22 results on '"Papo, Thomas"'
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2. Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia
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Hermine, Olivier, Mariette, Xavier, Tharaux, Pierre-Louis, Resche-Rigon, Matthieu, Porcher, Raphaël, Ravaud, Philippe, Bureau, Serge, Dougados, Maxime, Tibi, Annick, Azoulay, Elie, Cadranel, Jacques, Emmerich, Joseph, Fartoukh, Muriel, Guidet, Bertrand, Humbert, Marc, Lacombe, Karine, Mahevas, Matthieu, Pene, Frédéric, Pourchet-Martinez, Valérie, Schlemmer, Frédéric, Yazdanpanah, Yazdan, Baron, Gabriel, Perrodeau, Elodie, Vanhoye, Damien, Kedzia, Cécile, Demerville, Lauren, Gysembergh-Houal, Anne, Bourgoin, Alexandre, Dalibey, Sarah, Raked, Nabil, Mameri, Lakhdar, Alary, Stéphanie, Hamiria, Samir, Bariz, Thinhinane, Semri, Hala, Hai, Dhiaa Meriem, Benafla, Moustafa, Belloul, Mohamed, Vauboin, Pernelle, Flamand, Saskia, Pacheco, Claire, Walter-Petrich, Anouk, Stan, Emilia, Benarab, Souad, Nyanou, Corine, Montlahuc, Claire, Biard, Lucie, Charreteur, Robin, Dupré, Celine, Cardet, Kévin, Lehmann, Blandine, Baghli, Kamyl, Madeleine, Claire, DOrtenzio, Eric, Puéchal, Oriane, Semaille, Caroline, Savale, Laurent, Harrois, Anatole, Figueiredo, Samy, Duranteau, Jacques, Anguel, Nadia, Monnet, Xavier, Richard, Christian, Teboul, Jean-Louis, Durand, Philippe, Tissieres, Pierre, Jevnikar, Mitja, Montani, David, Pavy, Stéphan, Noel, Nicolas, Lambotte, Olivier, Escaut, Lelia, Jauréguiberry, Stéphane, Baudry, Elodie, Verny, Christiane, Lefèvre, Edouard, Zaidan, Mohamad, Le Tiec, Clotilde Le Tiec, Verstuyft, Céline Verstuyft, Roques, Anne-Marie, Grimaldi, Lamiae, Molinari, Domitille, Leprun, Gaël, Fourreau, Alain, Cylly, Laurent, Virlouvet, Myriam, Meftali, Ramdane, Fabre, Solène, Licois, Marion, Mamoune, Asmaa, Boudali, Yacine, Georgin-Lavialle, Sophie, Senet, Patricia, Soria, Angèle, Parrot, Antoine, François, Hélène, Rozensztajn, Nathalie, Blin, Emmanuelle, Choinier, Pascaline, Camuset, Juliette, Rech, Jean-Simon, Canellas, Antony, Rolland-Debord, Camille, Lemarié, Nadège, Belaube, Nicolas, Nadal, Marine, Siguier, Martin, Petit-Hoang, Camille, Chas, Julie, Drouet, Elodie, Lemoine, Matthieu, Phibel, Audrey, Aunay, Lucie, Bertrand, Eliane, Ravato, Sylviane, Vayssettes, Marie, Adda, Anne, Wilpotte, Celine, Thibaut, Pélagie, Fillon, Julie, Debrix, Isabelle, Fellahi, Soraya, Bastard, Jean-Philippe, Lefèvre, Guillaume, Fallet, Vincent, Gottenberg, Jacques-Eric, Hansmann, Yves, Andres, Emmanuel, Bayer, Sophie, Becker, Guillaume, Blanc, Frédéric, Brin, Stéphane, Castelain, Vincent, Chatelus, Emmanuel, Chatron, Eva, Collange, Olivier, Danion, François, De Blay, Frédéric, Demonsant, Eric, Diemunsch, Pierre, Diemunsch, Sophie, Felten, Renaud, Goichot, Bernard, Greigert, Valentin, Guffroy, Aurélien, Heger, Bob, Hutt, Anne, Kaeuffer, Charlotte, Kassegne, Loic, Korganow, Anne Sophie, Le Borgne, Pierrick, Lefebvre, Nicolas, Martin, Tristan, Mertes, Paul Michel, Metzger, Catherine, Meyer, Nicolas, Nisand, Gabriel, Noll, Eric, Oberlin, Mathieu, Ohlmann-Caillard, Sophie, Poindron, Vincent, Pottecher, Julien, Ruch, Yvon, Sublon, Cédric, Tayebi, Hakim, Weill, François, Mekinian, Arsène, Chopin, Dorothée, Fain, Olivier, Garnier, Marc, Krause Le Garrec, Jessica, Morgand, Marjolaine, Pacanowski, Jerome, Urbina, Tomas, Mcavoy, Chloe, Pereira, Maria, Aratus, Gladys, Berard, Laurence, Simon, Tabassome, Daguenel Nguyen, Anne, Antignac, Marie, Leplay, Céline, Arlet, Jean-Benoit, Diehl, Jean-Luc, Bellenfant, Florence, Blanchard, Anne, Buffet, Alexandre, Cholley, Bernard, Fayol, Antoine, Flamarion, Edouard, Godier, Anne, Gorget, Thomas, Hamada, Sophie-Rym, Hauw-Berlemont, Caroline, Hulot, Jean- Se´bastien, Lebeaux, David, Livrozet, Marine, Michon, Adrien, Neuschwander, Arthur, Penet, Marie-Aude, Planquette, Benjamin, Ranque, Brigitte, Sanchez, Olivier, Volle, Geoffroy, Briois, Sandrine, Cornic, Mathias, Elisee, Virginie, Jesuthasan, Denis, Djadi-Prat, Juliette, Jouany, Pauline, Junquera, Ramon, Henriques, Mickael, Kebir, Amina, Lehir, Isabelle, Meunier, Jeanne, Patin, Florence, Paquet, Vale´rie, Tre´Han, Anne, Vigna, Ve´ronique, Sabatier, Brigitte, Bergerot, Damien, Jouve, Charle`ne, Knosp, Camille, Lenoir, Olivia, Mahtal, Nassim, Resmini, Léa, Lescure, Xavier, Ghosn, Jade, Bachelard, Antoine, Bironne, Timothee, Borie, Raphael, Bounhiol, Agathe, Boussard, Catherine, Chauffier, Jeanne, Chalal, Solaya, Chalal, Lynda, Chansombat, Malikhone, Crespin, Paul, Crestani, Bruno, Daconceicao, Olivia, Deconinck, Laurene, Dieude, hilippe, Dossier, Antoine, Dubert, Marie, Ducrocq, Greggory, Fuentes, Axelle, Gervais, Anne, Gilbert, Marie, Isernia, Valentina, Ismael, Sophie, Joly, Veronique, Julia, Zelie, Lariven, Sylvie, Le Gac, Sylvie, Le Pluart, Diane, Louni, Francoise, Ndiaye, Awa, Papo, Thomas, Parisey, Marion, Phung, Bao, Pourbaix, Annabelle, Rachline, Anne, Rioux, Christophe, Sautereau, Aurelie, Steg, Gabriel, Tharini, Hassan, Valayer, Simon, Vallois, Dorothee, Vermes, Paul, Volpe, Thomas, Nguyen, Yann, Honsel, Vasco, Weiss, Emmanuel, Codorniu, Anaïs, Zarrouk, Virginie, De Lastours, Victoire, Uzzan, Matthieu, Gamany, Naura, Rahli, Roza, Louis, Zeina, Boutboul, David, Galicier, Lionel, Amara, Yaël, Archer, Gabrielle, Benattia, Amira, Bergeron, Anne, Bondeelle, Louise, De Castro, Nathalie, Clément, Melissa, Darmont, Michaël, Denis, Blandine, Dupin, Clairelyne, Feredj, Elsa, Feyeux, Delphine, Joseph, Adrien, Lengliné, Etienne, Le Guen, Pierre, Liégeon, Geoffroy, Lorillon, Gwenaël, Mabrouki, Asmaa, Mariotte, Eric, Martin De Frémont, Grégoire, Mirouse, Adrien, Molina, Jean-Michel, Peffault De Latour, Régis, Oksenhendler, Eric, Saussereau, Julien, Tazi, Abdellatif, Tudesq, Jean-Jacques, Zafrani, Lara, Brindele, Isabelle, Bugnet, Emmanuelle, Celli Lebras, Karine, Chabert, Julien, Djaghout, Lalia, Fauvaux, Catherine, Jegu, Anne Lise, Kozaliewicz, Ewa, Meunier, Martine, Tremorin, Marie-Thérèse, Davoine, Claire, Madeleine, Isabelle, Caillat-Zucman, Sophie, Delaugerre, Constance, Morin, Florence, Sene, Damien, Burlacu, Ruxandra, Chousterman, Benjamin, Megarbane, Bruno, Richette, Pascal, Riveline, Jean-Pierre, Frazier, Aline, Vicaut, Eric, Berton, Laure, Hadjam, Tassadit, Vasquez-Ibarra, Miguel Alejandro, Jourdaine, Clément, Jacob, Aude, Smati, Julie, Renaud, Stéphane, Manivet, Philippe, Pernin, Claire, Suarez, Lydia, Semerano, Luca, Abad, Sebastien, Benainous, Ruben, Bloch Queyrat, Coralie, Bonnet, Nicolas, Brahmi, Sabrina, Cailhol, johann, Cohen, Yves, Comparon, Celine, Cordel, Hugues, Dhote, Robin, Dournon, Nathalie, Duchemann, Boris, Ebstein, Nathan, Giroux-Leprieur, Benedicte, Goupil De Bouille, Jeanne, Jacolot, Anne, Nunes, Hilario, Oziel, Johanna, Rathouin, Vanessa, Rigal, Marthe, Roulot, Dominique, Tantet, Claire, Uzunhan, Yurdagul, Costedoat-Chalumeau, Nathalie, Ait Hamou, Zakaria, Benghanem, Sarah, Blanche, Philippe, Canoui, Etienne, Carlier, Nicolas, Chaigne, Benjamin, Contejean, Adrien, Dunogue, Bertrand, Dupland, Pierre, Durel - Maurisse, Aurélie, Gauzit, Remy, Jaubert, Paul, Joumaa, Hassan, Jozwiak, Mathieu, Kerneis, Solen, Lachatre, Marie, Lafoeste, Hélène, Legendre, Paul, Luong Nguyen, Liem Binh, Marey, Jonathan, Morbieu, Caroline, Mouthon, Luc, Nguyen, Lee, Palmieri, Lola-Jade, Regent, Alexis, Szwebel, Tali-Anne, Terrier, Benjamin, Guerin, Corinne, Zerbit, Jérémie, Cheref, Kahina, Chitour, Kamil, Cisse, Mamadou Salif, Clarke, Ada, Clavere, Gaelle, Dusanter, Isabelle, Gaudefroy, Caroline, Jallouli, Moez, Kolta, Sami, Le Bourlout, Catherine, Marin, Nathalie, Menage, Nathalie, Moores, Alexandre, Peigney, Isabelle, Pierron, Cédric, Saleh-Mghir, Samira, Vallet, Mathilde, Michel, Marc, Melica, Giovanna, Lelievre, Jean-Daniel, Fois, Elena, Lim, Pascal, Matignon, Marie, Guillaud, Constance, Thiemele, Alaki, Schmitz, David, Bouhris, Marion, Belazouz, Syllia, Languille, Laetitia, Mekontso-Dessaps, Armand, Sadaoui, Thiziri, Mayaux, Julien, Cacoub, Patrice, Corvol, Jean-Christophe, Louapre, Céline, Sambin, Sara, Mariani, Louise-Laure, Karachi, Carine, Tubach, Florence, Estellat, Candice, Gimeno, Linda, Martin, Karine, Bah, Aïcha, Keo, Vixra, Ouamri, Sabrine, Messaoudi, Yasmine, Yelles, Nessima, Faye, Pierre, Cavelot, Sébastien, Larcheveque, Cecile, Annonay, Laurence, Benhida, Jaouad, Zahrate-Ghoul, Aida, Hammal, Soumeya, Belilita, Ridha, Lecronier, Marie, Beurton, Alexandra, Haudebourg, Luc, Deleris, Robin, Le Marec, Julien, Virolle, Sara, Nemlaghi, Safaa, Bureau, Côme, Mora, Pierre, De Sarcus, Martin, Clovet, Olivier, Duceau, Baptiste, Grisot, Paul Henri, Pari, Marie hélène, Arzoine, Jérémy, Clarac, Ulrich, Faure, Morgane, Delemazure, Julie, Decavele, Maxence, Morawiec, Elise, Demoule, Alexandre, Dres, Martin, Vautier, Mathieu, Allenbach, Yves, Benveniste, Olivier, Leroux, Gaelle, Rigolet, Aude, Guillaume-Jugnot, Perrine, Domont, Fanny, Desbois, Anne Claire, Comarmond, Cloé, Champtiaux, Nicolas, Toquet, Segolene, Ghembaza, Amine, Vieira, Matheus, Maalouf, Georgina, Boleto, Gonçalo, Ferfar, Yasmina, Charbonnier, Fanny, Aguilar, Claire, Alby-Laurent, Fanny, Alyanakian, Marie-Alexandra, Bakouboula, Prissile, Broissand, Christine, Burger, Carole, Campos-Vega, Clara, Chavarot, Nathalie, Choupeaux, Laure, Elie, Caroline, Fournier, Benjamin, Granville, Sophie, Issorat, Elodie, Rouzaud, Claire, Vimpere, Damien, Geri, Guillaume, Derridj, Nawal, Sguiouar, Naima, Meddah, Hakim, Djadel, Mourad, Chambrin-Lauvray, Helene, Duclos-Vallée, Jean-Charles, Saliba, Faouzi, Sacleux, Sophie-Caroline, Koumis, Ilias, Michot, Jean-Marie, Stoclin, Annabelle, Colomba, Emeline, Pommeret, Fanny, Willekens, Chistophe, Da Silva, Rosa, Dejean, Valérie, Mekid, Yasmina, Ben-Mabrouk, Ines, Pradon, Caroline, Drouard, Laurence, Camara-Clayette, Valérie, Morel, Alexandre, Garcia, Gilles, Mohebbi, Abolfazl, Berbour, Férial, Dehais, Mélanie, Pouliquen, Anne-Lise, Klasen, Alison, Soyez-Herkert, Loren, London, Jonathan, Keroumi, Younes, Guillot, Emmanuelle, Grailles, Guillaume, El Amine, Younes, Defrancq, Fanny, Fodil, Hanane, Bouras, Chaouki, Dautel, Dominique, Gambier, Nicolas, Dieye, Thierno, Bienvenu, Boris, Lancon, Victor, Lecomte, Laurence, Beziriganyan, Kristina, Asselate, Belkacem, Allanic, Laure, Kiouris, Elena, Legros, Marie-Hélène, Lemagner, Christine, Martel, Pascal, Provitolo, Vincent, Ackermann, Félix, Le Marchand, Mathilde, Clan Hew Wai, Aurélie, Fremont, Dimitri, Coupez, Elisabeth, Adda, Mireille, Duée, Frédéric, Bernard, Lise, Gros, Antoine, Henry, Estelle, Courtin, Claire, Pattyn, Anne, Guinot, Pierre-Grégoire, Bardou, Marc, Maurer, Agnes, Jambon, Julie, Cransac, Amélie, Pernot, Corinne, Mourvillier, Bruno, Servettaz, Amélie, Deslée, Gaetan, Wynckel, Alain, Benoit, Philippe, Marquis, Eric, Roux, Damien, Gernez, Coralie, Yelnik, Cécile, Poissy, Julien, Nizard, Mandy, Denies, Fanette, Gros, Hélène, Mourad, Jean-Jacques, Sacco, Emmanuelle, Renet, Sophie, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Service de Rhumatologie [CHU Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hopital Saint-Louis [AP-HP] (AP-HP), Centre d'épidémiologie Clinique [Hôtel-Dieu], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Hôtel Dieu, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Centre de recherche en Myologie – U974 SU-INSERM, Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CORIMUNO-19 Collaborative Group, Porcher, Raphaël, Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), and ANR-21-COVR-0024,ACT-LONG-COVID,Caractérisation clinique et biologique du syndrome d'activation mastocytaire dans le COVID long et prédisposition génétique(2021)
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[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal Medicine - Abstract
International audience; Importance Severe pneumonia with hyperinflammation and elevated interleukin-6 is a common presentation of coronavirus disease 2019 (COVID-19).Objective To determine whether tocilizumab (TCZ) improves outcomes of patients hospitalized with moderate-to-severe COVID-19 pneumonia.Design, Setting, and Particpants This cohort-embedded, investigator-initiated, multicenter, open-label, bayesian randomized clinical trial investigating patients with COVID-19 and moderate or severe pneumonia requiring at least 3 L/min of oxygen but without ventilation or admission to the intensive care unit was conducted between March 31, 2020, to April 18, 2020, with follow-up through 28 days. Patients were recruited from 9 university hospitals in France. Analyses were performed on an intention-to-treat basis with no correction for multiplicity for secondary outcomes.Interventions Patients were randomly assigned to receive TCZ, 8 mg/kg, intravenously plus usual care on day 1 and on day 3 if clinically indicated (TCZ group) or to receive usual care alone (UC group). Usual care included antibiotic agents, antiviral agents, corticosteroids, vasopressor support, and anticoagulants.Main Outcomes and Measures Primary outcomes were scores higher than 5 on the World Health Organization 10-point Clinical Progression Scale (WHO-CPS) on day 4 and survival without need of ventilation (including noninvasive ventilation) at day 14. Secondary outcomes were clinical status assessed with the WHO-CPS scores at day 7 and day 14, overall survival, time to discharge, time to oxygen supply independency, biological factors such as C-reactive protein level, and adverse events.Results Of 131 patients, 64 patients were randomly assigned to the TCZ group and 67 to UC group; 1 patient in the TCZ group withdrew consent and was not included in the analysis. Of the 130 patients, 42 were women (32%), and median (interquartile range) age was 64 (57.1-74.3) years. In the TCZ group, 12 patients had a WHO-CPS score greater than 5 at day 4 vs 19 in the UC group (median posterior absolute risk difference [ARD] −9.0%; 90% credible interval [CrI], −21.0 to 3.1), with a posterior probability of negative ARD of 89.0% not achieving the 95% predefined efficacy threshold. At day 14, 12% (95% CI −28% to 4%) fewer patients needed noninvasive ventilation (NIV) or mechanical ventilation (MV) or died in the TCZ group than in the UC group (24% vs 36%, median posterior hazard ratio [HR] 0.58; 90% CrI, 0.33-1.00), with a posterior probability of HR less than 1 of 95.0%, achieving the predefined efficacy threshold. The HR for MV or death was 0.58 (90% CrI, 0.30 to 1.09). At day 28, 7 patients had died in the TCZ group and 8 in the UC group (adjusted HR, 0.92; 95% CI 0.33-2.53). Serious adverse events occurred in 20 (32%) patients in the TCZ group and 29 (43%) in the UC group (P = .21).Conclusions and Relevance In this randomized clinical trial of patients with COVID-19 and pneumonia requiring oxygen support but not admitted to the intensive care unit, TCZ did not reduce WHO-CPS scores lower than 5 at day 4 but might have reduced the risk of NIV, MV, or death by day 14. No difference on day 28 mortality was found. Further studies are necessary for confirming these preliminary results.Trial Registration ClinicalTrials.gov Identifier: NCT04331808
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- 2021
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3. French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
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Terrier, Benjamin, Darbon, Raphaël, Durel, Cécile-Audrey, Hachulla, Eric, Karras, Alexandre, Maillard, Hélène, Papo, Thomas, Puechal, Xavier, Pugnet, Grégory, Quemeneur, Thomas, Samson, Maxime, Taille, Camille, Guillevin, Loïc, Audard, Vincent, Aumaître, Olivier, Briot, Karine, Cacoub, Patrice, Cathebras, Pascal, Chauveau, Dominique, Chosidow, Olivier, Chouchana, Laurent, Cottin, Vincent, Cornec, Divi, Daugas, Eric, Diot, Elisabeth, Dupin, Nicolas, El Karoui, Khalil, Fain, Olivier, Gobert, Pierre, Guilpain, Philippe, Hamidou, Mohamed, Hummel, Aurelie, Jachiet, Marie, Jouneau, Stephane, Jourde-Chiche, Noémie, Landron, Cédric, Le Jeunne, Claire, Lega, Jean-Christophe, Mariette, Xavier, Morel, Nathalie, Pagnoux, Christian, Remy, Philippe, Vandergheynst, Frederic, 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association France Vascularites [Paris], Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Néphrologie et Hémodialyse [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Toulouse [Toulouse], Centre hospitalier [Valenciennes, Nord], Service de Médecine Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
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Pediatrics ,medicine.medical_specialty ,lcsh:Medicine ,Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ,Disease ,Churg-Strauss Syndrome ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Eosinophilic ,Necrotizing Vasculitis ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Position Statement ,Genetics (clinical) ,030203 arthritis & rheumatology ,Polyarteritis nodosa ,business.industry ,lcsh:R ,Granulomatosis with Polyangiitis ,General Medicine ,medicine.disease ,3. Good health ,Polyarteritis Nodosa ,[SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics ,Quality of Life ,Granulomatosis with polyangiitis ,business ,Microscopic polyangiitis ,Vasculitis ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Systemic necrotizing vasculitis comprises a group of diseases resembling polyarteritis nodosa and anti-neutrophil cytoplasmic antibody-associated vasculitis (ANCA): granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and microscopic polyangiitis. The definitive diagnosis is made in cooperation with a reference center for autoimmune diseases and rare systemic diseases or a competency center. The management goals are: to obtain remission and, in the long term, healing; to reduce the risk of relapses; to limit and reduce the sequelae linked to the disease; to limit the side effects and the sequelae linked to the treatments; to improve or at least maintain the best possible quality of life; and to maintain socio-professional integration and/or allow a rapid return to school and/or professional activity. Information and therapeutic education of the patients and those around them are an integral part of the care. All health professionals and patients should be informed of the existence of patient associations. The treatment of vasculitis is based on variable combinations of glucocorticoids and immunosuppressants, chosen and adapted according to the disease concerned, the severity and/or extent of the disease, and the underlying factors (age, kidney function, etc.). Follow-up clinical and paraclinical examinations must be carried out regularly to clarify the progression of the disease, detect and manage treatment failures and possible relapses early on, and limit sequelae and complications (early then late) related to the disease or treatment. A distinction is made between the induction therapy, lasting approximately 3–6 months and aimed at putting the disease into remission, and the maintenance treatment, lasting 12–48 months, or even longer. The role of the increase or testing positive again for ANCA as a predictor of a relapse, which has long been controversial, now seems to have greater consensus: Anti-myeloperoxidase ANCAs are less often associated with a relapse of vasculitis than anti-PR3 ANCA.
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- 2020
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4. Additional file 5 of French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
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Terrier, Benjamin, Darbon, Raphaël, Cécile-Audrey Durel, Hachulla, Eric, Karras, Alexandre, Maillard, Hélène, Papo, Thomas, Puechal, Xavier, Pugnet, Grégory, Quemeneur, Thomas, Samson, Maxime, Taille, Camille, and Guillevin, Loïc
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Additional file 5. Appendix 5—List of procedures and services needed for follow-up care and treatment of long-term conditions 21—Systemic necrotizing vasculitis.
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- 2020
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5. Additional file 2 of French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
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Terrier, Benjamin, Darbon, Raphaël, Cécile-Audrey Durel, Hachulla, Eric, Karras, Alexandre, Maillard, Hélène, Papo, Thomas, Puechal, Xavier, Pugnet, Grégory, Quemeneur, Thomas, Samson, Maxime, Taille, Camille, and Guillevin, Loïc
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surgical procedures, operative ,bacterial infections and mycoses ,neoplasms ,digestive system ,digestive system diseases - Abstract
Additional file 2. Appendix 2—Medications which may be associated with the occurrence of vasculitis.
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- 2020
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6. Additional file 1 of French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
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Terrier, Benjamin, Darbon, Raphaël, Cécile-Audrey Durel, Hachulla, Eric, Karras, Alexandre, Maillard, Hélène, Papo, Thomas, Puechal, Xavier, Pugnet, Grégory, Quemeneur, Thomas, Samson, Maxime, Taille, Camille, and Guillevin, Loïc
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digestive system diseases - Abstract
Additional file 1. Appendix 1—List of referral centers and centers for specialized care of the organization FAI2R for systemic autoimmune and autoinflammatory diseases.
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- 2020
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7. Additional file 3 of French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
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Terrier, Benjamin, Darbon, Raphaël, Cécile-Audrey Durel, Hachulla, Eric, Karras, Alexandre, Maillard, Hélène, Papo, Thomas, Puechal, Xavier, Pugnet, Grégory, Quemeneur, Thomas, Samson, Maxime, Taille, Camille, and Guillevin, Loïc
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Additional file 3. Vasculitis activity score—Birmingham vasculitis activity score version 2003.
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- 2020
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8. Additional file 4 of French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides)
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Terrier, Benjamin, Darbon, Raphaël, Cécile-Audrey Durel, Hachulla, Eric, Karras, Alexandre, Maillard, Hélène, Papo, Thomas, Puechal, Xavier, Pugnet, Grégory, Quemeneur, Thomas, Samson, Maxime, Taille, Camille, and Guillevin, Loïc
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surgical procedures, operative ,bacterial infections and mycoses ,neoplasms ,digestive system ,digestive system diseases - Abstract
Additional file 4. Appendix 4—Sequelae score—Vasculitis damage index.
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- 2020
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9. Prostaglandin D2 amplifies lupus disease through basophil accumulation in lymphoid organs
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Pellefigues, Christophe, Dema, Barbara, Lamri, Yasmine, Saidoune, Fanny, Chavarot, Nathalie, Loheac, Charlotte, Pacreau, Emeline, Dussiot, Michaël, Bidault, Caroline, Marquet, Florian, Jablonski, Mathieu, Chemouny, Jonathan Maurice, Jouan, Fanny, Dossier, Antoine, Chauveheid, Marie-Paule, Gobert, Delphine, Papo, Thomas, Karasuyama, Hajime, Sacre, Karim, Daugas, Eric, Charles, Nicolas, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Néphrologie [Bichat-Claude Bernard], Université Pierre et Marie Curie - Paris 6 (UPMC)-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), Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), 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], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Médecine Interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Médecine Interne, GH Bichat-Claude Bernard, Paris, Department of Immune Regulation [Tokyo, Japan], Graduate School of Medical and Dental Sciences [Tokyo, Japan]-Tokyo Medical and Dental University [Japan] (TMDU), UMR 1599, Centre National de la Recherche Scientifique (CNRS), Bureau de Recherches Géologiques et Minières (BRGM) (BRGM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU 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), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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[SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology ,Science ,parasitic diseases ,lcsh:Q ,chemical and pharmacologic phenomena ,hemic and immune systems ,lcsh:Science ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,ComputingMilieux_MISCELLANEOUS - Abstract
In a lupus environment, basophils accumulate in secondary lymphoid organs where they affect pathogenesis by stimulating autoantibody production. Here the authors show this accumulation is driven by PGD2-induced CXCR4 surface expression and trafficking of basophils.
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- 2018
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10. Symptomatic muscular sarcoidosis
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Cohen Aubart, Fleur, Abbara, Salam, Maisonobe, Thierry, Cottin, Vincent, Papo, Thomas, Haroche, Julien, Mathian, Alexis, Pha, Micheline, Gilardin, Laurent, Hervier, Baptiste, Soussan, Michael, Morlat, Philippe, Nunes, Hilario, Benveniste, Olivier, Amoura, Zahir, and Valeyre, Dominique
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Article - Abstract
Objectives To describe clinicopathologic features of muscular sarcoidosis and the associated sarcoidosis phenotype through a nationwide multicenter study. Methods Patients were included if they had histologically proven sarcoidosis and symptomatic muscular involvement confirmed by biological, imaging, or histologic examinations. Results Forty-eight patients (20 males) were studied, with a median age at muscular symptoms onset of 45 years (range 18–71). Four patterns were identified: a nodular pattern (27%); smoldering phenotype (29%); acute, subacute, or progressive myopathic type (35%); and combined myopathic and neurogenic pattern (10%). In all patterns, sarcoidosis was multivisceral with a median of 3 extramuscular organs involved (mostly lungs, lymph nodes, eyes, and skin) and a prolonged course with long-term use of corticosteroids and immunosuppressive drugs. Muscular patterns differed according to clinical presentation (myalgia, nodules, or weakness), electromyographic findings, muscular MRI, and response to sarcoidosis treatment. The myopathic and neuromuscular patterns were more severe. Conclusion This nationwide study of muscular sarcoidosis allowed the identification of 4 patterns of granulomatous myositis, which differed by phenotypes and the clinical course.
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- 2018
11. Adding Azathioprine to Remission-Induction Glucocorticoids for Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss), Microscopic Polyangiitis, or Polyarteritis Nodosa Without Poor Prognosis Factors
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Puechal, Xavier, Pagnoux, Christian, Baron, Gabriel, Quemeneur, Thomas, Néel, Antoine, Agard, Christian, Lifermann, François, Liozon, Eric, Ruivard, Marc, Godmer, Pascal, Limal, Nicolas, Mekinian, Arsène, Papo, Thomas, Ruppert, Anne, Bourgarit, Anne, Bienvenu, Boris, Geffray, Loïc, Saraux, Luc, Diot, Elisabeth, Crestani, Bruno, Delbrel, Xavier, Sailler, Laurent, Cohen, Pascal, Le Guern, Véronique, Terrier, Benjamin, Groh, Matthieu, Le Jeunne, Claire, Mouthon, Luc, Ravaud, Philippe, Guillevin, Loïc, Pineton de Chambrun, Marc, Luyt, Charles-Edouard, Beloncle, Francois, Gousseff, Marie, Mauhin, Wladimir, Argaud, Laurent, Ledochowski, Stanislas, Moreau, Anne-Sophie, Sonneville, Romain, Verdière, Bruno, Merceron, Sybille, Zappella, Nathalie, Landais, Mickael, Contou, Damien, Demoule, Alexandre, Paulus, Sylvie, Souweine, Bertrand, Lecomte, Bernard, Vieillard-Baron, Antoine, Terzi, Nicolas, Azoulay, Elie, Friolet, Raymond, Puidupin, Marc, Devaquet, Jérôme, Mazou, Jean-Marc, Fédun, Yannick, Mira, Jean-Paul, Raphalen, Jean-Herlé, Combes, Alain, Amoura, Zahir, Lega, Jean-Christophe, Lambert, Marc, Rivière, Sophie, Dossier, Antoine, Lhote, François, Blaison, Gilles, Alric, Laurent, Saadoun, David, Graveleau, Julie, Soubrier, Martin, Lecomte, Marie-Josée, Christides, Christine, Bosseray, Annick, Lévesque, Hervé, Viallard, François, Tieulie, Nathalie, Lovey, Pierre-Yves, Le Moal, Sylvie, Bibes, Béatrice, Malizia, Giuseppe, Abgueguen, Pierre, Liferman, François, Ninet, Jacques, Hatron, Pierre-Yves, Hot, Arnaud, Hernu, Romain, de La Salle, Sylvie, Similowski, Thomas, Haroche, Julien, Boileau, Julien, Hanslik, Thomas, Bulte, Caroline, Talasczka, Aline, Hachulla, Eric, Decaux, Olivier, Ibouanga, Florent, Arnulf, Bertrand, Benedit, Marc, Maalouf, Assaad, Moulin, Bruno, Cohen-Aubart, Fleur, Pha, Micheline, Rivard, Georges-Etienne, Rondeau, Eric, Debourdeau, Philippe, Presne, Claire, Andrieu, Maude, Len Abad, Oscar, Devilliers, Hervé, Rogers, Alister, Hie, Miguel, Mathian, Alexis, Heidelberger, Valentine, Ingen-Housz-Oro, Saskia, Marquet, Alicia, Mahevas, Matthieu, Bessis, Didier, Bouillet, Laurence, Caux, Frédéric, Chapelon-Abric, Catherine, Debarbieux, Sebastien, Delaporte, Emmanuel, Duval-Modeste, Anne-Bénédicte, Fain, Olivier, Joly, Pascal, Marchand-Adam, Marc, Monfort, Jean-Benoît, Noel, Nicolas, Passeron, Thierry, Sarrot-Reynauld, Françoise, Verrot, Denis, Bouvry, Diane, Fardet, Laurence, Chosidow, Olivier, Sève, Pascal, Valeyre, Dominique, Moreau, Sophie, 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Département de Médecine Interne (VALENCIENNES - Med Int), CH Valenciennes, Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Médecine Interne [Dax], Centre Hospitalier de Dax, Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Service de médecine interne [CHU Bretagnes Atlantique], CHU Bretagnes Atlantique, Service de rhumatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Internal Medicine, Université Paris Diderot - Paris 7 (UPD7), Centre d'Immunologie et de Maladies Infectieuses (CIMI), 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), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Médecine interne, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Interne [Pau], Centre hospitalier de Pau, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service des maladies infectieuses et tropicales, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Orthopédique et traumatique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre de référence pour les vascularites nécrosantes et la sclérodermie systémique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Faculté de Médecine-pôle de Médecine Interne, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Réanimation Médicale et de Médecine Hyperbare [Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), 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), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Ecole Polytechnique Fédérale de Lausanne (EPFL), 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), 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)-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Médecine générale, Service de réanimation medico-chirurgicale [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de réanimation médicale [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), Normandie Université (NU), Medical ICU, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'anesthésie-réanimation SAMU94-SMUR94 [Mondor], 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), Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre National de la Recherche Scientifique (CNRS), Hôpital pasteur [Colmar], Service de Medecine Interne, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Centre hospitalier de Saint-Nazaire, 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), Hôpital l'Archet, Service des maladies infectieuses et tropicales [CHU Angers], Médecine Interne Dax (MEDECINE INTERNE), Hopital, Service de Médecine Interne, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), 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), 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, CHU Pontchaillou [Rennes], Service d'hématologie biologique, Service de néphrologie, Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], Service d'Hématologie-Oncologie, Hôpital Ste-Justine, Département d'Oncologie (Dep Oncol - AVIGNON), Institut Ste Catherine, Service de Néphrologie - Médecine Interne, CHU Amiens-Picardie-hôpital Sud, Service de Médecine Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Henri Mondor, Service de Médecine Interne [Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Centre de référence maladie rare des cytopénies auto-immunes de l'adulte-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Dermatologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de dermatologie [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service de Dermatologie, Centre Hospitalier Sud, Hospices Civils, Lyon, Service de dermatologie (CHRU de Lille), Service de dermatologie [Rouen], Service de médecine interne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information (CEA-LETI), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Equipe 12, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet-Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet-Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Service de pneumologie [Avicenne], Service de médecine interne [Saint-Antoine], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Epidemiology in Dermatology and Evaluation in Therapeutics (EpiDermE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service Médecine interne [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Henri Mondor [Créteil], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (1965 - 2019) (UNS), Hôpital Ambroise Paré [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR113-Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Service de médecine interne [CHU Saint-Antoine]
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[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system ,[SDV]Life Sciences [q-bio] ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
- Published
- 2017
- Full Text
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12. Central Nervous System Involvement in Whipple Disease
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Compain, Caroline, Sacre, Karim, Puéchal, Xavier, Klein, Isabelle, Vital-Durand, Denis, Houeto, Jean-Luc, De Broucker, Thomas, Raoult, Didier, and Papo, Thomas
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Adult ,Male ,Tropheryma ,Middle Aged ,Magnetic Resonance Imaging ,Central Nervous System Infections ,Treatment Outcome ,Anti-Infective Agents ,Recurrence ,Humans ,Original Study ,Female ,Whipple Disease ,Aged ,Follow-Up Studies ,Retrospective Studies - Abstract
Whipple disease (WD) is a rare multisystemic infection with a protean clinical presentation. The central nervous system (CNS) is involved in 3 situations: CNS involvement in classic WD, CNS relapse in previously treated WD, and isolated CNS infection. We retrospectively analyzed clinical features, diagnostic workup, brain imaging, cerebrospinal fluid (CSF) study, treatment, and follow-up data in 18 patients with WD and CNS infection. Ten men and 8 women were included with a median age at diagnosis of 47 years (range, 30–56 yr). The median follow-up duration was 6 years (range, 1–19 yr). As categorized in the 3 subgroups, 11 patients had classic WD with CNS involvement, 4 had an isolated CNS infection, and 3 had a neurologic relapse of previously treated WD. CNS involvement occurred during prolonged trimethoprim-sulfamethoxazole (TMP-SMX) treatment in 1 patient with classic WD. The neurologic symptoms were various and always intermingled, as follows: confusion or coma (17%) related to meningo-encephalitis or status epilepticus; delirium (17%); cognitive impairment (61%) including memory loss and attention defects or typical frontal lobe syndrome; hypersomnia (17%); abnormal movements (myoclonus, choreiform movements, oculomasticatory myorhythmia) (39%); cerebellar ataxia (11%); upper motor neuron (44%) or extrapyramidal symptoms (33%); and ophthalmoplegia (17%) in conjunction or not with progressive supranuclear palsy. No specific pattern was correlated with any subgroup. Brain magnetic resonance imaging (MRI) revealed a unique focal lesion (35%), mostly as a tumorlike brain lesion, or multifocal lesions (23%) involving the medial temporal lobe, midbrain, hypothalamus, and thalamus. Periventricular diffuse leukopathy (6%), diffuse cortical atrophy (18%), and pachymeningitis (12%) were observed. The spinal cord was involved in 2 cases. MRI showed ischemic sequelae at diagnosis or during follow-up in 4 patients. Brain MRI was normal despite neurologic symptoms in 3 cases. CSF cytology was normal in 62% of patients, whereas Tropheryma whipplei polymerase chain reaction (PCR) analysis was positive in 92% of cases with tested CSF. Periodic acid–Schiff (PAS)-positive cells were identified in cerebral biopsies of 4 patients. All patients were treated with antimicrobial therapy for a mean duration of 2 years (range, 1–7 yr) with either oral monotherapy (TMP-SMX, doxycycline, third-generation cephalosporins) or a combination of antibiotics that sometimes followed parenteral treatment with beta-lactams and aminoglycosides. Eight patients also received hydroxychloroquine. At the end of follow-up, the clinical outcome was favorable in 14 patients (78%), with mild to moderate sequelae in 9. Thirteen patients (72%) had stopped treatment for an average time of 4 years (range, 0.7–14 yr). Four patients had clinical worsening despite antimicrobial therapy; 2 of those died following diffuse encephalitis (n = 1) and lung infection (n = 1). In conclusion, the neurologic manifestations of WD are diverse and may mimic almost any neurologic condition. Brain involvement may occur during or after TMP-SMX treatment. CSF T. whipplei PCR analysis is a major tool for diagnosis and may be positive in the absence of meningitis. Immune reconstitution syndrome may occur in the early months of treatment. Late prognosis may be better than previously reported, as a consequence of earlier diagnosis and a better use of antimicrobial therapy, including hydroxychloroquine and doxycycline combination.
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- 2013
13. Positron emission tomography and computed tomography angiography for the diagnosis of giant cell arteritis
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Lariviere, Delphine, Benali, Khadija, Coustet, Baptiste, Pasi, Nicoletta, Hyafil, Fabien, Klein, Isabelle, Chauchard, Maria, Alexandra, Jean-François, Goulenok, Tiphaine, Dossier, Antoine, Dieude, Philippe, Papo, Thomas, and Sacre, Karim
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Male ,diagnosis ,Computed Tomography Angiography ,case-control study ,Observational Study ,18F-fluoro-deoxyglucose positron emission tomography scan ,Multimodal Imaging ,Sensitivity and Specificity ,immune system diseases ,Fluorodeoxyglucose F18 ,Predictive Value of Tests ,Humans ,cardiovascular diseases ,Prospective Studies ,skin and connective tissue diseases ,Aged ,Aged, 80 and over ,giant cell arteritis ,Middle Aged ,C-Reactive Protein ,Positron-Emission Tomography ,cardiovascular system ,Female ,Radiopharmaceuticals ,Research Article - Abstract
The use of 18F-fluoro-deoxyglucose positron emission tomography scan (FDG-PET) and computed tomography angiography (CTA) to improve accuracy of diagnosis of giant cell arteritis (GCA) is a very important clinical need. We aimed to compare the diagnostic performance of FDG-PET and CTA in patients with GCA. FDG-PET and CTA were acquired in all consecutive patients suspected for GCA. Results of FDG-PET and CTA were compared with the final diagnosis based on clinical judgment, temporal artery biopsy (TAB) findings, and ACR criteria. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for each method. Twenty-four patients suspected for GCA were included. Fifteen (62.5%) were ultimately diagnosed as having GCA. Among them, all fulfilled ACR criteria and 6 had biopsy-proven GCA. Strong FDG uptake in large vessels was found in 10 patients who all had GCA. Mean maximal standard uptake values (SUVmax) per patient measured at all the arterial territories were of 3.7 (range: 2.8–4.7). FDG uptake was negative in 14 patients including 9 and 5 patients without and with GCA, respectively. Mural thickening suggestive of aortitis or branch vessel arteritis was observed on CTA in 11 patients with and 2 patients without GCA. No mural thickening was observed in 11 patients including 7 patients without and 4 patients with GCA. Overall, sensitivity was 66.7% and 73.3%, specificity was 100% and 84.6%, NPV was 64.3% and 64.6%, and PPV was 100% and 84.6% of FDG-PET and CTA, respectively. Both FDG-PET and CTA have a strong diagnostic yield for the diagnosis of GCA. FDG-PET appeared to have a higher PPV as compared to CTA and may be the preferred noninvasive technique to explore patients with suspected GCA.
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- 2016
14. Life-Threatening Hypercalcemia Revealing Diffuse and Isolated Acute Sarcoid-Like Myositis
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Mageau, Arthur, Rigolet, Aude, Benali, Khadija, Chauchard, Maria, Ladjeroud, Salima, Mahe, Isabelle, Maisonobe, Thierry, Chauveheid, Marie-Paule, Papo, Thomas, and Sacre, Karim
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Adult ,Male ,Myositis ,Sarcoidosis ,Paraneoplastic Syndromes ,Biopsy ,Middle Aged ,Diagnosis, Differential ,Positron-Emission Tomography ,Acute Disease ,Hypercalcemia ,Humans ,Female ,Clinical Case Report ,Research Article ,Aged ,Follow-Up Studies - Abstract
Up to 50% patients with sarcoidosis display extra-pulmonary disease. However, initial and isolated (ie, without lung disease) acute muscular involvement associated with pseudo-malignant hypercalcemia is very uncommon. We report on 3 cases of life-threatening hypercalcemia revealing florid and isolated acute sarcoid-like myositis. All patients complained of fatigue, progressive general muscle weakness, and weight loss. Laboratory tests showed a severe life-threatening hypercalcemia (>3.4 mmol/L). Hypercalcemia was associated with increased serum level of 1,25-(OH)2 vitamin D and complicated with acute renal failure. One patient displayed acute pancreatitis due to hypercalcemia. In all cases, PET-scan, performed for malignancy screening, incidentally revealed an intense, diffuse, and isolated muscular fluorodeoxyglucose (FDG) uptake consistent with diffuse non-necrotizing giant cells granulomatous myositis demonstrated by muscle biopsy. Of note, creatine phosphokinase blood level was normal in all cases. No patients displayed the usual thoracic features of sarcoidosis. All patients were treated with high dose steroids and achieved rapid, complete, and sustained remission. A review of English and French publications in Medline revealed 5 similar published cases. Steroid-sensitive acute sarcoid-like myositis causing high calcitriol levels and life-threatening hypercalcemia should be recognized as a separate entity.
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- 2016
15. Long-term outcomes of the WEGENT trial on remission-maintenance for granulomatosis with polyangiitis or microscopic polyangiitis
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Puéchal, Xavier, Pagnoux, Christian, Perrodeau, Elodie, Hamidou, Mohamed, Boffa, Jean-Jacques, Kyndt, Xavier, Lifermann, François, Papo, Thomas, Merrien, Dominique, Smail, Amar, Delaval, Philippe, Hanrotel-Saliou, Catherine, Imbert, Bernard, Khouatra, Chahéra, Lambert, Marc, Leské, Charles, Ly, Kim, Pertuiset, Edouard, Roblot, Pascal, Ruivard, Marc, Subra, Jean-François, Viallard, Jean-François, Terrier, Benjamin, Cohen, Pascal, Mouthon, Luc, Le Jeunne, Claire, Ravaud, Philippe, Guillevin, Loïc, Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Equipe 5 : METHODS - Méthodes de l’évaluation thérapeutique des maladies chroniques ( CRESS - U1153 ), Université Paris Descartes - Paris 5 ( UPD5 ) -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 ) -Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de médecine interne [Nantes], Université de Nantes ( UN ) -Hôtel-Dieu-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Remodelage et Reparation du Tissu Renal, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Néphrologie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Service de médecine interne et néphrologie, CH Valenciennes, Service de Médecine Interne [Dax], Hôpital Dax, Hôpital Bichat - Claude Bernard, Centre Hospitalier Compiègne-Noyon, Service de Néphrologie - Médecine Interne, CHU Amiens-Picardie-Hôpital Sud, Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Service de pneumologie, CHU Pontchaillou [Rennes], Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, CHRU - Service de néphrologie, dialyse et transplantation rénale, Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), CHU Grenoble, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon ( HCL ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), CH Cholet, CHU Limoges, Hopital Réné Dubos, Service de Médecine Interne, Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), CHU Estaing [Clermont-Ferrand], Service de Néphrologie [Angers], Université d'Angers ( UA ) -CHU Angers, Service de Médecine Interne et Maladies Infectieuses [Pessac], CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], CHU Cochin [AP-HP], Club Rhumatismes et Inflammation, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Equipe 5 : METHODS - Méthodes de l’évaluation thérapeutique des maladies chroniques (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Sorbonne Paris Cité (USPC), Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [APHP], Centre Hospitalier de Dax, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Amiens-Picardie-hôpital Sud, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), CHU Clermont-Ferrand, Hôpital Cochin [AP-HP], Hospices Civils de Lyon (Délégation à la Recherche Clinique, Lyon, France, Trial no. 97.129), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Jonchère, Laurent
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[SDV] Life Sciences [q-bio] ,[ SDV ] Life Sciences [q-bio] ,[SDV]Life Sciences [q-bio] - Abstract
International audience; Objective - Findings from the WEGENT trial and other short-term studies have suggested that azathioprine (AZA) or methotrexate (MTX) could effectively maintain remission of granulomatosis with polyangiitis (Wegener's) (GPA) or microscopic polyangiitis (MPA). This study was undertaken to examine whether differences in rates of relapse or adverse events would appear after discontinuation of these 2 maintenance regimens, when assessed over a longer followup period. Methods - Long-term outcomes in patients enrolled in the WEGENT trial were analyzed according to their randomized treatment group (AZA or MTX). Parameters at trial entry were evaluated as potential prognostic factors for death, relapse, or damage in multivariate models. Results - Data from 10 years of followup were available for 112 (88.8%) of the 126 original trial participants. The median followup time was 11.9 years (95% confidence interval [95% CI] 11.3-12.5 years). In patients receiving AZA and those receiving MTX, the 10-year overall survival rates were 75.1% (95% CI 64.8-86.9%) and 79.9% (95% CI 70.3-90.8%) (P = 0.56), respectively, and relapse-free survival rates were 26.3% (95% CI 17.3-40.1%) and 33.5% (95% CI 23.5-47.7%) (P = 0.29), respectively. No between-treatment differences were observed with regard to rates of relapse, adverse events, damage, survival without severe side effects, and survival without relapse and severe side effects. In analyses limited to the 97 patients with GPA, no between-treatment differences in survival rates were observed. The 10-year relapse-free survival rate was lower in patients with GPA than in patients with MPA. However, in the multivariate analysis, anti-proteinase 3 antineutrophil cytoplasmic antibody (ANCA) positivity, and not GPA, was retained as being independently associated with the relapse rate. Conclusion - The results of this long-term analysis confirm that AZA and MTX are comparable treatment options for maintaining remission of GPA or MPA. Despite achieving good overall survival with these treatments, relapse rates, adverse events, and damage remain matters of concern and further studies are needed to reduce their frequency in these ANCA-associated vasculitides.
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- 2016
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16. Granulomatosis with polyangiitis: endoscopic management of tracheobronchial stenosis: results from a multicentre experience
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Terrier, Benjamin, Dechartres, Agnès, Girard, Charlotte, Jouneau, Stéphane, Kahn, Jean-Emmanuel, Dhote, Robin, Lazaro, Estibaliz, Cabane, Jean, Papo, Thomas, Schleinitz, Nicolas, Cohen, Pascal, Begon, Edouard, Belenotti, Pauline, Chauveau, Dominique, Diot, Elisabeth, Généreau, Thierry, Hamidou, Mohamed, Hayem, Gilles, Le Guenno, Guillaume, Le Guern, Véronique, Michel, Marc, Moulis, Guillaume, Puéchal, Xavier, Rivière, Sophie, Samson, Maxime, Gonin, François, Le Jeunne, Claire, Corlieu, Pascal, Mouthon, Luc, Guillevin, Loïc, Group, French Vasculitis Study, 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Epidémiologie Clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-French Cochrane Centre, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Laboratoire d'Immunologie (EA 2686), Université de Lille, Droit et Santé, Service de Médecine Interne, CHU Avicenne, Service de médecine interne et maladies infectieuses, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Bichat - Claude Bernard, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Cochin [AP-HP], Service de Médecine Interne (MARSEILLE - Med Int), Assistance Publique - Hôpitaux de Marseille (APHM), Département de Néphrologie et Transplantation d'organes [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Référence du sud-Ouest des maladies rénales rares [CHU Toulouse] (SODARE), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut des Maladies Métaboliques et Cardiovasculaires (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), Hôpital Bretonneau, Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Rhumatologie, 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)-PRES Sorbonne Paris Cité, Service de médecine interne [Mondor], 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 Néphrologie - Médecine Interne, CHU Amiens-Picardie-hôpital Sud, Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Unité de Transplantation Pulmonaire, Hôpital Foch [Suresnes], CHU Tenon [AP-HP], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Service de médecine interne [Saint-Antoine], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Département de Néphrologie et Transplantation d'organes, Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre de référence des maladies rénales rares, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de médecine interne [CHU Saint-Antoine], Département de Néphrologie et Transplantation d'organes [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 ( UPD5 ) -PRES Sorbonne Paris Cité-French Cochrane Centre, Centre de recherches et d'études sur les droits fondamentaux ( CREDOF ), Centre de Théorie et Analyse du Droit ( CTAD ), École normale supérieure - Paris ( ENS Paris ) -École des hautes études en sciences sociales ( EHESS ) -Université Paris Nanterre ( UPN ) -Centre National de la Recherche Scientifique ( CNRS ) -École normale supérieure - Paris ( ENS Paris ) -École des hautes études en sciences sociales ( EHESS ) -Université Paris Nanterre ( UPN ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Laboratoire d'Immunologie ( EA 2686 ), Service de médecine interne, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), CHU Cochin [AP-HP], Service de Médecine Interne ( MARSEILLE - Med Int ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Université de Nantes ( UN ) -Hôtel-Dieu-Centre hospitalier universitaire de Nantes ( CHU Nantes ), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ) -PRES Sorbonne Paris Cité-AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), CHU Amiens-Picardie-Hôpital Sud, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), CHU Tenon [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-French Cochrane Centre, Centre de recherches et d'études sur les droits fondamentaux (CREDOF), Centre de Théorie et Analyse du Droit (CTAD), Université Paris Nanterre (UPN)-Centre National de la Recherche Scientifique (CNRS)-École des hautes études en sciences sociales (EHESS)-École normale supérieure - Paris (ENS Paris)-Université Paris Nanterre (UPN)-Centre National de la Recherche Scientifique (CNRS)-École des hautes études en sciences sociales (EHESS)-École normale supérieure - Paris (ENS Paris), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité-AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité
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Male ,[SDV]Life Sciences [q-bio] ,Constriction, Pathologic ,0302 clinical medicine ,Restenosis ,Prednisone ,Pharmacology (medical) ,Cumulative incidence ,Treatment Failure ,030223 otorhinolaryngology ,ddc:616 ,Laser Therapy/methods ,bronchial stenosis ,Hazard ratio ,Endoscopic dilatation ,Middle Aged ,3. Good health ,tracheobronchial involvement ,Treatment Outcome ,Constriction, Pathologic/etiology/therapy ,subglottic stenosis ,Female ,Stents ,Steroids ,Radiology ,Laser Therapy ,Bronchial Diseases/etiology/therapy ,Granulomatosis with polyangiitis ,Tracheal Stenosis ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Subglottic stenosis ,macromolecular substances ,Endoscopy/methods ,Injections ,Granulomatosis with Polyangiitis/complications ,03 medical and health sciences ,Young Adult ,stomatognathic system ,Steroids/administration & dosage/therapeutic use ,Rheumatology ,Dilatation/methods ,medicine ,Humans ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,granulomatosis with polyangiitis ,[ SDV ] Life Sciences [q-bio] ,Tracheal Stenosis/etiology/therapy ,business.industry ,Retrospective cohort study ,Bronchial Diseases ,Endoscopy ,medicine.disease ,Surgery ,prosthesis ,business ,dilatation - Abstract
International audience; OBJECTIVES: Tracheobronchial stenosis (TBS) is noted in 12-23% of patients with granulomatosis with polyangiitis (GPA), and includes subglottic stenosis and bronchial stenosis. We aimed to analyse the endoscopic management of TBS in GPA and to identify factors associated with the efficacy of endoscopic interventions. METHODS: We conducted a French nationwide retrospective study that included 47 patients with GPA-related TBS. RESULTS: Compared with patients without TBS, those with TBS were younger, more frequently female and had less frequent kidney, ocular and gastrointestinal involvement and mononeuritis multiplex. Endoscopic procedures included 137 tracheal and 50 bronchial interventions, mainly endoscopic dilatation, local steroid injection and conservative laser surgery, and less frequently stenting. After the first endoscopic procedure, the cumulative incidence of endoscopic treatment failure was 49% at 1 year, 70% at 2 years and 80% at 5 years. Factors significantly associated with a higher cumulative incidence of treatment failure were a shorter time from GPA diagnosis to endoscopic procedure [hazard ratio (HR) 1.08 (95% CI 1.01, 1.14); P = 0.01] and a bronchial stenosis [HR 1.96 (95% CI 1.28, 3.00); P = 0.002]. A prednisone dose ≥30 mg/day at the time of the procedure was associated with a lower cumulative incidence of treatment failure [HR 0.53 (95% CI 0.31, 0.89); P = 0.02]. CONCLUSION: TBS represents severe and refractory manifestations with a high rate of restenosis. High-dose systemic CSs at the time of the procedure and increased time from GPA diagnosis to bronchoscopic intervention are associated with a better event-free survival. In contrast, bronchial stenoses are associated with a higher rate of restenosis than subglottic stenosis.
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- 2015
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17. Extra- and Intracranial Cerebral Vasculitis in Giant Cell Arteritis
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Larivière, Delphine, Sacre, Karim, Klein, Isabelle, Hyafil, Fabien, Choudat, Laurence, Chauveheid, Marie-Paule, and Papo, Thomas
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Observational Study ,cardiovascular diseases ,Article - Abstract
Recognizing giant cell arteritis (GCA) in patients with stroke may be challenging. We aimed to highlight the clinical spectrum and long-term follow-up of GCA-specific cerebrovascular accidents. Medical charts of all patients followed in a French Department of Internal Medicine for GCA between January 2008 and January 2014 were retrospectively reviewed. Patients with cerebrovascular accidents at GCA diagnosis were included. Diagnosis of GCA was based on American College of Rheumatology criteria. Transient ischemic attacks and stroke resulting from an atherosclerotic or cardioembolic mechanism were excluded. Clinical features, GCA-diagnosis workup, brain imaging, cerebrospinal fluid (CSF) study, treatment, and follow-up data were analyzed. From January 2008 to January 2014, 97 patients have been followed for GCA. Among them, 8 biopsy-proven GCA patients (mean age 70 ± 7.8 years, M/F sex ratio 3/1) had stroke at GCA diagnosis. Six patients reported headache and visual impairment. Brain MR angiography showed involvement of vertebral and/or basilar arteries in all cases with multiple or unique ischemic lesions in the infratentorial region of the brain in all but one case. Intracranial cerebral arteries involvement was observed in 4 cases including 2 cases with cerebral angiitis. Long lasting lesions on diffusion-weight brain MRI sequences were observed in 1 case. All patients received steroids for a mean of 28.1 ± 12.8 months. Side effects associated with long-term steroid therapy occurred in 6 patients. Relapses occurred in 4 patients and required immunosuppressive drugs in 3 cases. After a mean follow-up duration of 36.4 ± 16.4 months, all but 1 patient achieved complete remission without major sequelae. The conjunction of headache with vertebral and basilar arteries involvement in elderly is highly suggestive of stroke associated with GCA. Intracranial cerebral arteries involvement with cerebral angiitis associated with long lasting brain lesions on diffusion-weight brain MRI sequences may occur in GCA. Both frequent relapses and steroid-induced side effects argue for the use of immunosuppressive agents combined with steroids as first-line therapy.
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- 2014
18. Intravenous immunoglobulin therapy for pure red cell aplasia related to human parvovirus b19 infection: a retrospective study of 10 patients and review of the literature
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Legendre Christophe, Yoann Crabol, Catherine Montagnier-Petrissans, Marjanovic Zora, Fischer Alain, Papo Thomas, Olivier Hermine, Le Parc Jean-Marie, Flore Rozenberg, Paré Hôpital Ambroise, Godeau Bertrand, Necker Hôpital, Montagnier-Petrissan Catherine, Mouthon Luc, Fantin Bruno, Bussel Annette, Benjamin Terrier, Hermine Olivier, Lesavre Philippe, Lortholary Olivier, Gorin Norbert-Claude, Dreyfus François, Fermand Jean-Paul, Benomar Amina, Parquet Nathalie, Christophe Legendre, Sharshar Tarek, Fontaine Bertrand, Guillevin Loïc, Charpentier Bernard, Loïc Guillevin, Sauvageon Hélène, Liou Amélie, Leverger Guy, Lopez Isabelle, Piette Jean-Charles, Bicêtre Hôpital, Luc Mouthon, Oksenhendler Eric, and Vincent Pestre
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Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Paris ,Adolescent ,viruses ,Pure red cell aplasia ,Red-Cell Aplasia, Pure ,Gastroenterology ,Parvoviridae Infections ,Intravenous Immunoglobulin Therapy ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Parvovirus B19, Human ,Humans ,Aplastic anemia ,Aged ,Retrospective Studies ,biology ,business.industry ,virus diseases ,Immunoglobulins, Intravenous ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Pulmonary edema ,Surgery ,Infectious Diseases ,medicine.anatomical_structure ,Treatment Outcome ,biology.protein ,Female ,Hemoglobin ,Bone marrow ,Immunotherapy ,Antibody ,business - Abstract
Background. We evaluated the efficacy of intravenous immunoglobulin (IVIG) therapy in patients with pure red cell aplasia (PRCA) related to human parvovirus B19 (HPV-B19) infection. Methods. We retrospectively reviewed all HPV-B19 PRCA cases treated with IVIG between January 2000 and December 2005 in the Assistance Publique-Hopitaux de Paris hospitals and reviewed all cases of HPV-B19 PRCA cases treated with IVIG in the literature. Results. Among our 36 patients, PRCA was confirmed in 22, including 10 with proven HPV-B19 infection. Nine patients were immunocompromised, including 4 who had undergone transplant. All patients had severe anemia (mean hemoglobin level, 5.0 ± 1.9 g/dL). Seven patients who underwent bone-marrow aspiration had positive HPV-B19 polymerase chain reaction (PCR) results at diagnosis. Patients received a mean of 2.7 ± 2.1 IVIG courses (1.3 ± 0.5 g/kg/course). Hemoglobin level was corrected in 9 of the 10 patients within a mean of 80 ± 54 days. The only nonresponsive patient had underlying myelodysplasia. Blood HPV-B19 PCR results were negative from 35 to 159 days after treatment. Four patients showed side effects of IVIG treatment: acute reversible renal failure (n = 2) and pulmonary edema (n = 2). Among 133 patients with HPV-B19 PRCA who received IVIG (our 10 patients and 123 from the literature), 63 had undergone solid-organ transplant and 39 had human immunodeficiency virus infection. Hemoglobin level was corrected after the first IVIG course in 124 patients (93%); disease relapsed in 42 (33.9%), at a mean of 4.3 months. Conclusions. IVIG therapy appears to be effective in the short term in immunocompromised patients with HPV-B19 PRCA.
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- 2012
19. Long-term outcome of 32 patients with chorea and systemic lupus erythematosus or antiphospholipid antibodies
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Reiner, Peggy, Galanaud, Damien, Leroux, Gaëlle, Vidailhet, Marie, Haroche, Julien, Huong, Du Le Thi, Francès, Camille, Papo, Thomas, De Gennes, Christian, Musset, Lucile, Wechsler, Bertrand, Amoura, Zahir, Piette, Jean-Charles, Costedoat-Chalumeau, Nathalie, Service de Neuroradiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière (NEMESIS-CRICM), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), 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)-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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), Hôpital Bichat - Claude Bernard, Service d'Immunologie [CHU Pitié-Salpétrière], Service de médecine interne [CHU Pitié-Salpétrière], 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), Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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)-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), Service de neuro-radiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière ( NEMESIS-CRICM ), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière ( CRICM ), 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 ) -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 ), AP-HP Hôpital Universitaire Pitié Salpêtrière - GHU Pitié Salpêtrière, 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 ), Service de Dermatologie, CHU Pitié-Salpêtrière [APHP], Service d'immunologie [CHU Pitié-Salpétrière], Service de Médecine Interne, and Immunologie - Immunopathologie - Immunothérapeutique ( I3 )
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Adult ,Male ,Risk ,Time Factors ,[ INFO.INFO-IM ] Computer Science [cs]/Medical Imaging ,Adolescent ,Arteries ,lupus ,Middle Aged ,Antiphospholipid Syndrome ,Young Adult ,antiphospholipid ,Treatment Outcome ,Antibodies, Antiphospholipid ,[INFO.INFO-IM]Computer Science [cs]/Medical Imaging ,Humans ,Lupus Erythematosus, Systemic ,Female ,Steroids ,chorea ,Child ,thrombosis ,Antipsychotic Agents ,Follow-Up Studies ,Retrospective Studies - Abstract
International audience; OBJECTIVE: The aim of this work was to describe chorea during systemic lupus erythematosus or antiphospholipid antibodies and its long-term outcome. METHODS: We retrospectively analyzed clinical features, laboratory findings, imaging characteristics, and outcome in a series of 32 patients. RESULTS: Most patients were women (28 of 32), and mean age at onset of chorea was 20.6 (9-62) years. Chorea was inaugural for 28 patients. Improvement was observed with various treatments. During follow-up (12.2 ± 11.3 years), severe manifestations of systemic lupus erythematosus were rare. Antiphospholipid antibodies were repeatedly positive for 90% of the patients. Twelve patients developed arterial thrombosis. Prophylactic treatment with antithrombotic therapy might reduce the risk of further thrombosis (8% versus 57%; P = 0.01). Cardiac valvulopathy occurred in 22 patients during follow-up. Chorea relapsed in 8 cases. CONCLUSIONS: Chorea had a good outcome in itself. This long-term follow-up shows, for the first time, that these patients have substantial risk for further arterial thrombosis.
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- 2011
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20. Resistance to trimethoprim/sulphamethoxazole and
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Fenollar, Florence, Rolain, Jean-Marc, Alric, Laurent, Papo, Thomas, Chauveheid, Marie-Paule, van de Beek, Diederik, Raoult, Didier, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Department of Internal Medicine, Université Paris Diderot - Paris 7 (UPD7), Department of Neurology, University of Amsterdam [Amsterdam] (UvA), and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
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Trimethoprim/sulphamethoxazole ,Antibiotic resistance ,Whipple's disease ,Sulfadiazine - Abstract
International audience; Whipple's disease (WD) is a chronic infection caused by . A 1-year treatment of oral trimethoprim/sulphamethoxazole (SXT) is commonly used. Advances in the culture of has allowed for full genome sequencing and antibiotic susceptibility testing, which has demonstrated resistance of to trimethoprim. Several mutations in the gene that encodes dihydropteroate synthase, the target of sulphonamides, has been reported for one patient with clinically acquired resistance to SXT. Here we report three new patients who experienced clinically acquired resistance to SXT during treatment and one patient with biological failure. Sixty-two sequences from DNA samples of 59 WD patients were also obtained. Among the detected amino acid changes, two positions (N4S and S234F) significantly predicted secondary sulphamethoxazole failure (four of five). We suggest that these mutations should be detected at the time of WD diagnosis by sequencing in order to avoid sulphamethoxazole monotherapy.
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- 2009
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21. Efficacy and Safety of ANTI-TNF ALPHA in BEHCET Disease: A International Multicenter Registry of 122 Patients
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Vallet, Helene, Riviere, Sophie, Alban DEROUX, Moulis, Guillaume, Addimanda, Olga, Salvarani, Carlo, Lambert, Marc, Bielfeld, Philip, Seve, Pascal, Sibilia, Jean, Fraison, Jean Baptiste, Schoindre, Yoland, Marie, Isabelle, Perard, Laurent, Papo, Thomas, Sene, Damien, Leroux, Gaelle, Royant, Valerie, Perlat, Antoinette, Mariette, Xavier, Lidove, Olivier, Fain, Olivier, Moreuil, Claire, Blaison, Gilles, Le, Phuc Hoang, Hachulla, Eric, Wechsler, Bertrand, Bodaghi, Barham, Cacoub, Patrice, and Saadoun, David
22. Infliximab Versus Adalimumab in Severe Uveitis: Multicenter Study from the French Uveitis Network
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Vallet, Helene, Seve, Pascal, Biard, Lucie, Feurer, Elodie, Riviere, Sophie, Bielfeld, Philip, Perard, Laurent, Bienvenu, Boris, Abad, Sebastien, Rigolet, Aude, Deroux, Alban, Perlat, Antoinette, Damien SENE, Marie, Isabelle, Heron, Emmanuel, Hachulla, Eric, Fain, Olivier, Clavel, Gaelle, Sibilia, Jean, Tieulie, Nathalie, Schoindre, Yoland, Fraison, Jean Baptiste, Moulis, Guillaume, Papo, Thomas, Blaison, Gilles, Gueudry, Julie, Lidove, Olivier, Phuc Le Hoang, Chapelon, Catherine, Regon, Mathieu Resche, Cacoub, Patrice, Bodaghi, Bahram, and Saadoun, David
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