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2. “Block-and-replace” treatment in Graves’ disease: experience in a cohort of pediatric patients

Author

Vigone, M. C., Peroni, E., Di Frenna, M., Mora, S., Barera, G., and Weber, G.

Abstract

Purpose: The “block-and-replace” (BR) method involves the use of a high dose of antithyroid drugs (ATD) with levothyroxine (L-T4). Its use in the management of Graves’ disease (GD) is still debated mainly because the frequency of side effects of ATD is dose dependent. We retrospectively studied the effect of medium dose of ATD with L-T4 versus monotherapy with ATD in pediatric patients with unstable GD. Methods: 28 pediatric patients with GD with unstable response to ATD were treated with L-T4 and medium dose of ATD. We compared the rate of euthyroidism, hypothyroidism and hyperthyroidism episodes observed during treatment with methimazole alone with those observed during the BR approach. We evaluated the occurrence of side effects and the rate of remission in patients treated with ATD + L-T4 therapy and the efficacy of combination therapy to postpone a definitive treatment (radioiodine and thyroidectomy). Results: Patients showed a better control of thyroid function during the BR therapy, presenting fewer episodes of hyperthyroidism and hypothyroidism. No serious side effects during the BR approach were observed. Only one patient went into remission with the ATD + L-T4 therapy. Fifteen patients required a definitive therapy (4 radioiodine, 11 thyroidectomy). The use of BR method has delayed radioiodine treatment for 4.9 years and surgery for 2.9 years. Conclusions: The BR method does not increase the remission rates. It may be useful to combine L-T4 with a medium dose of methimazole when GD is difficult to manage with methimazole alone. It may represent a therapeutic option to postpone definitive treatments to a suitable age.

Published
2024
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11. Do Different Initial Doses of L-T4 within the Range of 10-15 mcg/kg/day Influence Neurodevelopment during the First Two Years of Life in Children with Congenital Hypothyroidism?

Author

Esposito, A, Bravaccio, C, Bruzzese, D, Cassio, A, Gastaldi, R, Mussa, A, Peroni, E, Polizzi, M, Vigone, MC, Wasniewska, MG, Weber, G, Salerno, M, Esposito, A, Bravaccio, C, Bruzzese, D, Cassio, A, Gastaldi, R, Mussa, A, Peroni, E, Polizzi, M, Vigone, Mc, Wasniewska, Mg, Weber, G, and Salerno, M

Published
2016

12. Sequencing of the hypoxia pathway genes in patients with congenital erythrocytoses by next generation sequencing

Author

Girodon, F., Pacault, F., Airaud, M., Garrec, C., Corbineau, S., Casadevall, N., Rose, C., de Renzis, B., Peroni, E., Randi, Ml., Dumont, S., Ricordeau, I., Bezieau, S., Gardie, B., université de Bourgogne, LNC, Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Université de Nantes (UN), Service de génétique médicale - Unité de génétique clinique [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Hématopoïèse normale et pathologique (U1170 Inserm), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université catholique de Lille (UCL), Oncologie médicale [Hôpital Saint Vincent de Paul, Lille], Hôpital Saint-Vincent de Paul, Service d’Hématologie Biologique [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Department of Medicine (DIMED), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Nantes ( UN ), Université de Nantes ( UN ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Hématopoïèse normale et pathologique ( U1170 Inserm ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut Gustave Roussy ( IGR ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université catholique de Lille ( UCL ), and Service de thérapie cellulaire et hématologie clinique [CHU Clermont Ferrand]

Subjects
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, [ SDV.MHEP.HEM ] Life Sciences [q-bio]/Human health and pathology/Hematology, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology
Abstract

IF 7.702; International audience

Published
2017

15. Asymptomatic Thyrotropin-secreting Pituitary Macroadenoma in a Thirteen Year-old Girl: Successful First-line Treatment with Somatostatin Analogues

Author

Rabbiosi S, Peroni E, Tronconi GM, Chiumello G, Losa M, WEBER , GIOVANNA, Rabbiosi, S, Peroni, E, Tronconi, Gm, Chiumello, G, Losa, M, and Weber, Giovanna

Abstract

Background: Thyrotropin-secreting pituitary adenomas (TSHomas) are an extremely rare cause of hyperthyroidism. Up to now there are only few cases reported in pediatric age: the first therapeutic option is surgical resection, whereas medical treatment with somatostatin analogues has been reported only in cases wherein surgery was unsuccessful. Patient Findings: A 13-year-old girl was referred to our clinic for incidental finding of increased circulating free thyroid hormones in the presence of detectable TSH concentrations. She had no signs/symptoms of thyrotoxicosis. Resistance to thyroid hormone was excluded due to the lack of TSH response after TRH stimulation test. Cerebral magnetic resonance imaging showed the presence of a large pituitary macroadenoma, with intra- and supra-sellar extension. We decided to treat this patient with somatostatin analogue as first line therapy because of high surgery risks due to the tumor dimensions. The response to medical treatment was excellent, with rapid and significant tumor shrinkage. No major side effects were reported. Summary: We report the first pediatric case of TSHoma treated with somatostatin analogue as a first line therapy. The diagnosis was challenging because of the insidious and asymptomatic presentation of the tumor. Conclusions: We conclude that somatostatin analogues should be considered as first choice, bridge-to-surgery treatment in young patients, in order to reduce neurosurgical complications and prevent hypopituitarism during pubertal development

Published
2012

22. The glycopeptide CSF114(Glc) detects serum antibodies in multiple sclerosis

Author

Lolli, F, Mazzanti, B, Pazzagli, M, Peroni, E, Alcaro, Mc, Sabatino, G, Lanzillo, R, Morra, Vb, Santoro, L, Gasperini, C, Galgani, S, D'Elios, Mm, Zipoli, V, Sotgiu, S, Pugliatti, Maura, Rovero, P, Chelli, M, Papini, Am, RI Lolli Francesco/C 6439 2008, Lolli, F, Mazzanti, B, Pazzagli, M, Peroni, E, Alcaro, Mc, Sabatino, G, Lanzillo, Roberta, BRESCIA MORRA, Vincenzo, Santoro, L, Gasperini, C, Galgani, S, D'Elios, Mm, Zipoli, V, Sotgiu, S, Pugliatti, M, Rovero, P, Chelli, M, and Papini, Am

Subjects
Adult, Male, Multiple Sclerosis, Anti-nuclear antibody, Adolescent, diagnosis, Immunology, Enzyme-Linked Immunosorbent Assay, myelin autoantibodies, medicine.disease_cause, multiple sclerosis, glycosylated antigen, B cell, autoimmunity, Aged, Analysis of Variance, Antibodies, Female, Flow Cytometry, Humans, Middle Aged, ROC Curve, Sensitivity and Specificity, Glycopeptides, Subclass, Autoimmunity, medicine, Immunology and Allergy, biology, business.industry, Multiple sclerosis, medicine.disease, Glycopeptide, Neurology, biology.protein, Neurology (clinical), Antibody, business, Meningitis, Encephalitis
Abstract

Synthetic glycopeptides have the potential to detect antibodies in multiple sclerosis (MS). In the present study, we analyzed the antibodies (IgM class, IgG class and IgG subclasses) to the synthetic glycopeptide CSF114(Glc) in the serum of 186 MS patients, 166 blood donors (BDs), 25 patients affected by meningitis/encephalitis, 41 affected by systemic lupus erythematosus (SLE) and 49 affected by rheumatoid arthritis (RA). The IgM antibody level to CSF114(Glc) was significantly increased in MS patients versus BDs (p

Published
2005

38. A New Lipophilic Fluorescent Probe for Interaction Studies of Bioactive Lipopeptides with Membrane Models

Author

Peroni E., Caminati G., Baglioni P., Nuti F., Chelli M., and Papini A.M.

Abstract

The new fluorescent lipophilic moiety 11-[(7-amino-4-methyl-2-oxo-2H-1-benzopyran-3-acetyl)amino]undecanoic acid (AMCA-omegaAud-OH) was introduced by SPPS at the N-terminus of the immunodominant epitope GpMBP(74-85). FRET expts. using the new fluorescent lipopeptide demonstrate that the peptide interacts with much more affinity with the membrane compared to the lipid free analog

Published
2002

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