouries, Martine Porcheron, Jean Cabalion, Richard Lamarca, Nathalie Canu, Jean-Baptiste Roseau, Annabelle Stoclin, Luca Luminitan Elena Lupean, Rémi Gebeile, Celia Salanoubat, Carole Marmouset, Pierre Bigot, Anne-Laure Breton, Pierre Kalfon, Colette Vincent, Sophie Marty, Olivier Tandonnet, Alexis Redor, Xavier Valette, Ourida Aoudia, Jacques-Arnaud Seyrig, Bertrand Beaune, Hugues Aumaitre, Georges Pinon, Yann Leveneur, Sylvie Charachon, Raoul Herbrecht, Henriette de Valk, Gary David, Julien Pouyanne, Marc Dommergues, Majed Al Chaar, Véronique Blanc-Amrane, Pascale Guillarmé Grossmann, Bruno Abraham, Yves Morel, Philippe Suel, Denis Sautereau, Olivier Guilloy, Tu Anh Tran, Frédéric Laurent, Zahir Amoura, Jacques-Olivier Bay, Zoubida Elharie-Heraux, Joyce Sibony-Prat, Bernard Guillois, Dominique Rohmer-Heitz, Audrey Barrelet, Jérémie Courouble, Jean-Paul Herry, Daniel Vittecoq, Annie Vermesch-Langlin, Jean Auroux, Claude Aubert, Thierry Harvey, Ghislaine Lamoine-Gimet, J. Riahi, Florence Soraudeau, Bachar Al-Jalaby, Caroline Périsson, Khélifa Ayouz, Florence Cardot, François Maillet, Alain Goux, Théophile Magna, Bertille de Barbeyrac, Adrien May, Dominique Andreotti, Olivier Jonquet, Hélène Dumouchel, Didier Thibaud, Philippe Morlat, Pascal Chevalet, Pascal Ancelin, Guy Chambreuil, Cécile Le Boterff, Anne Ceriez, Olivier Detante, B Pangon, Claude C.A. Bernard, Vincent Cailleaux Pierre-Etienne Cailleux, Jordi Miatello, Pierre-Yves le Berruyer, Sylvain Kouaho, Michel Briaud, Hélène Delaby, Patrick Herbecq, Christine Segonds, Véronique Jault, Pascale Brunel, Christine Dussopt, Jean Thore, Jean-Marc Thouret, Jean-Marc Kerleau, François Le Baron, Slavius Matica, Sophie Leautez-Nainville, Matthieu Pecquet, Laurent Bret, Yacine Sedjelmaci, Pierre Metton, Habiboulaye Diallo, Jany Rey Zermati, Arnaud Delahaye, Hélène Chaussade, Laurent Mandelbrot, Emilie Bessede, Olivier Casanovas, Paul Pierrot, Annick Legras, Dominique Lauque, Hélène Gatti, Jean Catineau, Ebutu Likose, Gilles Capellier, Eric Kibbrecht, Freddy Thibaut, Patrick Valadier, Chantal Lemble, Joël Gaudelus, Joelle Mellier, Joëlle Brochen, Emmanuel Gascou, Stéphane Bonacorsi, Stéphanie Bannier, Bruno Fantin, Didier Raffenot, Valérie Revel, Hakim Amroun, Huguette Negrery, Anne-Laure Fauchais, Paul Mercury, Michel Chuzeville, Christian Zumbo, Nicolas Després, Pascal Roblot, Jérôme Pasche, Jean Claude Boufetteau, Jocelyne Caillon, Julien Boileau, V. Rabier, Benjamin Manéglier, Emilie Jourdes, Franck Ceppa, Christine Recule, Nicolas Degand, Benoît Henry, Thierry Baranger, Dominique Pateron, Agnès Pélaquier, Gérard Bouchet, Hélène Fiette, Ozel Guiden, Dana Ranta, Etienne Ruppé, Nabil Chiouk, Jacques Breuil, Dominique Leduc, Véronique Loustaud, Hervé Métenier, Michel Durand, Isabelle Mahé, Leila Karaoui, Marie-José Collus, Mehran Monchi, Olivier Belmonte, Romain Blondet, Jacques Thierry, Karine Humbert, Gilles Salama, Marie-Noelle Heurtaux, Cécile Goujard, Bruno Sivery, Martial Boisseau, Redouane Dahoumane, Pierre Delour, Christian Niels Meyer, Anne Faudon-Gibelin, Gérard Poulain, Roger-Charles Luciani, J.-C. Souquet, Olivier Grossi, François Vandenesch, Sylvain Mermont, Jacques Bronner, Sonia Dahan, Paul Marzouk, Pascal Pouedras, Noureddine Djafari, François-Xavier Caroli-Bosc, Jean-François Dessin, Brigitte Gruffat, Armelle Morin-Fatome, Sylvie Thoinet, Bano Konate, Jean-Winoc Decousser, Claire Poyart, Patrick Plessis, Olivier Millet, Vincent Cattoir, Françoise Geffroy, Manica Vasseur, Pierre Carli, Isabelle Citony, Christian Richard, Nicolas Sigur, Patrick Marthelet, Luwawu Mbimba, Pierre Feugier, Philippe Sauder, Hama Djerad, Evelyne Bourgerette, Hanen Chahtour, Adrien Lemaignen, Dominique Bechade, Patrick Ochocki, Antoine Vieillard Baron, Dominique Astruc, Marie-Pierre Moiton, Nicolas Dubois, Sylvie Ledru, Corinne Seknazi, Hélène Poupet, Jean-Philippe Brieux, Gérard Barthélémy, Aihem Yehia, Louis-Jean Couderc, Ahmed, Françoise Rigaux, Yohann N'guyen, Philippe Bethery, Damien Corberand, Etienne Auvray, Paul-Louis Woerther, Christian Combe, Sophie Delesalle, Jean-Marie Piala, Faraj Al Freijat, Philippe Juvin, Malcolm Lemyze, Hyacine Rey, Claire Larible, Noel Milpied, Lémia Zgarni, Julia Gaillard, Agnès Juven, Paola Otean, Adrien Melis, André Pechinot, Olivier Bouchaud, Olivier Chassin, Pierre Hausfater, Asma Trabelsi-Jnifen, Vincent Grobost, Didier Lemery, Pierre Soury, Françoise Brevet, Jacques Tankovic, Dominique Sansot, Jean Louis Salomon, Charlotte Cordonnier, Brigitte Lamy, Antoine Maisonneuve, Dominique Pressac, Claude Rémy, Rodolphe Sobesky, Stéphanie Cognet, Pierre Cougoul, Didier Jan, Dominique Perrotin, Cécile Hombrouk-Alet, Thierry André, Gilbert Pochmalicki, Serge Girard, Vincent Zerr, Guillaume Cadiot, Claudine Lasbasses, Michel Slama, Abderrazak El Yamani, Sophie Brovedani, Jean Armengaud, Romain Hernu, Géraldine Mascade, Aurélien Lorléa'ch, Ali Akkari, Mathieu Tourdjman, Christopher Payan, Eric Jullian, Nathalie Fonsale, Frédéric Riehl, Paul Strock, Geneviève Grise, Philippe Mottaz, Christian Floriot, Marie-Noëlle Ungeheuer, Denis Caillot, Arnaud Chalvon-Demersay, Catherine Branger, Stanislas Bruley des Varannes, Marc Paccalin, Marie-Pierre Danjean, Alexandre Mebazaa, Xavier Brunet, Roland De Varax, Laurence Delhoustal, Sophie Haro, Bruno Chabanon-Pouget, Isabelle Goidin, Dominique Chudersky, Corinne Costes, Delphine Chatellier, Maud Gelez, Damien Dassant, Pascal Joly, Jean-Michel Arnal, Zakaria Hamitou, Philippe Rondepierre, Carole Pignon, Valérie Crombe, Amanda Lopes, Chrystelle Kemenar, Olivia Raulin, Anne-Cécile Hochart, Sandrine Gérart Pons, Valérie Zeller, Guillermo Reyes Ortega, Mathilde Guérin, Audrey Migraine Bouvagnet, Florence Eboue, Isabelle Loury-Lariviere, Sophie Leotard, Suzanne Lima, Marie Kassis, Jean-Luc Donay, Jean-Pierre Audié, Guillaume Cartron, Arnaud Ribier, Fanny Buron, Mirela Tuca, Marius Semenescu, Arnaud Serre, Vincent Quentin, Denise Bouyssou-Destriau, Violaine Bresson, Christine Chandesris Joséphine Chapalain-Cagnon, Eric Cua, Henri Courtade, François Bénézit, Sébastien Lamache, Philippe Bonnefoy, Francis Schneider, Richard Monarchi, Adeline Schendel, Paramasiven Mootien, Ghislaine Gardes, Pierre-François Westeel, Jean-François Magny, François Caron, Jocelyn Michon, Didier Eyer, Isabelle Ronda, Pierre-Yves Robillard, Frédéric Renou, Anna Faucher, Jean-Robert Harlé, Anne Debernardi, Grégory Akerman, Benoît Fontenel, Pierre Hourdebaigt-Larrusse, Marie-Noëlle Adam, Aude Lessene, Abdelkader Hrichi, François Blot, Athéna Le Pierres, Romain Lemarie, Françoise Granier, Véronique Tardy, Marc Gatfosse, Pierre-Marie Roger, François Goupil, Saïd Aberrane, Franck Bernardi, Isabelle Plantier, Nathalie Funakoshi, Jean-Gilles Delecalle, Patricia Barbut, Jacques Reynes, Christophe Roy, Sophie Perreve, Michel Garre, David Ribes, Cyrille Ede, Jean-Claude Dausset, Francis Duchene, Jean Caussin, Michelle Becker-Schneider, Gilles Berthelot, Damien Dupont, Jean-Michel Gillot, Aurélie Messager, Jean-Marie Pannecouck, Jean-Christian Roussel, Alain Reynaud, Sylvie Cariou, Anne Dao, François Guillemot, Martin Martinot, Patrick Casali, Anne-Sophie Poirier, Aissa Kerchache, Necera Sakek, Eric Porthault, Christophe Decoene, Chantal Ache-Papillon, Brigitte Bicais, Jean-Claude Feugier, Thierry Masseron, Charles Marty-Ane, Daniele Goldgran Toledano, Jean-Christophe Dubus, Damien du Cheyron, Dominique Decré, Jean-Loup Pennaforte, Ahmed Tigaizin, Bernard Vache, Eric Oswald, Claire Moulinoux, Anne-Christine Jaouen, Caroline Charlier, Anne-Laure Virlouvet, Ali Kara, Jean-Luc Sicsic, Sylvie Goffart, Mathieu Zuber, Claudine Fèbre, Olivier Lortholary, Mathieu Dupont, Annie Vessieres, Thierry Helvadjian, Thomas Signouret, Cedric Daupin, Sandrine Essouri, Jean-Louis Jacob, Pascal Boileau, Caroline Blazejewski, Quentin Lepiller, Juan-Pablo Maureira, Eddy Lebas, Christophe Deschamps, Amévi Ananivi, Clovis Foguem, Daniel Adoue, Abdourahim Chamouine, Alain Michault, Bruno Guérin, Olivier Baud, Clara Vinci, Thierry Weitten, Jean-Marc Eychene, Marie Froidure, Julien Obiols, Patricia Roussellier, Marc Lecuit, André Cabié, Saskia Foucart, Karim Belhadj, Michel Cingotti, Bruno Dumoulard, Jean Puyhardy, Etienne Danquechin Dorval, Lucile Mendes-Martin, Enrique Casalino, Luc Jarrige, Fabien Lambiotte, Philippe Masson, Mohammed Mansouria, Pierre Thouvenot, Katy Jeannot, Martine Nyunga, Valérie Macci, Florent Masia, Claire Briere de la Hosseraye, Wassila Anteur, André Sommabère, Marie-Claude Germain, Isabelle Arnault, Bernard Carbonelle, Philippe Devos, Daniel Protar, Tiphaine Gaillart, Ludovic Lassel, Laurence Hamou-Plotkine, David Trystram, Thierry Bureau, Olivier Collard, Fanny Vuotto, Sophie Malhiere, Frederique Canis, Gillles Plainfosse, Catherine Lechiche, Bertrand Lassere, Martine Chouraqui, Jean Baptiste Michot, Fethi Radhouane-Khanjari, Carole Barbier, Pascal Bonitchi, Abdelaziz Benkhelil, Odile Salmon, Laurent Damaj Gandhi, Bertrand Minguet, Michel Wagner, Odile Falguières, Zahr-Eddine Ali Chaouche, Eric Zaoui, Isabelle Guichard, Bernard Huttin, Apollinaire Karirisi, Gaël Cinquetti, Christophe Plane, Lionel Rostaing, Yanne Henry-Andrieu, Daniel Re, Virginie Verrier, Pascal Bolot, Michel De Biasi, Laurence Vrigneaud, Mathilde Turpin, Marie-Claude Demachy, Etienne Roussel, Michèle Blancs, Olivier Join-Lambert, Yves Ville, Thierry Granger, Gilles Hilbert, Virginie Medeau, Daniel Villers, Benoit Pilmis, François Gouraud, Emmanuel Ardiet, Catherine Heyraud-Blanchet, Alain Devidas, Hélène Dieye, Julie Cremniter, Jean-François Bergmann, Rozenn Le Berre, Virginie Leguen, Daniel Royer, Gilles Le Maout, Christian Harou, Sylvie Gabriel-Soléan, Yves Regouby, Martine Pestel-Caron, Patrick Brunet, David Boutoille, Emmanuelle Bonnin, Patrice Coulon, Marc Sullice, Marianne Barbieux, Gilles Cambonie, Joëlle Tricoire, Marie-Nadège Bachelier, Delphine Briend, Céline Ramanantsoa, Nathalie Bednarek, Didier Lebreton, Julien Lagrandeur, Damien M'Bey, Philippe Audeguy, Elie Saliba, Lena Damaj, Hassan Fallouh, Pascal Couturier, Fabrice Prévost, Yves Domart, Marie-Odile Lafforgue, Anne Le Du, C. Beuscart, Pierre Guillet, Fabrice Larrazet, Marie-Hélène Hausermann, Henri Robert, Nicolas Fanjaud, François Goehringer, Thomas Bachelot Philippe Badia, Jean-Michel Coulaud, Cristel Fissore Magdelein, Renaud Defebvre, Anne-Sohie Moreau, Johan Courjon, Gilles Salles, Michel Mialon, Silvia Iacobelli, Emmanuelle Bille, Marie-Christine Barbier, Yves Aubard, Patrice Badila, Jean-Philippe Rasigade, Alban Deroux, Evelyne Lecaillon-Thibon, Michel Godin, Abdelmajid Djeffal, Viorica Badurescu, Meriem Canitrot, Pierre Blanchard, Antoine Legros, Laurence Got, Françoise Duluc, Mylène M. Maury, Gilles Dassieu, Nordine Khodeir, Jean-Marie Duez, Mathieu Morincomme, Jérôme Lacroix, Mathieu Revest, Koffi Blewoussi, Isabelle Barazer, Françoise Poitevin, Camille Seignovert, Stéphanie Honore Bouakline, Anne Heidt, Brigitte Malbruny, Julien Desblache, Christian Cattoen, Eric Jaunait, Bruno Chaminade, Claude Bazin, Jonathan Chelly, Anne Pottier, Alain Schmitt, Alain Tissot, Karim Dadoun, P. Rebattu, Claudine Contamin, Arnaud Guerard, Nathalie Ravet, Sandrine Khalifa-Thellier, Marlène Chatron, Gaëlle Dörr, Hélène Biessy, Emmanuel Forestier, Bruno Devaux, Jean-Jacques Grelaud, Xavier Tchenio, Marie-Cécile Ploy, Jérémie Violette, Michèle Burdin, Lionel Falchero, Dominique Jacomy, Jean-Christophe Rozé, Damien Labarriere, Stéphane Leroux, Corinne Meregnani, Assia Ferhat Carre, Paul Orode, Jean-Gabriel Paul, Catherine Godon, Agnès Vinay, Régine Barraduc, Dominique Dallay, Alexandre Ampère, Anne-Gaelle Kervegant, Guillaume Louart, Dominique Beal Ardisson, Francoise Leonetti, Jean-Yves Baril, Stéphanie Haiat, Bincy Darre, Jérôme Bay, Yvan Gauthier, Sylvie Radenne, Pierre-Yves Gueugniaud, Philippe Ravaud, Luc Landraud, Guillaume Ranchon, Loïc Chimot, Véronique Duval, Ilhem Agha-Mir, Sabine Camiade, Estelle Wafo, Jean-Patrick Laporte, Mariam Roncato-Saberane, Camille Bron, Patrice Laudat, Samir Kennouche, Nawel Afroukh, Dominique Neri, Hakim Kherouf, Yoar Hichri, Pierre-Edouard Bollaert, Gwenaelle Vary, Denis Castaing, Christine Lefort, Sébastien Rouget, René Robert, Christelle Guillet-Caruba, Catherine Simonin, Alain Vighetto, Severine Cabasson, Alain Brusset, Alexandra Doloy, Christel Cherlet, Ahmed Rouidi, Marina Salvucci, Réginald Pordes, René-Gilles Patrigeon, Emmanuelle Dupre-Narlet, Jacques Minet, Fethi Taleb, Anne-Marie Colingorski, Tahar Hadou, Sylvain Diamantis, Isabelle Glorieux, Thierry May, Jean-Claude Colombani, Anne Berth-Farges, Nicole Desplaces, Renaud de Tayrac, Elisabeth Walter, Fabienne Lorge, Pascal Reboul, Nathalie Dournon, Laurence Estépa, Marie-Lina Toubia, Mathilde Flahault, Thierry Delacour, Dominique Hurel, Hélinoro Andriamaneo, Cécile Bébéar, Denis Grasset, Miloud Serier, Oléna Orléva, Nadine Dubroca, Hervé Gentilhomme, Jean-Luc Baudel, Isabelle Lavenu, Salim Smati, Carlo Saroufim, Eric Placidi, Albert Sotto, Benoît Libeau, Hélène Leroy, François Golfier, Christophe Dollon, Laurence Desnoulez, Eric Barre, Daniel Cohen, Pascal Priollet, Thierry Marsepoil, Benoît Lionnet, Jacques Tebib, Pascale Penn, Antoine Bouissou, Christian Roth, Olivier Martinet, Anna Schmitt, Nathalie Fruleux, Fouzia Radaoui, Jean-Marc Lessinger, Virginie Morando, Jean-Jacques Maillet, Christophe Fruchart, François Boué, François Goffinet, Franck Lellouche, Martin Demarchi, Alain Geissler, Jean-Charles Picaud, David Assouline, Patricia Brazille, Philippe Guimier, Marie-Françoise Dabysing, Bruno Delpeuch, Vanessa Tran, Guy Gengembre, Delphine Deligne, Dominique Vodovar, Yvan Touze, Sabrina Parent, Anne Decoster, Camille Dewitte, Emmanuel Weiss, Thierry Lambert, Thomas Guimard, Vincent Caille, Claude Guérin, Françoise Evreux, Geneviève Barjon, Basile Ondze, Damien Fournier, Olivia Bandin, Sophie Mignart, Henri Demontclos, Didier Perez, Jacques Croize, Nicole Desbois-Nogard, Guenièvre Imbert, Clarisse Dupin, Khalid Ridah, Marie-Christine Varin, Guillaume Arlet, Edith De Clareuil, Marie-Line Eustache, Patricia Le Pimpec, Louise Fortin, Eugène Ngami, Fabrice Mihout, Cecilia Esnault, Vincent Bouden, Véronique Annaix, Yves Poinsignon, Aurélien Lorchleac'h, Jean-Marc Degreff, Marie Garofano, Renaud Mesnage, Anne-Marie Roque-Afonso, Alain Chevailler, Stéphane Hominal, Thierry Charbonnier, Adrianna Bildea, Fabien Fily, Benjamin Davido, Emmanuel Rassiat, Assi Assi, Stéphanie Brunet, Hervé Jacquier, Catherine Claise, Annie Durand, Yannick Monceau, Pierre Blanc, Jean-Marie Sire, Yves Sucin, Jean-Pierre Zarski, Nathalie Bronet, Ingrid Lafon, Philippe Rey, Jacques Markarian, Eric Sennevile, Olivier Wink, Guilène Barnaud, Anne-Sophie Peultier, Sabine Taylor, Rim Savatier, Patrick Valayer, Claude Negrier, Selim Jennane, Edouard Begon, Laura Hyerle, Delphine Bridoux, Claire Daurel, Benoît Dalle, Mathilde Lescat, Philippe Stolidi, Elodie Perrodeau, Xavier Heches, Pierre Castelnau, Philippe Bray, Jean-Claude Texier, Serge Rossignol, Maud Brung-Lefebvre, Jean-François Subra, Jean-Marie Delarbre, Morgane Schneerson, Guyro Jang, Mona Mehri, Nathalie Landgraf, Pierre-Marie Girard, Armand Goll, Zaineb Bekguesmia, Christophe Clement, Michel Collet, Vincent Maze, Amine Benjelloul, Solène Durliat-Ellie, Vincent Letouzey, François Schmitt, Valérie Martinez, Sarah Watson, Abderrezak Bouasria, François Barbier, Raphael Lauretta, Mirana Razafimahery, Cristina Sirbu, Patrick Malherbe, Anne Wuillai, Ludovic Lesecq, Philippe Gaudard, Serge Houssaye, Jacques Monsegu, Gilles Rival, Chantal Chaplain, Jean-Didier Grangé, Oana Zamfiri, Florence Nguyen-Khac, Marc Portneuf, Jean-Michel Pawlotsky, Delphine Bonnet, Laurent Traissac, Sophie Hamon-Charles, Didier Dreyfuss, Louis Bernard, Laurence Detourmignies, Olivier Martineau, François Pettinelli, Marc Zandecki, Michel Dreyfus, Alain Chapelle, Sébastien Sabbat, Anne-Sophie Labussiere, Jean-Louis Gaillard, Chloé Plouzeau-Jayle, Patrick Zoveda, Véronique Leflon, Marie Levy, Aurélie Labé, Bruno Soulie, Raoul Jacques Bensaude, Hecham Moussa, Sylviane Catteu, Nathalie Biron, Loïc Masson, Georges Mourad, Nejla Aissa, Dragos Ciocan, Hubert De Boysson, Jean-Luc Bouyer, Patrick Yeni, Thierry-Pascal Zame, Caroline Thomas, François Cavalié, Laurence Koulmann, Christophe Rioux, Olivier Barraud, François Bricaire, Marguerite Le Poulain, Marie-Noelle Noulard, René Thomas, Guy Semet, Laurent Mosser, Olivier Marret, Brigitte Rivière, Vincent Jarlier, Jean-Philippe Coindre, Marc Villemain, Martin Pierre, Yacine Benkaci, Philippe Chiron, Hoang Vu-Thien, Jérôme Gournay, Andrea Labaune-Kiss, Brigitte Lauzanne, Fanny Lemercier, Souad Silhadi, Imad Kansau, Christophe Poncelet, Olivier Baldesi, Francis Thuet, Olivier Leroy, Aurore Lamberet, Camille Petit Hoang, Sophie Micheli, Ayman Abokasem, Hakima Nesrine, Pierre Lureau, Christian Chidiac, Vincent Piriou, Fabien Zoulim, Dieudonné Nicobaharaye, Anne Tixier, Isabelle Matheron, Soumeth Abasse, Victoria Cacheux, Serge Herson, Christine Fuhrmann, Olivier Proost, Bernard Bedock, Olivier Rogeaux, Mostapha Hajjar, Anne Reverseau, René Courcol, Françoise Carmagnol, Yves Guénard, Céline Ménard, Bouchra Lamia, Bruno Lemmens, Damien Bouhour, L. Lequen, Gaëlle Baty, Cédric Bouet, Dominique Guerrot, Stéphane Blanc, Catherine Chirouze, Anne-Hélène Reboux, A. Vachée, Gregory Taurin, Myriam Mein-Bottini, Jean-Pierre Belot, Alain Lafeuillade, Patricia Gabez-Therou, Philippe Labrousse, Bernard Jarrousse, Philippe Noto, Vincent Brunot, Philippe Condominas, Marion Challier, Béatrice Berçot, Delphine Anuset, Mélanie Daval Cote, François Bernasconi, Y. Costa, Chandrah Goburdhun, Bernard Gressier, Alban Michaud-herbst, Franck Charlier, Moussa Hecham, Luc Boulain, Hélène Corneloup, Alix Greder Belan, Nicolas Boussekey, Claire-Antoinette Dupuy, Yannick Rouquet, Benoit Renard, Benifla Jl, Etienne Javouhey, Michèle Granier, Marie-Christine Jaffarbandjee, Emilie Piet, Benoît Bergues, Claire Malbrunot, Catherine Tiry, Philippe Mérigot, Mouna Ben Soltana, Chantal Roure Sobas, Florian Radenac, Yves Thomas, Agathe Blaise, Sylvie De Martino, Laurence Legout, Gabriel Choukroun, Jean-François Muir, Peggy Dupretz, Patrick Dupont, François Guichart, Julie Jean, Jean-Michel Descamps, Bernard Kittschke, Anne Gruson, Gerard Viquesnel, Marie Keller, Pascal Chavanet, Françis Vallet, Yvan Vaschalde, Jean-Luc Hanouz, Gerard Lina, Françoise Loison, Simon Vincent, Jean-Paul Thellier, Moncef Afi, Dominique Zagozda, Hélène Sokeng-Affoule, Marc Le Bideau, Jean-François Loriferne, Alain Gravet, Sophie Deprecq, Tarik Naceur, Severine Mielczarek, René-Jean Bensadoun, Bernard Karkous, Yves Bléher, Jocelyne Poulain, Véronique Goulet, Laurence Nicolet, Sophie Arista, Antônio Lúcio Teixeira, Jean-François Schved, Laurent Nicolet, Claire Lecomte, Faiza Benddif-Fin, Michel Aumersier, Laurence Burc-Struxiano, Maxime Thouvenin, Samia Harbi, Mathieu Detave, Catherine Rebeyrotte, Jean-Paul Kisterman, Bruno Berdin, Pascal Vincent, Laurent Argaud, Elisabeth Parisi-Duchene, Geneviève Julienne, Fernanda Farto-Bensasson, Georges-Fabrice Blum, Sad Gaizi, Tali-Anne Szwebel, Raphaël Lepeule, Marie-Thérèse Climas, Anne-Françoise Dillies, Amar Boudhane, Umberto Simeoni, Pierre-François Dequin, Gérard Oliviero, Alain Gourlaouen, Caroline Piau, Marie-France Lutz-Murphy, Benoît Claude, Jean-Paul Aubry, Nadine Dubosc-Marchenay, Kamilla Chraibi, Emmanuelle Heusse, Sylvain Le Chevallier, Nathalie Brieu, Farid Sifaoui, Lorraine Letranchant, Hélène Durox, Jean-Pierre Lagasse, Adel Ghedira, Xavier Roubert, Fatma Magdoud, Hélène Jean-Pierre, Etienne Carbonelle, Olivier Dereeper, Lionel Carbillon, Christophe Billy, Mélanie Roblin, Marie-José Kodzin, Philippe Niel, Solène Makdessi, Matteo Vassallo, Maryse Archambaud, Fabian Haccourt, Didier Blaise, Stéphane Bourgeois, Elena Marcu, Charles Kubiak, Brisse Castel, François Guinet, Marie Pouzoullic, Frédérique Nathan-Bonnet, Vincent Gendrin, Céline Becherrawy, Aline Secher, Pierre Abgueguen, Clarence Eloy, Jean-Marc Tourani, Frédéric Klapczynski, Bernard Montmasson, Philippe Real, Joanna Pofelski, Yves Welker, Karim Krechiem, Eric Caumes, Martine Elena-Daumas, Christophe Saigne, Gilles Hittinger, Chantal Delesalle, Jonathan Messika, Fabrice Lesage, Daniela Pop, Daniel Coetmeur, Renato Colamarino, Chetaou Mahaza, Patrick Plésiat, Isabelle Fredenucci, Mylène Baret, Guy Mager, Pascale Chavel, Isabelle Labourdette, Anne-Claude Menguy, Nicolas Fortineau, Ludovic Le Sec, Valérie Gauduchon, Francis Barraud, Nicolas Letellier, Didier Vincent, Janine Frey, Philippe Riegel, Michel Pavic, Jean-Luc Fabre, Jean-Pierre Fauchart, Alain Goudeau, Stéphanie Husson-Wetzel, Philippe Eymerit, Mohamed Camara, Nathalie Seta, Elisabeth Carole Ngo Bell, Philippe Repellin, Laurent Alric, Vincent Leroy, Françoise Delisle Mizon, Jean-Philippe Emond, Marie-Françoise Borie, Lise Crémet, Wladimir Chelle, Elisabeth Brottier-Mancini, Bernard Garrigues, Claire Letellier, Loïc Geffray, Frédéric Méchaï, Julien Bador, Benoit Guery, Alain-Charles Fouilhoux, Corinne Dagada, Pierre Duhaut, Julien Goustille, Arnaud Sément, Francis Carcenac, Isabelle Girard-Buttaz, Claire Chapuzet, Fabienne Jouatte, Bruno Riou, Fabrice Hayoun, Chloé Di Meglio, Youssef Ali, Michel Leneveu, Nathalie Montagne, Yves Garcera, Audrey Moustache, Pierre-Eric Danin, Geneviève Le Lay, Dominique Courouge-Dorcier, Isabelle Worcel, Emmanuel Morelon, Vincent Pestre, Jean-Pierre Vilque, Jean-Christophe Paquet, Lucien Bodson, Anne-Marie Forest, Fabrice Pierre, Christian Pommier, Fabien Dutasta, Pierre Fournel, Stéphanie Courtois, Elodie Dubois, Serge Vanden Einjden, Patrick Honderlick, Pascal Richette, Fabienne Tamion, Véronique Chassy, Richard Megbemado, Anne-Marie Le Reste, Bernard Simian, Henri Osman, Anthony Texier, Badih Ayach, François Simon, Jean-Michel Filloux, Béatrice Dubourdieu, Jean-Claude Semet, Sarah Kubab, Tawfiq Henni, Patrick Dudeffant, Delphine Hequet, Olivier Mimoz, Marc Auburtin, Amélie Chabrol, Mickael Bonnan, Caroline Léonnet, Claire Wintenberger, Serge Ilunga, Patrice Lanba, Sophie Rosello, Alexandre Damage, Flore Bouche, Michel Thibault, Frederic Faibis, Chantal Dhennain, Jean-Philippe Talarmin, Armelle Lamour, Remi Boussier, Fabien Garnier, Marie-Laure Brival, Nourredine Hedjem, Philippe Vande-perre, Raphaël Coint, Jean-Claude Reveil, Eva Weinbronn, Emmanuelle Lavalard, Alexandra Fille, Françoise Le Turdu, Lionel Leroux, Jean-Yves Lefrant, Jean Berthet, Radia Bouaziz, Alain Ravaud, Sylvaine Rousseau, Yacine Merrouche, Alain Le Coustumier, Bertrand Guider, Gisèle Dewulf, Jean-Marc Faucheux, Jacques Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [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), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), 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), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)
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Bacteremia/epidemiology/mortality ,0301 basic medicine ,Male ,Pediatrics ,bacteraemia ,Infectious Disease Transmission ,[SDV]Life Sciences [q-bio] ,Bacteremia ,France/epidemiology ,Infant, Newborn, Diseases ,Foodborne Diseases ,Meningoencephalitis ,Pregnancy ,Risk Factors ,Vertical ,Medicine ,Listeriosis ,Prospective Studies ,Pregnancy Complications, Infectious ,Prospective cohort study ,ddc:618 ,diabetes ,alcoholism ,Hazard ratio ,Foodborne Diseases/microbiology ,immuno suppressive therapies ,Prognosis ,3. Good health ,[SDV] Life Sciences [q-bio] ,Hospitalization ,Infectious Diseases ,isolates ,Population Surveillance ,Female ,France ,Listeria monocytogenes/classification/isolation & purification ,Cohort study ,Adult ,medicine.medical_specialty ,030106 microbiology ,Notifiable disease ,Listeriosis/diagnosis/epidemiology/microbiology ,Context (language use) ,macromolecular substances ,03 medical and health sciences ,Humans ,study ,Aged ,[ SDV ] Life Sciences [q-bio] ,business.industry ,Public health ,cirrhosis ,Infant, Newborn ,Infant ,Diseases/epidemiology/microbiology ,HIV ,Mandatory Reporting ,Newborn ,medicine.disease ,Listeria monocytogenes ,infection ,Infectious Disease Transmission, Vertical ,Pregnancy Complications ,Infectious/epidemiology/microbiology ,Meningoencephalitis/epidemiology/microbiology/mortality ,Observational study ,business ,prognostic ,mellitus - Abstract
International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (
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- 2016
38. Recommandations francophones, internationales et multidisciplinaires d’experts pour l’utilisation de biomédicaments dans le lupus érythémateux systémique : le groupe de travail du CRI-IMIDIATE
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François Maurier, Jérémie Sellam, Florence Tubach, Laurent Chiche, Dan Lipsker, A. Ladjouz-Rezig, Raphaèle Seror, Pierre Quartier, Sylvain Audia, N. Derdèche, J.F. Kleinmann, Brigitte Bader-Meunier, Jacques-Eric Gottenberg, Jacques Morel, Eric Hachulla, Olivier Chosidow, Xavier Puéchal, David Saadoun, Bernard Bonnotte, Noémie Jourde-Chiche, S. Guillo, B. Moulin, Fadi Fakhouri, Nathalie Costedoat-Chalumeau, Olivier Meyer, Leith Zakraoui, Martin Soubrier, Arsène Mekinian, Isabelle Koné-Paut, Dominique Farge, Denis Mulleman, Emmanuel Andrès, Karim Sacre, Olivier Lambotte, Leonardo Punzi, Amar Smail, Christophe Richez, Vincent Poindron, N. Martin Silva, V. Le Guern, Stéphane Zuily, Jean Sibilia, Mohamed Hamidou, Eric Daugas, Andrea Doria, Olivier Fain, Gilles Blaison, Frédéric Houssiau, S. Mohamed, Z. Amoura, A. Sparsa, Sophie Caillard, Alexis Mathian, Claire Daien, Laurent Sailler, Najia Hajjaj-Hassouni, Xavier Mariette, Z. Tazi Mezalek, Patrice Cacoub, R. Meckenstock, Thierry Martin, Cem Gabay, and Thomas Papo
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Gastroenterology ,Internal Medicine - Abstract
Introduction Les lupus actifs et corticodependants malgre un traitement immunosuppresseur conventionnel, representent un defi therapeutique. Aujourd’hui, si seul le belimumab a ete autorise par une AMM, d’autres biomedicaments sont parfois utilises au lieu a titre derogatoire dans des lupus refractaires. Etant donne le manque de donnees prouvant l’efficacite de ces biomedicaments dans certaines situations rencontrees en clinique, nous avons decide d’etablir des recommandations d’experts pour l’utilisation de biomedicaments dans le lupus erythemateux systemique. Materiels et methodes Nous avons developpe ces recommandations par « consensus formalise d’experts ». Le but de cette methode est de formaliser le degre d’accord entre experts en identifiant, par une cotation iterative avec retour d’information, les points de convergence, de divergence ou d’indecision entre experts. Cette methode comporte plusieurs etapes chronologiques consecutives (phase de pilotage, de cotation, de lecture, de finalisation et diffusion) realisees par des groupes de travail independants. Au travers de 3 reseaux dedies aux maladies auto-immunes systemiques (FLEUR, IMIDIATE, FAI2R) et sous l’egide du CRI, nous avons recueilli les opinions de 59 experts francophones du lupus exercant en Algerie, Belgique, France, Italie, Maroc, Suisse et Tunisie. Les specialites medicales representees etaient la medecine interne (49 %), rhumatologie (34 %), nephrologie (7 %), dermatologie (5 %), pediatrie (3 %) et medecine vasculaire (2 %). Deux methodologistes et 3 groupes d’experts strictement independants ont contribues a ces recommandations : un groupe de pilotage (GP) (n = 9), un groupe de cotation (GC) (n = 28) et un groupe de lecture (GL) (n = 23). Les propositions de recommandations ont ete redigees par le GP et soumises au GC. Chaque membre du GC a indique son degre d’accord de 1 a 9 (1 : totalement inapproprie ; 9 : totalement approprie ; 5 : indecision) et ses commentaires pour chaque recommandation. Apres 2 tours de cotations, le GP a reformule une version initiale des recommandations qui a ete soumise au GL. La distribution des scores et les commentaires du GL ont permis au GP de rediger une version finale des recommandations ( Tableau 1 , Tableau 2 , Tableau 3 , Tableau 4 ). Resultats Dix-sept recommandations finales ont ete elaborees par le GP, en tenant compte de tous les scores et commentaires faits par chaque membre du GC, du GL et des 2 methodologistes de l’etude. Ces recommandations definissent notamment 4 domaines : – le type de patients necessitant un biomedicament ; – le type de biomedicament (belimumab, rituximab, etc.) et de co-traitement a utiliser en fonction de l’atteinte d’organe ; – l’information a donner aux patients ; – la facon d’evaluer l’efficacite du traitement. Un algorithme de choix de biomedicament a ete realise a partir des recommandations finales du domaine 2. Conclusion Dix-sept recommandations pour l’utilisation de biomedicaments dans le lupus erythemateux systemique ont ete formulees par un large panel d’experts pour donner des conseils aux cliniciens dans la pratique quotidienne. Ces recommandations seront regulierement mises a jour en fonction des resultats de nouveaux essais cliniques randomises et de l’experience clinique croissante.
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- 2016
39. Value of 18F-FDG-PET/CT in patients with fever of unknown origin and unexplained prolonged inflammatory syndrome: a single centre analysis experience
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Gilles Blaison, Jean-Louis Pasquali, D. Christmann, Bernard Goichot, Jean-Christophe Weber, Jean Sibilia, A. Imperiale, C. Blondet, Laure Federici, André Constantinesco, Emmanuel Andrès, and F. Pflumio
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,General Medicine ,University hospital ,medicine.disease ,Single centre ,Positron emission tomography ,medicine ,Fdg pet ct ,In patient ,Tomography ,Radiology ,Fever of unknown origin ,business - Abstract
Summary Objective: The aim of our study was to evaluate the diagnostic contribution of 18F-fluoro-deoxyglucose (18F-FDG)-positron emission tomography (PET)/computed tomography (CT) in patients with fever of unknown origin (FUO) or unexplained prolonged inflammatory syndrome (UPIS) in real life. Patients and methods: We performed a retrospective study including 14 patients with FUO or UPIS hospitalised in our institution (Strasbourg University Hospital, France) between January 2005 and July 2006. 18F-FDG-PET/CT was considered helpful when abnormal results allowed an accurate diagnosis. Results: 18F-FDG-PET/CT was helpful in half the patients (7/14) for final diagnosis. A diagnosis was reached in 87.5% of the patients (7/8) with an abnormal 18F-FDG-PET/CT but only in 50% of the patients (3/6) with a normal 18F-FDG-PET/CT. Conventional chest and abdominal CT was performed in 13 patients before ordering 18F-FDG-PET/CT. We considered that 18F-FDG-PET/CT was essential to establish the final diagnosis in only 23% of the patients (3/13) since neither chest nor abdominal CT identified abnormalities consistent with the final diagnosis. However, among the three patients, two were diagnosed with large vessel vasculitis and one patient with local prosthetic infection. Conclusions: Our study supports the potential interest of 18F-FDG-PET/CT in the diagnostic workup of FUO and UPIS as it helped establish a fine diagnosis in half of the cases. However, 18F-FDG-PET/CT appeared to be essential to the final diagnosis in only 23% of the cases. In our opinion, this protocol should be performed as a second level test, especially when conventional CT is normal or is unable to discriminate between active and silent lesions.
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- 2010
40. Étude descriptive de la cohorte franco–allemande LBBR de patients ayant un lupus erythémateux systémique
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A. Schwarting, Hanns-Martin Lorenz, P. Jl., Vincent Poindron, Gilles Blaison, P.E. Gavand, Christoph Fiehn, Reinhard E. Voll, J. Sibilia, Thierry Martin, Z. Amoura, and François Maurier
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0301 basic medicine ,03 medical and health sciences ,030104 developmental biology ,Gastroenterology ,Internal Medicine - Abstract
Introduction La cohorte LBBR est une cohorte franco–allemande de patients ayant un lupus erythemateux systemique (LES). Les patients ont ete inclus prospectivement entre 2011 et 2015 dans 17 centres avec un recueil de sang a l’inclusion afin de constituer bio-banque. L’objectif de cette etude est de decrire les caracteristiques demographiques, cliniques et biologiques de cette cohorte. Patients et methodes Pour etre inclus les patients devaient etre majeurs et avoir consulte dans un des 17 centres participants. Un phenotypage detaille etait recueilli a l’inclusion en meme temps que le prelevement sanguin. La bio-banque conserve du plasma, des cellules et de l’ADN de tous les patients inclus. Les patients devaient avoir un lupus selon les criteres ACR ou SLICC ou 3 criteres et un diagnostic pose par un centre expert. Par ailleurs, un certain nombre de patients avec un syndrome d’Evans et des ANA positifs ont ete inclus. Les donnees etaient monitorees par les investigateurs. Resultats Au total, 1077 patients ont ete inclus, avec un âge moyen au moment de l’inclusion de 43,6 ans ( ± 16,8). Il y avait une majorite de femme (88,6 %). L’origine ethnique etait frequemment caucasienne (84,3 %), mais on notait egalement des patients d’origine nord-africaine (7,0 %), asiatique (2,8 %) et africaine (2,4 %). Il y avait 78 patients avec un cas familial de lupus systemique au premier degre. Parmi les patients, 30,6 % avaient une autre maladie auto-immune associee. Huit-cent-cinquante-huit (79,7 %) patients remplissaient les 4 criteres ACR ou les criteres SLICC. Le score SLEDAI moyen a l’inclusion etait de 4,07 ( ± 4,7). Les principales manifestations cliniques etaient : des arthrites (n = 743), une photosensibilite (n = 643), un erytheme malaire (n = 549), une nephropathie lupique (n = 348), des serites (n = 255), des manifestations neurologiques (n = 150). Au niveau biologique on notait des Ac antinucleaire positifs chez 95,1 % des patients, des Ac anti-DNA natifs positifs chez 75,7 % et des Ac anti-Sm chez 14,8 %. Une lymphopenie inferieure a 1500/mm3 et une thrombopenie Conclusion Il s’agit de la premiere description d’une grande cohorte franco–allemande de patients avec un lupus systemique. Les caracteristiques cliniques de cette cohorte sont comparables avec celles d’autres cohortes de patients ayant un lupus systemique comme RELESSER et GLADEL. L’analyse genetique couplee a ces donnees phenotypiques detaillees permettra d’avoir plus d’information sur l’impact de la genetique sur le developpement et le pronostic de la maladie. Cette bio-banque est ouverte a tout investigateur pour realiser des projets de recherche.
- Published
- 2017
41. Agranulocytoses médicamenteuses idiosyncrasiques
- Author
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Alina Zamfir, Bruno Audhuy, Laure Federici, Emmanuel Andrès, Gilles Blaison, Thierry Weitten, Martine Alt, and Frédéric Maloisel
- Subjects
education.field_of_study ,medicine.medical_specialty ,business.industry ,Mortality rate ,Population ,General Medicine ,medicine.disease ,Comorbidity ,Trimethoprim ,Sulfasalazine ,Internal medicine ,Immunology ,medicine ,Absolute neutrophil count ,Ticlopidine ,education ,Adverse effect ,business ,medicine.drug - Abstract
Key points Idiosyncratic drug-induced agranulocytosis is a potential adverse event of most drugs, rare but life-threatening. Its annual incidence does not exceed 10 cases per million population in Europe and has remained stable over the past two decades. Its pathogenesis is poorly understood . The principal drugs associated with it are antithyroid drugs, antibiotics including trimethoprim, sulfamethoxazole, and beta-lactamines, ticlopidine, sulfasalazine and dipyrone. Clinical presentation is highly variable but a severe infection is observed in more than one third of cases. Poor prognostic factors include a neutrophil count under 100/mm 3 , age > 65 years, septicemia or shock, and severe comorbidity. Improvement in the management of infectious complications and the use of hematopoietic growth factors in severe cases helps explain that mortality rate has fallen to less than 5%.
- Published
- 2008
42. Brief Report: Spatial Heterogeneity of Systemic Sclerosis in France: High Prevalence in the Northeast Region
- Author
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Alain, Meyer, Hélène, Chifflot, Emmanuel, Chatelus, Jean-François, Kleinmann, Cécile, Ronde-Ousteau, Delphine, Klein, Jérémy, Jégu, Bernard, Geny, Sandrine, Hirshi, Matthieu, Canuet, Gilles, Blaison, Pierre, Kieffer, Dan, Lipsker, Thierry, Martin, Erik, Sauleau, Michel, Velten, and Jean, Sibilia
- Subjects
Adult ,Aged, 80 and over ,Male ,Young Adult ,Scleroderma, Systemic ,Adolescent ,Prevalence ,Cluster Analysis ,Humans ,Female ,France ,Middle Aged ,Aged - Abstract
Alsace is a region in eastern France with a population of ∼2 million. All residents have high access to health care and an accredited referral center for SSc. Seeking care outside of this region is difficult because of the peculiar geography. The aim of this study was to assess the prevalence and spatial variation of systemic sclerosis (SSc) in eastern France.Data for SSc patients were obtained from 3 sources (all general practitioners and community specialists, capillaroscopy centers, and all public and private hospital records) and were used to estimate the prevalence of SSc. Surviving patients who resided in Alsace on January 1, 2008 and fulfilled the American College of Rheumatology and/or the LeRoy and Medsger criteria were included in this study. The clinical characteristics of the patients were also assessed. Potentially incomplete case ascertainment was corrected by capture-recapture analyses. Geographic disparities were assessed by spatial cluster analysis and by comparing our results with those for other geographic areas in the world for which data derived using similar methodology were available.The review of 499 potential cases identified a total of 244 SSc patients. A trend toward a west-to-east gradient was observed but did not reach statistical significance. According to log-linear modeling, an estimated 83.87 additional cases were missed. Thus, the SSc prevalence was 228.42 cases per million adult inhabitants of Alsace (95% confidence interval 203.70-253.14); this prevalence was significantly higher than that in 2 other regions of France and comparable with the reported prevalence in Detroit, Michigan.The stringent methodology used in the current study is very likely to provide an accurate estimation of the prevalence of SSc. Design similarity with 3 other surveys extends the scope of the results by identifying geographic disparities that were previously indistinguishable due to methodologic differences.
- Published
- 2015
43. Données actuelles sur la maladie de Biermer. À propos d'une étude rétrospective de 49 observations
- Author
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M. Rondeau, Esther Noel, Noureddine Henoun Loukili, Georges Kaltenbach, Bernard Goichot, Gilles Blaison, and Emmanuel Andrès
- Subjects
Gynecology ,medicine.medical_specialty ,B vitamins ,Vitamin deficiency ,Sex factors ,business.industry ,Gastroenterology ,Internal Medicine ,medicine ,Nutritional status ,medicine.disease ,business - Abstract
Resume Propos. – Le but de cette etude est de determiner le tableau clinique actuel de la maladie de Biermer (MB) en medecine interne. Methode. – Il s'agit d'une etude retrospective (de 1996 a 2002), multicentrique (5 services de medecine interne), incluant 49 observations de MB averee avec une carence en vitamine B12 (B12) documentee. Resultats. – L'âge median des patients etait de 74 ans (25–93), le sex-ratio H/F de 13/36. Trente-cinq pour cent des patients avaient des antecedents et/ou de maladies auto-immunes evolutives ou dysimmunitaires. Des manifestations cliniques variees, neurologiques mais egalement cutaneomuqueuses et thrombotiques etaient trouvees chez 65,4 % des patients, au moins une anomalie hematologique chez 100 %. La B12 serique et l'homocysteinemie moyennes etaient respectivement a 73 pg/ml (20–196) et 42,9 μmol/l (7,8–124). Les anticorps (Ac) antifacteur intrinseque etaient positifs chez 87,5 % des patients, les Ac anticellules parietales gastriques chez 62 % (au moins un des deux Ac chez 96 %). Le test de Schilling affirmait le diagnostic de MB dans 86 % des cas. Le traitement par B12 intramusculaire (n = 27) ou administree par voie orale (n = 5) s'est revele constamment efficace. Conclusion. – L'association de la MB a des maladies auto-immunes et/ou dysimmunitaires est tres frequente ; les tableaux cliniques et les manifestations biologiques de la MB sont extremement varies ; et le traitement par B12 per os peut etre une alternative therapeutique a la voie parenterale.
- Published
- 2004
44. Facteurs sociodémographiques et cliniques influençant la qualité de vie générique et spécifique au cours du lupus systémique
- Author
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J.F. Besancenot, Sylvain Audia, Christiane Broussolle, Hervé Devilliers, Z. Amoura, N. Magy-Bertrand, Thierry Martin, Gilles Blaison, D. Wahl, Jean-Loup Pennaforte, François Maurier, and O. Aumaître
- Subjects
Gastroenterology ,Internal Medicine - Abstract
Introduction Cette etude avait pour objectif de decrire les facteurs demographiques, socio-economiques et les caracteristiques du lupus systemique (LS) associes a la qualite de vie (QDV) mesuree par deux instruments generiques (Medical Outcome Study Short Form 36 [SF-36] et World Health Organisation Quality of life [WHOQOL]) et 2 questionnaires specifiques du LS (LupusQoL et SLEQOL) administres simultanement. Patients et methodes Nous avons conduit une etude de cohorte prospective multicentrique dans 10 hopitaux francais entre 2010 et 2014. L’activite de la maladie evaluee par le questionnaire SELENA-SLEDAI Flare Index Revised (SFI-R) a ete enregistree par le medecin interniste assurant le suivi habituel chez des patients atteints de LS selon les criteres ACR 1997, recrutes consecutivement. Les echelles de qualite de vie ont ete remplies par les patients et les variables socio-economiques recueillies par auto-questionnaire. La precarite sociale a ete evaluee grâce au score « EPICES ». Les variables associees a la QDV (cotee comme un score de 0 a 100 dans chacun des domaines, 100 correspondant a la meilleure QDV) ont ete etudiees a l’aide d’un modele de regression lineaire multiple. Resultats Les 336 patients inclus sur la periode d’etude etaient de sexe feminin dans 90 % des cas, et d’âge moyen (ecart-type) 41(11,9) ans. Le SLEDAI median (intervalle interquartile) etait de 4 (0–8), et 39 % des patientes avaient une poussee moderee dans au moins un organe/systeme d’apres le SFI-R. Cinquante-neuf pour cent des patients etaient traites par corticoides et 1/3 par immunosuppresseurs. D’apres le score EPICES, 38 % des patients etaient en situation de precarite sociale, 62 % des patients avaient un niveau d’etude superieur au baccalaureat et 31 % etaient sans emploi. En regression lineaire multiple, l’origine ethnique n’etait pas associee a la QDV. La precarite sociale etait fortement associee avec le score de qualite de vie dans tous les domaines des questionnaires generiques et specifiques, avec une diminution estimee de la QDV entre −6,5 (domaine « fonction physique » du SF-36, p = 0,02) et −17,84 (domaine « humeur » du SLEQOL, p p p = 0,01]), a l’exception des domaines « psychologique » et « environnement » du WHOQOL. Les signes neuropsychiatriques etaient plus fortement associes aux questionnaires specifiques. Un âge plus eleve etait associe avec une QDV plus faible dans les domaines physiques des questionnaires specifiques, mais pas avec les questionnaires generiques. L’obesite etait associee avec une diminution significative de la QDV dans les domaines physiques du SF-36 (−12,9, p = 0,02 dans le domaine « fonction physique »), a l’exception du domaine « image du corps » du LupusQoL (−8,57, p = 0,02). Par ailleurs, le tabagisme etait associe a une moindre qualite de vie dans certains des domaines physiques des questionnaires generiques, mais pas avec les questionnaires specifiques. Conclusion L’environnement social est fortement associe a la QDV chez les patients atteints de LS, quel que soit l’instrument utilise. Les questionnaires generiques et specifiques pourraient enregistrer des informations differentes et complementaires. Les questionnaires specifiques pourraient etre plus fortement correles avec certains aspects de la maladie et etre utiles pour distinguer le retentissement du LS de celui d’autres comorbidites, comme les pathologies liees au tabagisme, ou a l’obesite.
- Published
- 2017
45. Neuroborréliose après une borréliose de Lyme primaire traitée par azithromycine
- Author
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Martin Martinot, C. Iltis, Gilles Blaison, P. Cordonnier, and C. Martinez
- Subjects
Gynecology ,medicine.medical_specialty ,Infectious Diseases ,business.industry ,medicine ,business ,Antibacterial agent ,Beta lactam antibiotics - Published
- 2010
46. Toxocarose révélée par des nodules pulmonaires excavés et une hyperéosinophilie chez une patiente présentant des douleurs mammaires atypiques
- Author
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K. Sawaf, N.Y. Dupré, P. Potelon, D. De Briel, Gilles Blaison, O. Taheri, and Martin Martinot
- Subjects
Gastroenterology ,Internal Medicine - Abstract
Introduction Nous rapportons le cas d’une toxocarose revelee par des nodules pulmonaires excaves au scanner. Observation Une femme de 27 ans, d’origine caucasienne, se presentait a la consultation de medecine interne pour decouverte de micronodules pulmonaires dissemines, dont certains excaves, mis en evidence sur un examen scannographique. Elle avait en effet remarque une lesion nodulaire au niveau de son sein gauche depuis environ 4 ans, avec quelques fois un aspect inflammatoire de la peau et une exteriorisation purulente. Son medecin traitant avait demande une mammographie, interpretee comme normale, un bilan biologique qui retrouvait une hypereosinophilie a 1500/mm3 et une radiographie thoracique qui mettait en evidence un syndrome interstitiel micronodulaire bilateral. L’interrogatoire retrouvait un amaigrissement involontaire de 20 kg en deux ans, des episodes febriles intermittents depuis 6 mois, avec des pics jusqu’a 39 °C, des sueurs nocturnes, avec un etat general conserve. Une toux ancienne semblait par ailleurs persister. Il n’y avait pas de notion de voyage en zone tropicale. Elle avait travaille un an dans la marine, ou elle avait voyage en Ecosse uniquement. La patiente possedait en revanche un chat et un chien depuis plusieurs annees. Ses principaux antecedents comprenaient un tabagisme recemment sevre a 12 paquets-annees et une allergie aux acariens, phaneres d’animaux et pollens de gramines. L’examen clinique etait normal en dehors une lesion pigmentee centimetrique d’allure ancienne au niveau du sein gauche. Le bilan biologique etait marque par une hypereosinophilie (1,5 G/L), une elevation des IgE totales a 460 kUI/L. On ne notait pas de syndrome inflammatoire et l’electrophorese des proteines plasmatiques etait normale. Fonction renale et bilan hepatique etaient sans particularites. Le bilan auto-immun en particulier etait negatif, le dosage de l’enzyme de conversion de l’angiotensine normal. Les coprocultures bacteriennes et parasitaires (en particulier la recherche d’anguillules) etaient negatives. Les serologies parasitaires Toxocarose larva migrans (IFI A. Suum a 1/60, Western Blot T. canis positif), Trichinellose (IFI T. Spiralis a 1/60) et Ascaridose se revelaient positives (IFI sur A. suum a 1/60, Western Blot sur T. canis positif). Les serologies hydatidose, echinococcose alveolaire, Taenia saginata et T. anguillulose etaient negatives. L’echographie abdomino-pelvienne etait sans particularite. L’echographie des seins concluait a une mastodystrophie d’origine fonctionnelle. La biopsie cutanee de l’areole mammaire retrouvait un infiltrat inflammatoire non specifique sans arguments pour une lesion maligne. Le scanner thoracique sans injection mettait en evidence des micronodules dissemines intra-pulmonaires, predominant en peripherie, avec pour certains un aspect d’excavation, de l’ordre de 8 mm. Il n’y avait pas de lesions kystiques a paroi fine. Le lavage broncho-alveolaire retrouvait une flore normale, pas de bacilles acido-alcoolo-resistants ni d’histiocytes, et la culture (en particulier de mycobacteries, notamment atypiques) etait negative. Un traitement par albendazole per os administre empiriquement avant l’ensemble des resultats biologiques permettait tres rapidement une amelioration clinique, biologique et radiologique : dix jours plus tard, la patiente ne presentait plus aucun symptome. L’hypereosinophilie se normalisait et le scanner thoracique de controle a 3 mois etait strictement normal. Discussion Devant le tableau de granulomatose avec excavations pulmonaires, il n’etait aucunement evident d’evoquer le diagnostic de toxocarose. Il etait d’abord legitime d’eliminer une infection, et en particulier une mycobacteriose. Une histiocytose langerhansienne pulmonaire etait peu probable en l’absence d’images kystiques, et en presence de l’hypereosinophilie. Une maladie de Wegener etait peu probable en l’absence de signes extra-pulmonaires. Les metastases ne pouvaient etre exclues sans documentation histologique. Ici, le diagnostic de toxocarose a ete pose a posteriori sur la base de l’hypereosinophilie biologique, des lesions pulmonaires scannographiques (bien qu’atypiques), des serologies positives, de l’amelioration spectaculaire de la symptomatologie sous traitement anti-parasitaire, et de l’absence d’arguments pour un autre diagnostic. Conclusion La toxocarose peut etre revelee chez le sujet caucasien par un tableau pulmonaire avec des nodules excaves. Il est important de connaitre ce diagnostic peu frequent, car il est accessible a un traitement curatif rapidement efficace.
- Published
- 2015
47. Clinical Spectrum, Treatment, and Outcome of Patients with Type II Mixed Cryoglobulinemia without Evidence of Hepatitis C Infection
- Author
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Yves Etienne, Gilles Blaison, Roland Jaussaud, Laure Foessel, Nadine Magy-Bertrand, Sylvain Audia, François Maurier, Jean-François Besancenot, Thierry Martin, Department of Clinical Immunology, Immunologie et chimie thérapeutiques (ICT), Cancéropôle du Grand Est-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Department of Internal Medicine, Hôpital pasteur [Colmar], Service de Médecine interne [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Université de Reims Champagne-Ardenne (URCA), Hôpital Saint Dié, Service de médecine interne, and Hôpital Sainte-Blandine-Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cyclophosphamide ,Hepatitis C virus ,Immunology ,medicine.disease_cause ,Gastroenterology ,03 medical and health sciences ,Antibodies, Monoclonal, Murine-Derived ,0302 clinical medicine ,Rheumatology ,Internal medicine ,Immunopathology ,medicine ,Immunology and Allergy ,Humans ,Immunologic Factors ,030212 general & internal medicine ,Lenalidomide ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Autoimmune disease ,business.industry ,Hepatitis C ,[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy ,Middle Aged ,medicine.disease ,Cryoglobulinemia ,3. Good health ,Treatment Outcome ,[SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology ,Rituximab ,Female ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,medicine.drug - Abstract
Objective.The clinical spectrum, etiologies, and best therapeutic approaches of type II mixed cryoglobulinemia (MC) not associated with hepatitis C virus (HCV) infection have been poorly described to date. We studied the clinical presentation and outcome of patients with type II MC with no evidence of HCV.Methods.This was a multicenter retrospective study on the clinical presentation and outcome of patients with type II MC without evidence of HCV infection. Only patients with symptomatic MC were included.Results.Thirty-three patients were included (median followup 67.2 mo). Extensive investigations for associated diseases were performed at presentation. MC was related to an autoimmune disease in 14 patients, to a lymphoid malignancy in 4 patients, and to an infectious disease in 2 patients, while MC was classified as essential (primary) in 13. Essential MC tended to be more severe than secondary disease with, in particular, more frequent renal and peripheral nerve involvement. Most patients were treated with steroid with or without immunosuppressive agents, mainly cyclophosphamide. These treatments were unable to induce sustained remission. One patient was successfully treated with lenalidomide. Seven patients with nonmalignant MC were treated with rituximab; 2 had a sustained complete remission, 3 improved greatly but relapsed within 5 months, and 2 experienced a disease flare.Conclusion.An important proportion of non HCV-related type II MC remains essential. Efforts should be made to find other etiologies than HCV, because treatments with steroid and immunosuppressants are not satisfactory, especially in severe forms. In these situations anti-CD20 therapy may present the best option but should be used with caution. New agents such as lenalidomide remain to be evaluated.
- Published
- 2011
48. B cell signature during inactive systemic lupus is heterogeneous: toward a biological dissection of lupus
- Author
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Pauline Soulas-Sprauel, Gilles Blaison, Doulaye Dembélé, Jean-Louis Pasquali, Julie Ruer-Laventie, Anne-Sophie Korganow, Jean-Claude Garaud, Anne-Marie Knapp, Jean-Nicolas Schickel, and Thierry Martin
- Subjects
B Cells ,Immune Cells ,Cellular differentiation ,Immunology ,lcsh:Medicine ,Biology ,Endoplasmic Reticulum ,Systemic Lupus Erythematosus ,Transcriptomes ,Autoimmune Diseases ,Immunophenotyping ,Rheumatology ,Genome Analysis Tools ,immune system diseases ,medicine ,Humans ,Lupus Erythematosus, Systemic ,skin and connective tissue diseases ,lcsh:Science ,B cell ,Autoimmune disease ,B-Lymphocytes ,Multidisciplinary ,Systemic lupus erythematosus ,Lupus Erythematosus ,Microarray analysis techniques ,Gene Expression Profiling ,lcsh:R ,Hypergammaglobulinemia ,Autoantibody ,Computational Biology ,Genomics ,Microarray Analysis ,medicine.disease ,Phenotype ,medicine.anatomical_structure ,Gene Expression Regulation ,Case-Control Studies ,Unfolded Protein Response ,Medicine ,Clinical Immunology ,lcsh:Q ,Interleukin-4 ,Research Article - Abstract
Systemic lupus erythematosous (SLE) is an autoimmune disease with an important clinical and biological heterogeneity. B lymphocytes appear central to the development of SLE which is characterized by the production of a large variety of autoantibodies and hypergammaglobulinemia. In mice, immature B cells from spontaneous lupus prone animals are able to produce autoantibodies when transferred into immunodeficient mice, strongly suggesting the existence of intrinsic B cell defects during lupus. In order to approach these defects in humans, we compared the peripheral B cell transcriptomas of quiescent lupus patients to normal B cell transcriptomas. When the statistical analysis is performed on the entire group of patients, the differences between patients and controls appear quite weak with only 14 mRNA genes having a false discovery rate ranging between 11 and 17%, with 6 underexpressed genes (PMEPA1, TLR10, TRAF3IP2, LDOC1L, CD1C and EGR1). However, unforced hierarchical clustering of the microarrays reveals a subgroup of lupus patients distinct from both the controls and the other lupus patients. This subgroup has no detectable clinical or immunological phenotypic peculiarity compared to the other patients, but is characterized by 1/an IL-4 signature and 2/the abnormal expression of a large set of genes with an extremely low false discovery rate, mainly pointing to the biological function of the endoplasmic reticulum, and more precisely to genes implicated in the Unfolded Protein Response, suggesting that B cells entered an incomplete BLIMP1 dependent plasmacytic differentiation which was undetectable by immunophenotyping. Thus, this microarray analysis of B cells during quiescent lupus suggests that, despite a similar lupus phenotype, different biological roads can lead to human lupus.
- Published
- 2011
49. A Minor Group of Rheumatoid Factors Isolated from a Patient with Rheumatoid Arthritis is Derived from Somatically Mutated VK1 Genes Further Evidence That Rheumatoid Factors During Autoimmune Diseases Undergo an Antigen Driven Maturation
- Author
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Jean Louis Pasquali, Thierry Martin, Honey Levallois, Rachel Crouzier, and Gilles Blaison
- Subjects
Molecular Sequence Data ,Immunology ,Immunoglobulin Variable Region ,Arthritis ,Immunogenetics ,Immunoglobulin light chain ,Epitope ,Arthritis, Rheumatoid ,Immunoglobulin kappa-Chains ,Antigen ,Rheumatoid Factor ,Humans ,Immunology and Allergy ,Medicine ,Rheumatoid factor ,Amino Acid Sequence ,Base Sequence ,Genes, Immunoglobulin ,biology ,business.industry ,medicine.disease ,Molecular biology ,Mutation ,biology.protein ,Antibody ,business ,Kappa - Abstract
To better understand the structural basis for rheumatoid factor [RF] activity and the origin of autoantibodies in human autoimmune diseases, we isolated the RF producing B cells from the peripheral blood and from the synovial fluid of a patient suffering from rheumatoid arthritis [RA]. We previously demonstrated that a significant fraction of these RF were derived from three V kappa III genes known to encode most of the monoclonal RF light chain variable regions. To get more insight into the actual repertoire of RF-V kappa genes during RA, we analyzed the nucleotide sequences of RF light chain variable regions of other V kappa families. Using two sets of polymerase chain reactions in order to amplify the cDNA derived from RF producing cells from the same patient KRA, we isolated only three different rearranged V kappa-J kappa complexes: slkv5, slkv7 and bkv42, all derived from V kappa I germ-line genes not previously known to be associated with RF activity; this suggests that the repertoire of VL genes coding for RF during RA is more diverse than the one involved in the generation of paraprotein RF during monoclonal lymphoid proliferations, although there remains a possible bias in favor of the V kappa III family. Moreover, each of these genes is somatically mutated with a pattern suggesting a selective pressure of the antigen. Particularly interesting is the additional proline residue at the V kappa-J kappa junction of bkv42, an unorthodox feature that we found previously in more than 50% of RF V kappa III-J kappa gene complexes. Finally, the homogeneity of some non conservative mutations suggests the existence of a restricted set of pathogenic epitopes driving the production of RF during RA.
- Published
- 1993
50. Déterminants de la qualité de vie liée au lupus systémique en France : résultats préliminaires de l’étude EQUAL sur 328 patients
- Author
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J.-L. Pasquali, O. Aumaître, Nadine Magy-Bertrand, D. Wahl, Gilles Blaison, Hervé Devilliers, Jean-Loup Pennaforte, Pierre Kaminsky, Z. Amoura, J.F. Besancenot, Christiane Broussolle, and François Maurier
- Subjects
Gastroenterology ,Internal Medicine - Published
- 2014
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