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1. Long-term efficacy and safety of rituximab in IgG4-related disease: Data from a French nationwide study of thirty-three patients.

Author

Mikael Ebbo, Aurélie Grados, Maxime Samson, Matthieu Groh, Anderson Loundou, Aude Rigolet, Benjamin Terrier, Constance Guillaud, Clarisse Carra-Dallière, Frédéric Renou, Agnieszka Pozdzik, Pierre Labauge, Sylvain Palat, Jean-Marie Berthelot, Jean-Loup Pennaforte, Alain Wynckel, Céline Lebas, Noémie Le Gouellec, Thomas Quémeneur, Karine Dahan, Franck Carbonnel, Gaëlle Leroux, Antoinette Perlat, Alexis Mathian, Patrice Cacoub, Eric Hachulla, Nathalie Costedoat-Chalumeau, Jean-Robert Harlé, and Nicolas Schleinitz

Subjects
Medicine, Science
Abstract

To assess efficacy and safety of rituximab (RTX) as induction therapy, maintenance of remission and treatment of relapses in a cohort of IgG4-related disease (IgG4-RD) patients.Nationwide retrospective multicenter study of IgG4-RD patients treated with at least one course of RTX. Clinical, biological and radiological response, relapse rate and drug tolerance were analyzed. Kaplan-Meier curves were plotted and risk factors for relapse studied with a Cox regression model.Among 156 IgG4-RD patients included in the French database, 33 received rituximab. Clinical response was noted in 29/31 (93.5%) symptomatic patients. Glucocorticoids withdrawal was achieved in 17 (51.5%) patients. During a mean follow-up of 24.8 ±21 months, 13/31 (41.9%) responder patients relapsed after a mean delay of 19 ±11 months after RTX. Active disease, as defined by an IgG4-RD Responder Index >9 before RTX, was significantly associated with relapse (HR = 3.68, 95% CI: 1.1, 12.6) (P = 0.04), whereas maintenance therapy with systematic (i.e. before occurrence of a relapse) RTX retreatment was associated with longer relapse-free survival (41 versus 21 months; P = 0.02). Eight severe infections occurred in 4 patients during follow-up (severe infections rate of 12.1/100 patient-years) and hypogammaglobulinemia ≤5 g/l in 3 patients.RTX is effective for both induction therapy and treatment of relapses in IgG4-RD, but relapses are frequent after B-cell reconstitution. Maintenance therapy with systematic RTX infusions is associated with longer relapse-free survival and might represent a novel treatment strategy. Yet, the high rate of infections and the temporary effect of RTX might be hindrances to such strategy.

Published
2017
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2. Efficacy and safety of ustekinumab in Behçet disease: Results from the prospective phase 2 STELABEC trial

Author

Selim Aractingi, Marie Jachiet, Sarah Guégan, Benjamin Terrier, Olivier Lidove, Jérémie Dion, Lea Jilet, Fleur Cohen-Aubart, Hendy Abdoul, Xavier Puéchal, Jonathan London, Alexis Régent, and Jean-Loup Pennaforte

Subjects
medicine.medical_specialty, business.industry, Behcet Syndrome, Antibodies, Monoclonal, Dermatology, Behcet's disease, medicine.disease, Severity of Illness Index, Treatment Outcome, Double-Blind Method, Ustekinumab, medicine, Humans, Psoriasis, Prospective Studies, business, medicine.drug
Published
2021

3. Disease-specific quality of life following a flare in systemic lupus erythematosus: an item response theory analysis of the French EQUAL cohort

Author

Nadine Magy-Bertrand, Gilles Blaison, Pascal Sève, Thierry Martin, Marie Corneloup, Sabine Berthier, Jean-Loup Pennaforte, Géraldine Muller, Abderrahmane Bourredjem, François Maurier, Hervé Devilliers, Zahir Amoura, Denis Wahl, Olivier Aumaître, and Laurent Arnaud

Subjects
Adult, Male, medicine.medical_specialty, Logistic regression, law.invention, Disease activity, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Quality of life, law, Item response theory, Humans, Lupus Erythematosus, Systemic, Medicine, Pharmacology (medical), Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, 030203 arthritis & rheumatology, business.industry, Physical health, Middle Aged, Symptom Flare Up, Clinical trial, Logistic Models, Latent Class Analysis, Cohort, Quality of Life, Physical therapy, Female, France, business, Flare
Abstract

Objective To explore, at an item-level, the effect of disease activity (DA) on specific health-related quality of life (HRQoL) in SLE patients using an item response theory longitudinal model. Methods This prospective longitudinal multicentre French cohort EQUAL followed SLE patients over 2 years. Specific HRQoL according to LupusQoL and SLEQOL was collected every 3 months. DA according to SELENA-SLEDAI flare index (SFI) and revised SELENA-SLEDAI flare index (SFI-R) was evaluated every 6 months. Regarding DA according to SFI and each SFI-R type of flare, specific HRQoL of remitting patients was compared with non-flaring patients fitting a linear logistic model with relaxed assumptions for each domain of the questionnaires. Results Between December 2011 and July 2015, 336 patients were included (89.9% female). LupusQoL and SLEQOL items related to physical HRQoL (physical health, physical functioning, pain) were most affected by musculoskeletal and cutaneous flares. Cutaneous flares had significant influence on self-image. Neurological or psychiatric flares had a more severe impact on specific HRQoL. Patient HRQoL was impacted up to 18 months after a flare. Conclusion Item response theory analysis is able to pinpoint items that are influenced by a given patient group in terms of a latent trait change. Item-level analysis provides a new way of interpreting HRQoL variation in SLE patients, permitting a better understanding of DA impact on HRQoL. This kind of analysis could be easily implemented for the comparison of groups in a clinical trial. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov, NCT01904812.

Published
2019

4. Absence of Anti-Glomerular Basement Membrane Antibodies in 200 Patients With Systemic Lupus Erythematosus With or Without Lupus Nephritis: Results of the GOODLUPUS Study

Author

Bernard Bonnotte, P. Orquevaux, Bach Nga Pham, Zahir Amoura, S. Revuz, Delphine Giusti, Laurent Arnaud, Moustapha Dramé, Gilles Blaison, Marcelle Tonye Libyh, Thierry Martin, Hanns-Martin Lorenz, Nadine Magy-Bertrand, Grace Stockton-Bliard, Reinhard E. Voll, Amélie Servettaz, Grégory Gatouillat, Jan Chrusciel, Nellie Bourse Chalvon, Jean-Loup Pennaforte, Andreas Schwarting, Thierry Tabary, Oliver Hinschberger, Centre Hospitalier Universitaire de Reims (CHU Reims), Immuno-Régulation dans les Maladies Auto-Immunes Inflammatoires et le Cancer - EA 7509 (IRMAIC), and Université de Reims Champagne-Ardenne (URCA)

Subjects
Male, Anti-Glomerular Basement Membrane Disease, [SDV]Life Sciences [q-bio], Lupus nephritis, Aucun, urologic and male genital diseases, Severity of Illness Index, Gastroenterology, anti-glomerular basement membrane antibodies, 0302 clinical medicine, systemic lupus erythematosus, Lupus Erythematosus, Systemic, Immunology and Allergy, 030212 general & internal medicine, Original Research, medicine.diagnostic_test, biology, anti-GBM glomerulonephritis, Glomerular basement membrane, IIf, Middle Aged, 3. Good health, Titer, medicine.anatomical_structure, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Antibody, Vasculitis, Adult, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, Immunology, 03 medical and health sciences, Antigen, Internal medicine, anti-GBM antibodies, medicine, Humans, Autoantibodies, Retrospective Studies, 030203 arthritis & rheumatology, lupus nephritis, business.industry, Goodpasture disease, medicine.disease, Case-Control Studies, Immunoassay, biology.protein, business, lcsh:RC581-607, Biomarkers
Abstract

IntroductionAnti-glomerular basement membrane (GBM) antibodies are pathogenic antibodies first detected in renal-limited anti-GBM disease and in Goodpasture disease, the latter characterized by rapidly progressive crescentic glomerulonephritis combined with intra-alveolar hemorrhage. Studies have suggested that anti-GBM antibody positivity may be of interest in lupus nephritis (LN). Moreover, severe anti-GBM vasculitis cases in patients with systemic lupus erythematosus (SLE) have been described in the literature, but few studies have assessed the incidence of anti-GBM antibodies in SLE patients.ObjectiveThe main study objective was to determine if positive anti-GBM antibodies were present in the serum of SLE patients with or withoutproliferativerenal damage and compared to a healthy control group.MethodologyThis retrospective study was performed on SLE patients’ sera from a Franco-German European biobank, developed between 2011 and 2014, from 17 hospital centers in the Haut-Rhin region. Patients were selected according to their renal involvement, and matched by age and gender. The serum from healthy voluntary blood donors was also tested. Anti-GBM were screened by fluorescence enzyme immunoassay (FEIA), and then by indirect immunofluorescence (IIF) in case of low reactivity detection (titer >6 U/ml).ResultsThe cohort was composed of 100 SLE patients withproliferativeLN (27% with class III, 67% with class IV, and 6% with class V), compared to 100 SLE patients without LN and 100 controls. Patients were mostly Caucasian and met the ACR 1997 criteria and/or the SLICC 2012 criteria. Among the 300 tested sera, no significant levels of anti-GBM antibodies were detected (>10 U/ml) by the automated technique, three sera were found “ambivalent” (>7 U/ml): one in the SLE with LN group and two in the SLE without LN group. Subsequent IIF assays did not detect anti-GBM antibodies.ConclusionAnti-GBM antibodies were not detected in the serum of Caucasian patients with SLE, even in case of renal involvement, a situation favoring the antigenic exposure of glomerular basement membranes. Our results reaffirm the central role of anti-GBM antibodies as a specific diagnostic biomarker for Goodpasture vasculitis and therefore confirm that anti-GBM antibody must not be carried out in patients with SLE (with or without LN) in the absence of disease-suggestive symptoms.

Published
2020

5. In VitroFertilization in 37 Women with Systemic Lupus Erythematosus or Antiphospholipid Syndrome: A Series of 97 Procedures

Author

Agathe Masseau, P. Orquevaux, Véronique Le Guern, Jean-Charles Piette, D. Vauthier, Jean-Loup Pennaforte, Gaëlle Guettrot-Imbert, Du Le Thi Huong, Patrice Cacoub, Nathalie Morel, Nathalie Costedoat-Chalumeau, Bertrand Wechsler, and Vanessa Gayet

Subjects
030203 arthritis & rheumatology, Infertility, medicine.medical_specialty, Pregnancy, 030219 obstetrics & reproductive medicine, Systemic lupus erythematosus, Obstetrics, business.industry, Immunology, Ovarian hyperstimulation syndrome, Hydroxychloroquine, Premature ovarian insufficiency, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Antiphospholipid syndrome, medicine, Immunology and Allergy, Polyarthritis, skin and connective tissue diseases, business, medicine.drug
Abstract

Objective.To compile and assess data about complication and success rates forin vitrofertilization (IVF) of women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). To date, such data are sparse.Methods.This retrospective study described women with SLE and/or APS who have had at least 1 IVF cycle.Results.Thirty-seven women with SLE (n = 23, including 8 with antiphospholipid antibodies), SLE with APS (n = 4), or primary APS (n = 10) underwent 97 IVF procedures. For 43% of cases, the infertility was female in origin, for 19% male, 14% mixed, and 24% unexplained. No women had premature ovarian insufficiency because of cyclophosphamide. Median age at IVF was 34 years (range 26–46). The median number of IVF cycles was 2.6 (1–8). Patients were treated with hydroxychloroquine (72%), steroids (70%), azathioprine (3%), aspirin (92%), and/or low molecular weight heparin (62%). There were 27 (28%) pregnancies, 23 live births among 26 neonates (3 twin pregnancies), 2 miscarriages, and 2 terminations for trisomy 13 and 21. Six spontaneous pregnancies occurred during the followup. Finally, 26 women (70%) delivered at least 1 healthy child. Complications occurred in or after 8 IVF cycles (8%): SLE flares in 4 (polyarthritis in 3 and lupus enteritis in 1) and thromboembolic events in 4 others. One SLE flare was the first sign of previously undiagnosed SLE. Poor treatment adherence was obvious in 2 other flares and 2 thromboses. No ovarian hyperstimulation syndrome was reported.Conclusion.These preliminary results confirm that IVF can be safely and successfully performed in women with SLE and/or APS.

Published
2017

6. Association of antiphospholipid antibodies with active digital ulceration in systemic sclerosis

Author

Jean-Christophe Weber, Vincent Poindron, Jean-Loup Pennaforte, Gilles Blaison, Denis Wahl, C. Martinez, Nadine Magy-Bertrand, Philip Bielefeld, Pierre Kieffer, Bernard Bonnotte, Hervé Devilliers, Sabine Berthier, Thierry Martin, Laurent Arnaud, Mickael Martin, François Maurier, Médecine interne [ Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Médecine interne [Hôpitaux civils de Colmar], Hôpitaux Civils de Colmar, Service de rhumatologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Centre National de Référence pour les Maladies Auto-immunes Rares [CHU Strasbourg] (RESO), CHU Strasbourg, Médecine interne [CHU Strasbourg], Département de Médecine Interne et Immunologie Clinique (DMIIC - STRASBOURG), Médecine interne [CH Emile Muller, Mulhouse], Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA)-Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Service de médecine interne et immunologie clinique (SOC 1) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Interne et Vasculaire [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre régional de compétence des Maladies systémiques et auto-immunes rares de l'adulte et Maladies vasculaires rares, Faculté de Médecine [Nancy], Université de Lorraine (UL), Service de Médecine Interne [CHR Metz-Thionville], Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Service de Rhumatologie [Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Service de médecine interne (Med Int - BESANCON), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and WEBER, JEAN-CHRISTOPHE

Subjects
Male, Raynaud’s phenomenon, 0302 clinical medicine, Risk Factors, Informed consent, Immunology and Allergy, Medicine, 030212 general & internal medicine, skin and connective tissue diseases, ComputingMilieux_MISCELLANEOUS, Gangrene, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, integumentary system, biology, antiphospholipid antibodies, Interstitial lung disease, Middle Aged, Pathophysiology, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antibodies, Antiphospholipid, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Disease Susceptibility, Antibody, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Immunology, digital ulcer, Systemic Sclerosis, Fingers, 03 medical and health sciences, Rheumatology, Antiphospholipid syndrome, Internal medicine, Skin Ulcer, Humans, Aged, Autoantibodies, 030203 arthritis & rheumatology, Autoimmune disease, Scleroderma, Systemic, business.industry, medicine.disease, Cross-Sectional Studies, biology.protein, business, antiphospholipid syndrome, Biomarkers
Abstract

Key messages #### What is already known about this subject? #### What does this study add? #### How might this impact on clinical practice? Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) can be severe with active digital ulceration (ADU) and gangrene. RP physiopathology includes early endothelial cell injury, vascular dysfunction and sometimes microvascular thrombosis.1 Antiphospholipid antibodies (aPL) activate endothelial cells and platelets by complexes of beta-2 glycoprotein 1 (β2GP1) and anti-β2GP12 and could therefore contribute to the initiation of and/or aggravate SSc-related RP. aPL prevalence seems increased in patients with SSc compared with controls,3 but aPL-associated clinical features are often contradictory. The aims of this study were to assess aPL and antiphospholipid syndrome (APS) prevalence in patients with SSc and their association with ADU. Consecutive patients aged more than 18 years, fulfilling the American College of Rheumatology/EULAR classification criteria for SSc4 and followed in seven French expert centres for autoimmune diseases labelled by the French national network for autoimmune disease care, were enrolled prospectively during 8 months. Patients with other associated autoimmune disease were excluded. All patients provided written informed consent. SSc subtype was classified based on LeRoy and Medsger’s criteria,5 and skin involvement was assessed according to the modified Rodnan skin score (mRSS).6 Interstitial lung disease …

Published
2019

7. Characteristics and clinical outcomes after treatment of a national cohort of PCR-positive Lyme arthritis

Author

Marc Scherlinger, Didier Eyer, Aleth Perdriger, Amandine Blasquez, Frédéric Bastides, Laurence Zilliox, François Guérin, Jean-Marie Woehl, Antoine Grillon, Yves Maugars, Pierre-Hugues Boyer, Alain Cantagrel, Antoine Colombey, Paul Moreau, Jean Sibilia, François Cuchet, Anne-Sophie Korganow, Christian Bonnard, Julien Wipff, Joel Lechevallier, Isabelle Imbert, Irène Monteiro, Jean-Loup Pennaforte, Laurent Arnaud, Philippe Gicquel, Michel Brax, Benoît Jaulhac, Sylvie De Martino, Cathy Barthel, Virulence bactérienne précoce : fonctions cellulaires et contrôle de l'infection aiguë et subaiguë, Université de Strasbourg (UNISTRA), Virulence Bactérienne Précoce : fonctions cellulaires et contrôle de l'infection aigüe et subaigüe, Immuno-Rhumatologie Moléculaire, and Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Arthritis, Lyme Arthritis, Polymerase Chain Reaction, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Rheumatology, Internal medicine, Borrelia, Synovitis, Synovial Fluid, Medicine, Synovial fluid, Humans, 030212 general & internal medicine, Child, Aged, 030203 arthritis & rheumatology, Doxycycline, Lyme Disease, biology, business.industry, Amoxicillin, Middle Aged, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Sciences du Vivant [q-bio]/Microbiologie et Parasitologie, 3. Good health, Anti-Bacterial Agents, Anesthesiology and Pain Medicine, Treatment Outcome, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Polyarthritis, Female, France, business, medicine.drug
Abstract

To describe the clinical and microbiological characteristics and outcomes after antibiotic treatment of a national cohort of patients with Lyme arthritis confirmed by PCR testing on synovial fluid and by serology, when available. Objectives To describe the clinical and microbiological characteristics and outcomes after antibiotic treatment of a national cohort of patients with Lyme arthritis confirmed by PCR testing on synovial fluid and by serology, when available. Methods Using the French National Reference Center for Borrelia database, patients with a positive PCR on synovial fluid for Borrelia were identified. Patient clinical and biological characteristics were reviewed from patient records. Long-term outcomes after treatment were studied through a questionnaire and with follow-up data. Results Among 357 synovial fluid testing by PCR between 2010 and 2016, 37 (10.4%) were positive for Borrelia. Patients’ median age was 36 years (range 6–78) with 61% of men and 28% patients under 18. The presentation was monoarticular in 92% and the knee was involved in 97%. Contrary to the Borrelia species repartition in European ticks, B. burgdorferi sensu stricto was the most prevalent species found in synovial fluid (54%) followed by B. azfelii (29%) and B. garinii (17%). Antibiotic treatments were mainly composed of doxycycline (n = 24), ceftriaxone (n = 10) and amoxicillin (n = 6), for a median duration of 4 weeks (range 3–12). Despite a properly conducted treatment, 34% of patients (n = 12) developed persistent synovitis for at least 2 months (median duration 3 months, range 2–16). Among those, 3 developed systemic inflammatory oligo- or polyarthritis in previously unaffected joints with no signs of persistent infection (repeated PCR testing negative), which mandated Disease-Modifying Antirheumatic Drugs (DMARD) introduction, leading to remission. Conclusion In France and contrary to ticks ecology, Lyme arthritis is mainly caused by B. burgdorferi sensu stricto. Despite proper antibiotic therapy, roughly one third of patients may present persistent inflammatory synovitis and a small proportion may develop systemic arthritis. In such cases, complete remission can be reached using DMARD. journal article 2019 06 2018 09 28 imported

Published
2019

8. Description of 214 cases of autoimmune congenital heart block: Results of the French neonatal lupus syndrome

Author

Kateri Levesque, Nathalie Morel, Alice Maltret, Gabriel Baron, Agathe Masseau, Pauline Orquevaux, Jean-Charles Piette, Francois Barriere, Jérome Le Bidois, Laurent Fermont, Olivier Fain, Arnaud Theulin, Francois Sassolas, Philippe Pezard, Zahir Amoura, Gaëlle Guettrot-Imbert, Delphine Le Mercier, Sophie Georgin-Lavialle, Christophe Deligny, Eric Hachulla, Luc Mouthon, Philippe Ravaud, Elisabeth Villain, Damien Bonnet, Nathalie Costedoat-Chalumeau, Holy Bezanahary, Boris Bienvenu, Gilles Blaison, Philippe Blanche, Bernard Bonnotte, Pascal Cathebras, Christine Christides, Fleur Cohen, Laurence Cohen, Edouard Devaud, Elisabeth Diot, Pierre Duhaut, Yves Dulac, Bertrand Godeau, Véronique Gournay, Céline Gronier, Loïc Guillevin, Mohamed Hamidou, Julien Haroche, Gilles Hayem, François Heitz, Richard Isnard, Moez Jallouli, Anne-Sophie Korganow, Claire Le Jeunne, François Lhote, Hugues Lucron, Jean-René Lusson, Suzel Magnier, Jacques Ninet, Nicolas Pangaud, Thomas Papo, Jean-Luc Pellegrin, Jean Loup Pennaforte, Jacques Pouchot, Françoise Sarrot-Reynauld, Nicolas Schleinitz, Pascal Seve, Bertrand Stos, Denis Vital-Durand, and Bertrand Wechsler

Subjects
Pacemaker, Artificial, medicine.medical_specialty, Pediatrics, Fetus, Pregnancy, Multivariate analysis, Heart block, business.industry, Immunology, Retrospective cohort study, Dilated cardiomyopathy, medicine.disease, Prosthesis Implantation, Heart Block, Treatment Outcome, In utero, Internal medicine, medicine, Cardiology, Humans, Lupus Erythematosus, Systemic, Immunology and Allergy, Gestation, business
Abstract

Cardiac neonatal lupus syndrome is due to anti-SSA or SSB antibodies and mainly includes congenital heart block (CHB) and dilated cardiomyopathy (DCM). Its optimal management is still debated. We report a large series of autoimmune high degree CHB.Inclusion criteria in this retrospective study were fetuses or neonates with high-degree CHB associated with maternal anti-SSA/SSB antibodies.214 CHB were included: 202 detected in utero at a median term of 23 weeks' gestation (WG) [range 16 to 39 WG] and 12 neonatal cases diagnosed at a median age of 0 days [range birth to 8 days]. The 214 cases of CHB included 202 (94.4%) third-degree CHB, 8 (3.7%) second-degree CHB, and 4 (1.9%) intermittent CHB. In multivariate analysis, the factors associated with feto-neonatal deaths (15.7%) were hydrops (p0.001; hazard ratio [HR] 12.4 [95% confidence interval (95%CI) 4.7-32.7]) and prematurity (p=0.002; HR 17.1 [95%CI 2.8-103.1]). During a median follow-up of 7 years [birth to 36 years], 148 of 187 children born alive (79.1%) had a pacemaker, 35 (18.8%, one missing data) had DCM, and 22 (11.8%) died. In multivariate analysis, factors associated with child death were in utero DCM (p=0.0157; HR 6.37 [95%CI: 1.25-32.44]), postnatal DCM (p0.0001; HR 227.58[95%CI: 24.33-2128.46]) and pacemaker implantation (p=0.0035; HR 0.11[95%CI: 0.02-0.51]). The use of fluorinated steroids was neither associated with survival nor with regression of 2nd degree CHB.In this second largest series of CHB, we confirm some of the previous results. We were unable to find data supporting the routine use of in utero fluorinated steroids.

Published
2015

9. Predictors of fatigue and severe fatigue in a large international cohort of patients with systemic lupus erythematosus and a systematic review of the literature

Author

Rheinardt Voll, Hannes M. Lorenz, Gilles Blaison, Pierre Kieffer, Bernard Bonnotte, Laurent Arnaud, Zahir Amoura, Vincent Poindron, Jean-Loup Pennaforte, Jean Sibilia, Thierry Martin, Pierre Edouard Gavand, Nadine Magy-Bertrand, Hans-Harmut Peter, François Maurier, Andreas Schwarting, and Christoph Fiehn

Subjects
Adult, Male, medicine.medical_specialty, Anxiety, Logistic regression, Severity of Illness Index, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Rheumatology, Interquartile range, Risk Factors, Internal medicine, medicine, Humans, Lupus Erythematosus, Systemic, Pharmacology (medical), 030212 general & internal medicine, Depression (differential diagnoses), Fatigue, Aged, 030203 arthritis & rheumatology, Systemic lupus erythematosus, Lupus erythematosus, business.industry, Depression, Odds ratio, Middle Aged, medicine.disease, Cohort, Quality of Life, Female, medicine.symptom, business
Abstract

OBJECTIVE Fatigue is reported in up to 90% of patients with SLE. This study was conducted to identify the determinants associated with fatigue in a large cohort of patients with SLE, as well as to provide a systematic review of the literature. METHODS Patients from the Lupus BioBank of the upper Rhein, a large German-French cohort of SLE patients, were included in the FATILUP study if they fulfilled the 1997 ACR criteria for SLE and had Fatigue Scale for Motor and Cognitive Functions scores collected. Multivariate logistic regression analyses were performed to assess the determinants of fatigue and severe fatigue. RESULTS A total of 570 patients were included (89.1% female). The median age was 42 years (interquartile range 25-75: 34-52). The median value of the SAfety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI was 2 (0-4). Fatigue was reported by 386 patients (67.7%) and severe fatigue by 209 (36.7%). In multivariate analyses, fatigue was associated with depression [odds ratio (OR): 4.72 (95% CI: 1.39-16.05), P = 0.01], anxiety [OR: 4.49 (95% CI: 2.60-7.77), P < 0.0001], glucocorticoid treatment [OR: 1.59 (95% CI 1.05-2.41), P = 0.04], SELENA-SLEDAI scores [OR: 1.05 (95% CI: 1.00-1.12) per 1 point increase, P = 0.043] and age at sampling [OR: 1.01 (95% CI: 1.00-1.03) per 1 year increase, P = 0.03]. Severe fatigue was independently associated with anxiety (P < 0.0001), depression (P < 0.0001), glucocorticoid treatment (P = 0.047) and age at sampling (P = 0.03). CONCLUSION Both fatigue and severe fatigue are common symptoms in SLE, and are strongly associated with depression and anxiety. Disease activity and the use of glucocorticoids were also independently associated with fatigue, although more weakly.

Published
2018

10. AB0593 Predictors of fatigue and severe fatigue in a large multicenter international cohort of patients with systemic lupus erythematosus: the fatilup study

Author

J. Sibilia, Reinhard E. Voll, Z. Amoura, Gilles Blaison, A. Schwartzing, Christoph Fiehn, François Maurier, Thierry Martin, P.E. Gavand, N. Magy Bertrand, Laurent Arnaud, H.-M. Lorenz, Pierre Kieffer, B. Bonnote, Vincent Poindron, and Jean-Loup Pennaforte

Subjects
030203 arthritis & rheumatology, 0301 basic medicine, medicine.medical_specialty, Univariate analysis, Multivariate analysis, Systemic lupus erythematosus, business.industry, medicine.disease, Hospital Anxiety and Depression Scale, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Quality of life, Internal medicine, Cohort, medicine, Anxiety, medicine.symptom, skin and connective tissue diseases, business, Depression (differential diagnoses)
Abstract

Background Fatigue is an important issue in systemic lupus and has a major impact on quality of life of the patients. Data are controversial about the factors associated with this complex symptom.1 Objectives To identify the factors associated with fatigue and severe fatigue in patients with systemic lupus erythematosus (SLE) in a large cohort using a multivariate model to precise the importance of each parameter in this multidimensional symptom. Methods We used the LBBR data base, a German French data base of SLE patients. All patients fulfilled the 1997 ACR criteria for SLE. The Fatigue Scale for Motor and Cognitive Functions (FSMC) was used to assess fatigue and severe fatigue. The depression and anxiety were measured with Hospital Anxiety and Depression Scale (HADS). Tests were performed at sampling. Results A total of 570 patients were included (89.1% female). The median age was 42 years (QR25–75: 34–52). The median value of the SELENA-SLEDAI was 2 (QR25–75: 0–4) and 136 patients had a SELENA-SLEDAI score >6. Fatigue was reported by 386 patients (67.7%) including severe fatigue by 209 (36.7%). In univariate analysis among the individual components of the SLEDAI arthritis (p=0.003) and oral ulcers (p=0.002) were associated with severe fatigue. In multivariate analysis fatigue was strongly associated with anxiety (OR: 4.49 [95%CI: 2.60–7.77], p Severe fatigue was strongly associated with depression (OR:6.87 [95%CI: 3.12–15.11], p Conclusions Fatigue is a common symptom in SLE patients and is strongly associated with anxiety and depression. While remission remains an important therapeutic target, these manifestations should also be taken care of with psychological counselling and pharmacological intervention, when needed. Reference [1] Cleanthous S, Tyagi M, Isenberg DA, Newman SP. What do we know about self-reported fatigue in systemic lupus erythematosus?Lupus. 2012Apr;21(5):465–76 Disclosure of Interest None declared

Published
2018

11. Iron deficiency and pernicious anemia: a rare association?

Author

Abrar-Ahmad Zulfiqar, Jean-Luc Novella, Moustapha Dramé, Emmanuel Andrès, Thomas Vogel, and Jean-Loup Pennaforte

Subjects
Adult, Male, medicine.medical_specialty, Anemia, Achlorhydria, Gastroenterology, Internal medicine, Anemia, Pernicious, Prevalence, medicine, Humans, Vitamin B12, Mean corpuscular volume, Aged, Retrospective Studies, pernicious anemia, Aged, 80 and over, Anemia, Iron-Deficiency, biology, medicine.diagnostic_test, business.industry, Microcytosis, General Medicine, Iron deficiency, Middle Aged, medicine.disease, Ferritin, biology.protein, Female, business
Abstract

The aim of this study was to determine the prevalence of iron deficiency among patients with pernicious anemia. We realized a retrospective study from 2000 to 2010 including 55 patients suffering from pernicious anemia who were followed in Reims and Strasbourg university hospitals. Inclusion criteria were histological diagnosis of immune atrophic fundic gastritis and criteria of gastric autoimmuninty, and for which ferritin was measured. Iron deficiency is defined as serum ferritin level

Published
2015

12. Dépistage et prise en charge du risque cardiovasculaire au cours du lupus systémique : élaboration de recommandations pour la pratique clinique, à partir d’une analyse de la littérature et de l’avis d’experts

Author

Philippe Remy, V. Baudouin, M. Chauchard, T. Papo, A. Ghali, Laurent Arnaud, A.S. Korganow, P. Gobert, O. Meyer, A. Viau Brabant, P. Marianetti-Guingel, Viviane Queyrel, N. Martin Silva, Aurélie Hummel, T. Kwon, N. Magy-Bertrand, A. Le Quellec, Noémie Jourde-Chiche, Jean-Loup Pennaforte, V. Le Guern, Thierry Martin, Bernard Bonnotte, Sandrine Morell-Dubois, Jean-François Viallard, M. Hamidou, Nicolas Limal, Makoto Miyara, E. Hachulla, Eric Daugas, A. Chaib, Cristina Belizna, F. Boumedine, Zahir Amoura, Julien Haroche, Denis Wahl, I. Raymond, Brigitte Bader-Meunier, J. Sibilia, Karim Sacre, Guillaume Gondran, E. Bruckert, Laurent Chiche, Jeannot Schmidt, K. Polomat, Baptiste Hervier, Jacques Ninet, Daniel Adoue, Jacques Pourrat, Alexis Mathian, and Gaëlle Guettrot-Imbert

Subjects
Gynecology, medicine.medical_specialty, business.industry, Cardiovascular risk factors, Gastroenterology, Internal Medicine, medicine, business
Abstract

Resume Propos L’objectif de ce travail etait de proposer des recommandations relatives aux modalites de depistage et de prise en charge des facteurs de risque cardiovasculaire au cours du lupus systemique. Methodes Trente-neuf experts internistes, rhumatologues ou nephrologues francais, membres du reseau des centres de reference et de competence du lupus systemique ont pris part a un vote visant a retenir ou non des recommandations preparees par un groupe de travail a partir d’une revue de la litterature. Resultats Les experts ont souligne que les facteurs de risque cardiovasculaires modifiables doivent etre recherches au moins annuellement au cours du lupus systemique. La prescription d’une statine en prevention primaire depend du taux de LDL-cholesterol et du nombre de facteurs de risque cardiovasculaires, en considerant le lupus systemique comme un facteur de risque cardiovasculaire supplementaire. En prevention secondaire, les experts s’accordent a proposer une cible de LDL-cholesterol Conclusions Ces recommandations vont permettre d’ameliorer et d’homogeneiser la pratique des differents medecins francais impliques dans la prise en charge du lupus systemique. L’actualisation de ces recommandations pourra etre ulterieurement envisagee, en fonction des nouvelles donnees publiees.

Published
2015

13. Late-onset lupus in the elderly after 65 years: retrospective study of 18 cases

Author

Tommy Courtel, Jean-Luc Novella, Abrar-Ahmad Zulfiqar, and Jean-Loup Pennaforte

Subjects
Adult, Male, Aging, medicine.medical_specialty, Adolescent, Late onset, Young Adult, Adrenal Cortex Hormones, medicine, Humans, Lupus Erythematosus, Systemic, Age of Onset, Child, Biological Psychiatry, Aged, Retrospective Studies, Aged, 80 and over, Gynecology, Systemic lupus erythematosus, business.industry, Middle Aged, Prognosis, medicine.disease, Neuropsychology and Physiological Psychology, Child, Preschool, Female, France, Neurology (clinical), Geriatrics and Gerontology, business
Abstract

Le lupus erythemateux systemique (LES) du sujet âge est rare apres 65 ans et reste peu etudie. L’objectif de cette etude etait d’etudier les particularites du LES survenant apres 65 ans par rapport aux sujets jeunes. Methode : Les patients avec un LES debute apres 65 ans ont ete recherches dans 4 centres hospitaliers francais entre 1985 et 2013. Ont ete inclus les cas presentant 4 criteres de l’American college of rheumatology ou plus. Les caracteristiques clinico-biologiques, pronostiques, les traitements et les comorbidites ont ete decrits retrospectivement et compares a la cohorte de 1 000 patients lupiques publiee par Cervera et al. de 1993. Resultats : 18 patients ont ete inclus (14 femmes et 4 hommes) dont 6 reveles apres 75 ans. L’âge moyen etait de 73,0 ± 4,6 ans. Les manifestations revelatrices les plus frequentes etaient les atteintes articulaires (13/18), cutanees (9/18), sereuses (4/18). L’anemie hemolytique et les thromboses etaient plus frequemment revelatrices que chez le sujet jeune (p < 0,05). Au cours de l’evolution, seules les atteintes cutanees (sauf le lupus discoide) etaient moins frequentes que chez les sujets jeunes (p < 0,05). Les atteintes renales, pulmonaires et neurologiques etaient rares apres 75 ans. La corticotherapie, souvent utilisee (16/18), entrainait frequemment des complications (10/16). La survenue d’hemopathie maligne (3 cas) etait plus frequente en cas de LES revele par une thrombopenie ou une anemie hemolytique (p < 0,05). Conclusion : Le lupus du sujet âge est rare mais doit etre evoque dans un contexte clinique evocateur. Son diagnostic et son traitement sont difficiles du fait des complications iatrogenes et de l’intrication avec les comorbidites.

Published
2015

14. Fécondation in vitro au cours du lupus érythémateux systémique ou du syndrome des antiphospholipides : mise au point

Author

D. Vauthier, V. Le Guern, Jean-Loup Pennaforte, J.C. Piette, P. Orquevaux, N. Costedoat-Chalumeau, Gaëlle Guettrot-Imbert, Agathe Masseau, Nathalie Morel, B. Wechsler, D. Boutin, and V. Gayet

Subjects
Gynecology, education.field_of_study, medicine.medical_specialty, In vitro fertilisation, Lupus Flare, business.industry, media_common.quotation_subject, medicine.medical_treatment, Population, Gastroenterology, Ovarian hyperstimulation syndrome, Fertility, medicine.disease, Thrombosis, Induction ovulation, immune system diseases, Antiphospholipid syndrome, Internal Medicine, Medicine, skin and connective tissue diseases, business, education, media_common
Abstract

Fertility is not impaired in systemic lupus erythematosus or antiphospholipid syndrome, but, similarly to the general population, these patients may undergo in vitro fertilization. This type of treatment increases the risk of lupus flare, thrombosis, and ovarian hyperstimulation syndrome. This review will focus on in vitro fertilization in systemic lupus erythematosus or antiphospholipid syndrome. Literature data are relatively scant with only 3 reported studies. The first one included 17 patients and 63 cycles of induction ovulation/in vitro fertilization leading to 25 % of lupus flare, no thrombosis, and 3 % of ovarian hyperstimulation syndrome. The second study included 10 patients and 40 cycles of in vitro fertilization showing 31 % of lupus flare, no thrombosis and no ovarian hyperstimulation syndrome. The last one included 34 patients and 83 procedures of in vitro fertilization leading to 8 % of flares, 5 % of thrombosis and no ovarian hyperstimulation syndrome. Interestingly, in this last study, half of the complications were explained by poor adherence to treatment. These data are reassuring but it is important to remember that in vitro fertilization should be scheduled and carefully supervised in the same way as the high-risk pregnancies occurring in these patients.

Published
2015

15. Responsiveness of the 36-item Short Form Health Survey and the Lupus Quality of Life questionnaire in SLE

Author

Francis Guillemin, Claire Bonithon-Kopp, François Maurier, Laurent Arnaud, Pierre Kaminsky, Bernard Bonnotte, Jean-Louis Pasquali, Jean-François Besancenot, Hervé Devilliers, Zahir Amoura, Denis Wahl, Jean-Loup Pennaforte, Nadine Magy-Bertrand, and Christine Binquet

Subjects
Adult, Male, medicine.medical_specialty, Psychometrics, Visual Analog Scale, SF-36, Visual analogue scale, Health Status, Cohort Studies, Cost of Illness, Rheumatology, Quality of life, Surveys and Questionnaires, Body Image, medicine, Humans, Lupus Erythematosus, Systemic, Pharmacology (medical), Prospective Studies, skin and connective tissue diseases, Prospective cohort study, business.industry, Repeated measures design, Middle Aged, Health Surveys, Cohort, Disease Progression, Quality of Life, Physical therapy, Female, France, Self Report, business, Cohort study
Abstract

OBJECTIVES This study aimed to estimate the responsiveness to change of a generic [the 36-item Short Form Health Survey (SF-36)] and a specific health-related quality of life questionnaire [the Lupus Quality if Life questionnaire (LupusQoL)] according to SLE patients' self-reported changes in health status. METHODS In a cohort of 185 SLE patients, quality of life (QoL) was measured three times at 3 month intervals by the LupusQoL and SF-36 questionnaires. Anchors for responsiveness were defined by patients' global assessment of disease impact according to changes in a visual analogue scale (VAS), a 7-point Likert scale and a 0-3 scale of five patient-reported symptoms. Mean change and s.d. in worsening and improving patients according to anchors were estimated using mixed models for repeated measures. Standardized response means (SRMs) were calculated in each group. RESULTS Patients [mean age 39.6 years (s.d. 10.5), mean Safety of Estrogen in Lupus Erythematosus National Assessment-SLEDAI score 2.6 (s.d. 3.5)] answered a total of 515 questionnaires. For the VAS and Likert global anchors, worsening patients showed a significant decrease in all LupusQoL domains except for burden to others, body image and fatigue and all SF-36 domains with low to moderate responsiveness. Improving patients had a significant increase in all LupusQoL domains except for intimate relationship and all SF-36 domains except for physical functioning and global health with low to moderate responsiveness. Regarding similar domains in the SF-36 and LupusQoL, SRMs were higher in LupusQoL domains in improving patients, while SF-36 domains had larger SRMs in worsening patients. CONCLUSION Both the SF-36 and LupusQoL were responsive to changes in QoL in SLE patients over a 3 month interval. LupusQoL seems to be more appropriate to measure improvements in QoL.

Published
2014

16. Failure of tocilizumab therapy in a patient with mouth and genital ulcers with inflamed cartilage syndrome complicated by aortic aneurysm: Table 1

Author

Jean-Paul Eschard, Christian Penalba, Stéphanie Mestrallet, William Terreaux, Jean-Hugues Salmon, Marion Fauconier, and Jean-Loup Pennaforte

Subjects
medicine.medical_specialty, business.industry, Cartilage, medicine.disease, Mouth and genital ulcers with inflamed cartilage syndrome, Tocilizumab therapy, Surgery, Aortic aneurysm, chemistry.chemical_compound, Tocilizumab, medicine.anatomical_structure, Rheumatology, chemistry, medicine, Pharmacology (medical), business
Published
2015

17. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

Author

Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. Berger, Jean-Daniel Lelièvre, Dominique Perotin, Abdelkader Bemrah, Alain Lozniewski, Bernard Borstein, Hanna Eid, Diana Suatean, Virginie Mignaut, Jean-Claude N'guyen, Valérie Le Goff, Laurent Teillet, Christophe Rolland, Gwenaël Alfonsi, Florence Lachenal, Philippe Bossi, Yves Botreau, Florence Doucet Populaire, Henry Jardel, Nicolas Gallo, Elias Jabre-Sikias, Michel Dupon, Hélène Brihier, Isabelle Patry, Alexandre Leclercq, Bernadette Tourrand, Christophe Roussel, Jean-Emmanuel Kurtz, Bénédicte Paindaveine, Simon Elhadad, Richard Sanchez, Eric Sgro, Pierre Berger, Valérie Murbach, Anne Holstein, Florence Martin, Taoufik Merabet, Amélie Benbara, Milagros Ferreyra, Laure Esposito, Pierre Delobel, Antoine Andremont, Marc Bourlière, Carole-Anne Boudy, Jean-Baptiste Gaulthier, Laurent Tacchini, Olivier Marpeau, Sonia Tesseydre, Marie-Pierre Coulhon, Nathalie Hodee, Marie-Chrsitine Conroy, Pierre Weinbreck, Roland Leclercq, Laurent Souply, Christian Bidault, Annie Elbez, Marie-Annick Lebreton, Patrick Brisou, Agnès Ferroni, Jean-Louis Pourriat, Nadia Anguel, Christian Noel, Philippe Jouvencel, Eric Pichard, Xavier Martin, Mathieu Coste, Pierre Zuber, Catherine Neuwirth, Jean-Pierre Hacot, Paul Aye, Jérôme Guinard, Yves Pean, Jean-Christophe Dengo, Fabrice Petassou, Didier Viole, Thierry Messiaen, Jean Beytout, Philippe Petitjean, Ferdinand Savare, Patrice Cuvillier, Sophie Coignard, Hélène Anglaret, Nassim Kamar, Elisabeth Chachaty, Karine Guimard, Louis Braem, Hacene Fezoui, Pierre Martin, Jean-Paul Viard, Claire Larroche, Nicolai Claudiu-Plesa, Thierry Benoit-Cattin, Olivier Moquet, Thierry Pasdeloup, David Rosay, Rodolphe Jean, Jean-Bernard Mariette, Marc Debouverie, Hervé Peltier, Mustapha Terki, Jacques Daleas, Valérie Dattin-Dorrière, Michel Vergnaud, Emmanuel Grimprel, Sylvène Rosselli, Jean-Marc Didier, Pierre Faurie, Luc Frimat, Aziza Mandjee, Sabine Etchemendy, Pierre Tissières, Jean Nakhleh, Sylvie Mariette, Christian Perronne, Bruno Carbonne, Nathalie Houssiaux-Maisonneuve, Tristan Ferry, S Beague, Anthony Sebban, Marie-Thérèse Hili, Jean-Michel De Kermadec, Lucien Brasme, Gilles Blaison, Caroline Garandeau, Jean-Pierre Sollet, Laurent Tronchon, Thierry Samson, Julien Gesquière, Nicolas Ettahar, Alain Créange, Etienne Laurens, Véronique Equy, Fréderic Bart, Bernard Bouffandeau, Christine Vaillant, Valerie Pesque, Jean-Marc Lalot, Marc Levy, Michel Kaidomar, Mihaela Saplacan, Sterenn Yvenou, Marie-Isabelle Steibach, Emmanuelle Cambau, Agnès Riche, François Fourrier, François Raffi, Mélissa Lalu, Henri Bérard, Danielle Clave, Jean-Claude Mouries, Martine Porcheron, Jean Cabalion, Richard Lamarca, Nathalie Canu, Jean-Baptiste Roseau, Annabelle Stoclin, Luca Luminitan Elena Lupean, Rémi Gebeile, Celia Salanoubat, Carole Marmouset, Pierre Bigot, Anne-Laure Breton, Pierre Kalfon, Colette Vincent, Sophie Marty, Olivier Tandonnet, Alexis Redor, Xavier Valette, Ourida Aoudia, Jacques-Arnaud Seyrig, Bertrand Beaune, Hugues Aumaitre, Georges Pinon, Yann Leveneur, Sylvie Charachon, Raoul Herbrecht, Henriette de Valk, Gary David, Julien Pouyanne, Marc Dommergues, Majed Al Chaar, Véronique Blanc-Amrane, Pascale Guillarmé Grossmann, Bruno Abraham, Yves Morel, Philippe Suel, Denis Sautereau, Olivier Guilloy, Tu Anh Tran, Frédéric Laurent, Zahir Amoura, Jacques-Olivier Bay, Zoubida Elharie-Heraux, Joyce Sibony-Prat, Bernard Guillois, Dominique Rohmer-Heitz, Audrey Barrelet, Jérémie Courouble, Jean-Paul Herry, Daniel Vittecoq, Annie Vermesch-Langlin, Jean Auroux, Claude Aubert, Thierry Harvey, Ghislaine Lamoine-Gimet, J. Riahi, Florence Soraudeau, Bachar Al-Jalaby, Caroline Périsson, Khélifa Ayouz, Florence Cardot, François Maillet, Alain Goux, Théophile Magna, Bertille de Barbeyrac, Adrien May, Dominique Andreotti, Olivier Jonquet, Hélène Dumouchel, Didier Thibaud, Philippe Morlat, Pascal Chevalet, Pascal Ancelin, Guy Chambreuil, Cécile Le Boterff, Anne Ceriez, Olivier Detante, B Pangon, Claude C.A. Bernard, Vincent Cailleaux Pierre-Etienne Cailleux, Jordi Miatello, Pierre-Yves le Berruyer, Sylvain Kouaho, Michel Briaud, Hélène Delaby, Patrick Herbecq, Christine Segonds, Véronique Jault, Pascale Brunel, Christine Dussopt, Jean Thore, Jean-Marc Thouret, Jean-Marc Kerleau, François Le Baron, Slavius Matica, Sophie Leautez-Nainville, Matthieu Pecquet, Laurent Bret, Yacine Sedjelmaci, Pierre Metton, Habiboulaye Diallo, Jany Rey Zermati, Arnaud Delahaye, Hélène Chaussade, Laurent Mandelbrot, Emilie Bessede, Olivier Casanovas, Paul Pierrot, Annick Legras, Dominique Lauque, Hélène Gatti, Jean Catineau, Ebutu Likose, Gilles Capellier, Eric Kibbrecht, Freddy Thibaut, Patrick Valadier, Chantal Lemble, Joël Gaudelus, Joelle Mellier, Joëlle Brochen, Emmanuel Gascou, Stéphane Bonacorsi, Stéphanie Bannier, Bruno Fantin, Didier Raffenot, Valérie Revel, Hakim Amroun, Huguette Negrery, Anne-Laure Fauchais, Paul Mercury, Michel Chuzeville, Christian Zumbo, Nicolas Després, Pascal Roblot, Jérôme Pasche, Jean Claude Boufetteau, Jocelyne Caillon, Julien Boileau, V. Rabier, Benjamin Manéglier, Emilie Jourdes, Franck Ceppa, Christine Recule, Nicolas Degand, Benoît Henry, Thierry Baranger, Dominique Pateron, Agnès Pélaquier, Gérard Bouchet, Hélène Fiette, Ozel Guiden, Dana Ranta, Etienne Ruppé, Nabil Chiouk, Jacques Breuil, Dominique Leduc, Véronique Loustaud, Hervé Métenier, Michel Durand, Isabelle Mahé, Leila Karaoui, Marie-José Collus, Mehran Monchi, Olivier Belmonte, Romain Blondet, Jacques Thierry, Karine Humbert, Gilles Salama, Marie-Noelle Heurtaux, Cécile Goujard, Bruno Sivery, Martial Boisseau, Redouane Dahoumane, Pierre Delour, Christian Niels Meyer, Anne Faudon-Gibelin, Gérard Poulain, Roger-Charles Luciani, J.-C. Souquet, Olivier Grossi, François Vandenesch, Sylvain Mermont, Jacques Bronner, Sonia Dahan, Paul Marzouk, Pascal Pouedras, Noureddine Djafari, François-Xavier Caroli-Bosc, Jean-François Dessin, Brigitte Gruffat, Armelle Morin-Fatome, Sylvie Thoinet, Bano Konate, Jean-Winoc Decousser, Claire Poyart, Patrick Plessis, Olivier Millet, Vincent Cattoir, Françoise Geffroy, Manica Vasseur, Pierre Carli, Isabelle Citony, Christian Richard, Nicolas Sigur, Patrick Marthelet, Luwawu Mbimba, Pierre Feugier, Philippe Sauder, Hama Djerad, Evelyne Bourgerette, Hanen Chahtour, Adrien Lemaignen, Dominique Bechade, Patrick Ochocki, Antoine Vieillard Baron, Dominique Astruc, Marie-Pierre Moiton, Nicolas Dubois, Sylvie Ledru, Corinne Seknazi, Hélène Poupet, Jean-Philippe Brieux, Gérard Barthélémy, Aihem Yehia, Louis-Jean Couderc, Ahmed, Françoise Rigaux, Yohann N'guyen, Philippe Bethery, Damien Corberand, Etienne Auvray, Paul-Louis Woerther, Christian Combe, Sophie Delesalle, Jean-Marie Piala, Faraj Al Freijat, Philippe Juvin, Malcolm Lemyze, Hyacine Rey, Claire Larible, Noel Milpied, Lémia Zgarni, Julia Gaillard, Agnès Juven, Paola Otean, Adrien Melis, André Pechinot, Olivier Bouchaud, Olivier Chassin, Pierre Hausfater, Asma Trabelsi-Jnifen, Vincent Grobost, Didier Lemery, Pierre Soury, Françoise Brevet, Jacques Tankovic, Dominique Sansot, Jean Louis Salomon, Charlotte Cordonnier, Brigitte Lamy, Antoine Maisonneuve, Dominique Pressac, Claude Rémy, Rodolphe Sobesky, Stéphanie Cognet, Pierre Cougoul, Didier Jan, Dominique Perrotin, Cécile Hombrouk-Alet, Thierry André, Gilbert Pochmalicki, Serge Girard, Vincent Zerr, Guillaume Cadiot, Claudine Lasbasses, Michel Slama, Abderrazak El Yamani, Sophie Brovedani, Jean Armengaud, Romain Hernu, Géraldine Mascade, Aurélien Lorléa'ch, Ali Akkari, Mathieu Tourdjman, Christopher Payan, Eric Jullian, Nathalie Fonsale, Frédéric Riehl, Paul Strock, Geneviève Grise, Philippe Mottaz, Christian Floriot, Marie-Noëlle Ungeheuer, Denis Caillot, Arnaud Chalvon-Demersay, Catherine Branger, Stanislas Bruley des Varannes, Marc Paccalin, Marie-Pierre Danjean, Alexandre Mebazaa, Xavier Brunet, Roland De Varax, Laurence Delhoustal, Sophie Haro, Bruno Chabanon-Pouget, Isabelle Goidin, Dominique Chudersky, Corinne Costes, Delphine Chatellier, Maud Gelez, Damien Dassant, Pascal Joly, Jean-Michel Arnal, Zakaria Hamitou, Philippe Rondepierre, Carole Pignon, Valérie Crombe, Amanda Lopes, Chrystelle Kemenar, Olivia Raulin, Anne-Cécile Hochart, Sandrine Gérart Pons, Valérie Zeller, Guillermo Reyes Ortega, Mathilde Guérin, Audrey Migraine Bouvagnet, Florence Eboue, Isabelle Loury-Lariviere, Sophie Leotard, Suzanne Lima, Marie Kassis, Jean-Luc Donay, Jean-Pierre Audié, Guillaume Cartron, Arnaud Ribier, Fanny Buron, Mirela Tuca, Marius Semenescu, Arnaud Serre, Vincent Quentin, Denise Bouyssou-Destriau, Violaine Bresson, Christine Chandesris Joséphine Chapalain-Cagnon, Eric Cua, Henri Courtade, François Bénézit, Sébastien Lamache, Philippe Bonnefoy, Francis Schneider, Richard Monarchi, Adeline Schendel, Paramasiven Mootien, Ghislaine Gardes, Pierre-François Westeel, Jean-François Magny, François Caron, Jocelyn Michon, Didier Eyer, Isabelle Ronda, Pierre-Yves Robillard, Frédéric Renou, Anna Faucher, Jean-Robert Harlé, Anne Debernardi, Grégory Akerman, Benoît Fontenel, Pierre Hourdebaigt-Larrusse, Marie-Noëlle Adam, Aude Lessene, Abdelkader Hrichi, François Blot, Athéna Le Pierres, Romain Lemarie, Françoise Granier, Véronique Tardy, Marc Gatfosse, Pierre-Marie Roger, François Goupil, Saïd Aberrane, Franck Bernardi, Isabelle Plantier, Nathalie Funakoshi, Jean-Gilles Delecalle, Patricia Barbut, Jacques Reynes, Christophe Roy, Sophie Perreve, Michel Garre, David Ribes, Cyrille Ede, Jean-Claude Dausset, Francis Duchene, Jean Caussin, Michelle Becker-Schneider, Gilles Berthelot, Damien Dupont, Jean-Michel Gillot, Aurélie Messager, Jean-Marie Pannecouck, Jean-Christian Roussel, Alain Reynaud, Sylvie Cariou, Anne Dao, François Guillemot, Martin Martinot, Patrick Casali, Anne-Sophie Poirier, Aissa Kerchache, Necera Sakek, Eric Porthault, Christophe Decoene, Chantal Ache-Papillon, Brigitte Bicais, Jean-Claude Feugier, Thierry Masseron, Charles Marty-Ane, Daniele Goldgran Toledano, Jean-Christophe Dubus, Damien du Cheyron, Dominique Decré, Jean-Loup Pennaforte, Ahmed Tigaizin, Bernard Vache, Eric Oswald, Claire Moulinoux, Anne-Christine Jaouen, Caroline Charlier, Anne-Laure Virlouvet, Ali Kara, Jean-Luc Sicsic, Sylvie Goffart, Mathieu Zuber, Claudine Fèbre, Olivier Lortholary, Mathieu Dupont, Annie Vessieres, Thierry Helvadjian, Thomas Signouret, Cedric Daupin, Sandrine Essouri, Jean-Louis Jacob, Pascal Boileau, Caroline Blazejewski, Quentin Lepiller, Juan-Pablo Maureira, Eddy Lebas, Christophe Deschamps, Amévi Ananivi, Clovis Foguem, Daniel Adoue, Abdourahim Chamouine, Alain Michault, Bruno Guérin, Olivier Baud, Clara Vinci, Thierry Weitten, Jean-Marc Eychene, Marie Froidure, Julien Obiols, Patricia Roussellier, Marc Lecuit, André Cabié, Saskia Foucart, Karim Belhadj, Michel Cingotti, Bruno Dumoulard, Jean Puyhardy, Etienne Danquechin Dorval, Lucile Mendes-Martin, Enrique Casalino, Luc Jarrige, Fabien Lambiotte, Philippe Masson, Mohammed Mansouria, Pierre Thouvenot, Katy Jeannot, Martine Nyunga, Valérie Macci, Florent Masia, Claire Briere de la Hosseraye, Wassila Anteur, André Sommabère, Marie-Claude Germain, Isabelle Arnault, Bernard Carbonelle, Philippe Devos, Daniel Protar, Tiphaine Gaillart, Ludovic Lassel, Laurence Hamou-Plotkine, David Trystram, Thierry Bureau, Olivier Collard, Fanny Vuotto, Sophie Malhiere, Frederique Canis, Gillles Plainfosse, Catherine Lechiche, Bertrand Lassere, Martine Chouraqui, Jean Baptiste Michot, Fethi Radhouane-Khanjari, Carole Barbier, Pascal Bonitchi, Abdelaziz Benkhelil, Odile Salmon, Laurent Damaj Gandhi, Bertrand Minguet, Michel Wagner, Odile Falguières, Zahr-Eddine Ali Chaouche, Eric Zaoui, Isabelle Guichard, Bernard Huttin, Apollinaire Karirisi, Gaël Cinquetti, Christophe Plane, Lionel Rostaing, Yanne Henry-Andrieu, Daniel Re, Virginie Verrier, Pascal Bolot, Michel De Biasi, Laurence Vrigneaud, Mathilde Turpin, Marie-Claude Demachy, Etienne Roussel, Michèle Blancs, Olivier Join-Lambert, Yves Ville, Thierry Granger, Gilles Hilbert, Virginie Medeau, Daniel Villers, Benoit Pilmis, François Gouraud, Emmanuel Ardiet, Catherine Heyraud-Blanchet, Alain Devidas, Hélène Dieye, Julie Cremniter, Jean-François Bergmann, Rozenn Le Berre, Virginie Leguen, Daniel Royer, Gilles Le Maout, Christian Harou, Sylvie Gabriel-Soléan, Yves Regouby, Martine Pestel-Caron, Patrick Brunet, David Boutoille, Emmanuelle Bonnin, Patrice Coulon, Marc Sullice, Marianne Barbieux, Gilles Cambonie, Joëlle Tricoire, Marie-Nadège Bachelier, Delphine Briend, Céline Ramanantsoa, Nathalie Bednarek, Didier Lebreton, Julien Lagrandeur, Damien M'Bey, Philippe Audeguy, Elie Saliba, Lena Damaj, Hassan Fallouh, Pascal Couturier, Fabrice Prévost, Yves Domart, Marie-Odile Lafforgue, Anne Le Du, C. Beuscart, Pierre Guillet, Fabrice Larrazet, Marie-Hélène Hausermann, Henri Robert, Nicolas Fanjaud, François Goehringer, Thomas Bachelot Philippe Badia, Jean-Michel Coulaud, Cristel Fissore Magdelein, Renaud Defebvre, Anne-Sohie Moreau, Johan Courjon, Gilles Salles, Michel Mialon, Silvia Iacobelli, Emmanuelle Bille, Marie-Christine Barbier, Yves Aubard, Patrice Badila, Jean-Philippe Rasigade, Alban Deroux, Evelyne Lecaillon-Thibon, Michel Godin, Abdelmajid Djeffal, Viorica Badurescu, Meriem Canitrot, Pierre Blanchard, Antoine Legros, Laurence Got, Françoise Duluc, Mylène M. Maury, Gilles Dassieu, Nordine Khodeir, Jean-Marie Duez, Mathieu Morincomme, Jérôme Lacroix, Mathieu Revest, Koffi Blewoussi, Isabelle Barazer, Françoise Poitevin, Camille Seignovert, Stéphanie Honore Bouakline, Anne Heidt, Brigitte Malbruny, Julien Desblache, Christian Cattoen, Eric Jaunait, Bruno Chaminade, Claude Bazin, Jonathan Chelly, Anne Pottier, Alain Schmitt, Alain Tissot, Karim Dadoun, P. Rebattu, Claudine Contamin, Arnaud Guerard, Nathalie Ravet, Sandrine Khalifa-Thellier, Marlène Chatron, Gaëlle Dörr, Hélène Biessy, Emmanuel Forestier, Bruno Devaux, Jean-Jacques Grelaud, Xavier Tchenio, Marie-Cécile Ploy, Jérémie Violette, Michèle Burdin, Lionel Falchero, Dominique Jacomy, Jean-Christophe Rozé, Damien Labarriere, Stéphane Leroux, Corinne Meregnani, Assia Ferhat Carre, Paul Orode, Jean-Gabriel Paul, Catherine Godon, Agnès Vinay, Régine Barraduc, Dominique Dallay, Alexandre Ampère, Anne-Gaelle Kervegant, Guillaume Louart, Dominique Beal Ardisson, Francoise Leonetti, Jean-Yves Baril, Stéphanie Haiat, Bincy Darre, Jérôme Bay, Yvan Gauthier, Sylvie Radenne, Pierre-Yves Gueugniaud, Philippe Ravaud, Luc Landraud, Guillaume Ranchon, Loïc Chimot, Véronique Duval, Ilhem Agha-Mir, Sabine Camiade, Estelle Wafo, Jean-Patrick Laporte, Mariam Roncato-Saberane, Camille Bron, Patrice Laudat, Samir Kennouche, Nawel Afroukh, Dominique Neri, Hakim Kherouf, Yoar Hichri, Pierre-Edouard Bollaert, Gwenaelle Vary, Denis Castaing, Christine Lefort, Sébastien Rouget, René Robert, Christelle Guillet-Caruba, Catherine Simonin, Alain Vighetto, Severine Cabasson, Alain Brusset, Alexandra Doloy, Christel Cherlet, Ahmed Rouidi, Marina Salvucci, Réginald Pordes, René-Gilles Patrigeon, Emmanuelle Dupre-Narlet, Jacques Minet, Fethi Taleb, Anne-Marie Colingorski, Tahar Hadou, Sylvain Diamantis, Isabelle Glorieux, Thierry May, Jean-Claude Colombani, Anne Berth-Farges, Nicole Desplaces, Renaud de Tayrac, Elisabeth Walter, Fabienne Lorge, Pascal Reboul, Nathalie Dournon, Laurence Estépa, Marie-Lina Toubia, Mathilde Flahault, Thierry Delacour, Dominique Hurel, Hélinoro Andriamaneo, Cécile Bébéar, Denis Grasset, Miloud Serier, Oléna Orléva, Nadine Dubroca, Hervé Gentilhomme, Jean-Luc Baudel, Isabelle Lavenu, Salim Smati, Carlo Saroufim, Eric Placidi, Albert Sotto, Benoît Libeau, Hélène Leroy, François Golfier, Christophe Dollon, Laurence Desnoulez, Eric Barre, Daniel Cohen, Pascal Priollet, Thierry Marsepoil, Benoît Lionnet, Jacques Tebib, Pascale Penn, Antoine Bouissou, Christian Roth, Olivier Martinet, Anna Schmitt, Nathalie Fruleux, Fouzia Radaoui, Jean-Marc Lessinger, Virginie Morando, Jean-Jacques Maillet, Christophe Fruchart, François Boué, François Goffinet, Franck Lellouche, Martin Demarchi, Alain Geissler, Jean-Charles Picaud, David Assouline, Patricia Brazille, Philippe Guimier, Marie-Françoise Dabysing, Bruno Delpeuch, Vanessa Tran, Guy Gengembre, Delphine Deligne, Dominique Vodovar, Yvan Touze, Sabrina Parent, Anne Decoster, Camille Dewitte, Emmanuel Weiss, Thierry Lambert, Thomas Guimard, Vincent Caille, Claude Guérin, Françoise Evreux, Geneviève Barjon, Basile Ondze, Damien Fournier, Olivia Bandin, Sophie Mignart, Henri Demontclos, Didier Perez, Jacques Croize, Nicole Desbois-Nogard, Guenièvre Imbert, Clarisse Dupin, Khalid Ridah, Marie-Christine Varin, Guillaume Arlet, Edith De Clareuil, Marie-Line Eustache, Patricia Le Pimpec, Louise Fortin, Eugène Ngami, Fabrice Mihout, Cecilia Esnault, Vincent Bouden, Véronique Annaix, Yves Poinsignon, Aurélien Lorchleac'h, Jean-Marc Degreff, Marie Garofano, Renaud Mesnage, Anne-Marie Roque-Afonso, Alain Chevailler, Stéphane Hominal, Thierry Charbonnier, Adrianna Bildea, Fabien Fily, Benjamin Davido, Emmanuel Rassiat, Assi Assi, Stéphanie Brunet, Hervé Jacquier, Catherine Claise, Annie Durand, Yannick Monceau, Pierre Blanc, Jean-Marie Sire, Yves Sucin, Jean-Pierre Zarski, Nathalie Bronet, Ingrid Lafon, Philippe Rey, Jacques Markarian, Eric Sennevile, Olivier Wink, Guilène Barnaud, Anne-Sophie Peultier, Sabine Taylor, Rim Savatier, Patrick Valayer, Claude Negrier, Selim Jennane, Edouard Begon, Laura Hyerle, Delphine Bridoux, Claire Daurel, Benoît Dalle, Mathilde Lescat, Philippe Stolidi, Elodie Perrodeau, Xavier Heches, Pierre Castelnau, Philippe Bray, Jean-Claude Texier, Serge Rossignol, Maud Brung-Lefebvre, Jean-François Subra, Jean-Marie Delarbre, Morgane Schneerson, Guyro Jang, Mona Mehri, Nathalie Landgraf, Pierre-Marie Girard, Armand Goll, Zaineb Bekguesmia, Christophe Clement, Michel Collet, Vincent Maze, Amine Benjelloul, Solène Durliat-Ellie, Vincent Letouzey, François Schmitt, Valérie Martinez, Sarah Watson, Abderrezak Bouasria, François Barbier, Raphael Lauretta, Mirana Razafimahery, Cristina Sirbu, Patrick Malherbe, Anne Wuillai, Ludovic Lesecq, Philippe Gaudard, Serge Houssaye, Jacques Monsegu, Gilles Rival, Chantal Chaplain, Jean-Didier Grangé, Oana Zamfiri, Florence Nguyen-Khac, Marc Portneuf, Jean-Michel Pawlotsky, Delphine Bonnet, Laurent Traissac, Sophie Hamon-Charles, Didier Dreyfuss, Louis Bernard, Laurence Detourmignies, Olivier Martineau, François Pettinelli, Marc Zandecki, Michel Dreyfus, Alain Chapelle, Sébastien Sabbat, Anne-Sophie Labussiere, Jean-Louis Gaillard, Chloé Plouzeau-Jayle, Patrick Zoveda, Véronique Leflon, Marie Levy, Aurélie Labé, Bruno Soulie, Raoul Jacques Bensaude, Hecham Moussa, Sylviane Catteu, Nathalie Biron, Loïc Masson, Georges Mourad, Nejla Aissa, Dragos Ciocan, Hubert De Boysson, Jean-Luc Bouyer, Patrick Yeni, Thierry-Pascal Zame, Caroline Thomas, François Cavalié, Laurence Koulmann, Christophe Rioux, Olivier Barraud, François Bricaire, Marguerite Le Poulain, Marie-Noelle Noulard, René Thomas, Guy Semet, Laurent Mosser, Olivier Marret, Brigitte Rivière, Vincent Jarlier, Jean-Philippe Coindre, Marc Villemain, Martin Pierre, Yacine Benkaci, Philippe Chiron, Hoang Vu-Thien, Jérôme Gournay, Andrea Labaune-Kiss, Brigitte Lauzanne, Fanny Lemercier, Souad Silhadi, Imad Kansau, Christophe Poncelet, Olivier Baldesi, Francis Thuet, Olivier Leroy, Aurore Lamberet, Camille Petit Hoang, Sophie Micheli, Ayman Abokasem, Hakima Nesrine, Pierre Lureau, Christian Chidiac, Vincent Piriou, Fabien Zoulim, Dieudonné Nicobaharaye, Anne Tixier, Isabelle Matheron, Soumeth Abasse, Victoria Cacheux, Serge Herson, Christine Fuhrmann, Olivier Proost, Bernard Bedock, Olivier Rogeaux, Mostapha Hajjar, Anne Reverseau, René Courcol, Françoise Carmagnol, Yves Guénard, Céline Ménard, Bouchra Lamia, Bruno Lemmens, Damien Bouhour, L. Lequen, Gaëlle Baty, Cédric Bouet, Dominique Guerrot, Stéphane Blanc, Catherine Chirouze, Anne-Hélène Reboux, A. Vachée, Gregory Taurin, Myriam Mein-Bottini, Jean-Pierre Belot, Alain Lafeuillade, Patricia Gabez-Therou, Philippe Labrousse, Bernard Jarrousse, Philippe Noto, Vincent Brunot, Philippe Condominas, Marion Challier, Béatrice Berçot, Delphine Anuset, Mélanie Daval Cote, François Bernasconi, Y. Costa, Chandrah Goburdhun, Bernard Gressier, Alban Michaud-herbst, Franck Charlier, Moussa Hecham, Luc Boulain, Hélène Corneloup, Alix Greder Belan, Nicolas Boussekey, Claire-Antoinette Dupuy, Yannick Rouquet, Benoit Renard, Benifla Jl, Etienne Javouhey, Michèle Granier, Marie-Christine Jaffarbandjee, Emilie Piet, Benoît Bergues, Claire Malbrunot, Catherine Tiry, Philippe Mérigot, Mouna Ben Soltana, Chantal Roure Sobas, Florian Radenac, Yves Thomas, Agathe Blaise, Sylvie De Martino, Laurence Legout, Gabriel Choukroun, Jean-François Muir, Peggy Dupretz, Patrick Dupont, François Guichart, Julie Jean, Jean-Michel Descamps, Bernard Kittschke, Anne Gruson, Gerard Viquesnel, Marie Keller, Pascal Chavanet, Françis Vallet, Yvan Vaschalde, Jean-Luc Hanouz, Gerard Lina, Françoise Loison, Simon Vincent, Jean-Paul Thellier, Moncef Afi, Dominique Zagozda, Hélène Sokeng-Affoule, Marc Le Bideau, Jean-François Loriferne, Alain Gravet, Sophie Deprecq, Tarik Naceur, Severine Mielczarek, René-Jean Bensadoun, Bernard Karkous, Yves Bléher, Jocelyne Poulain, Véronique Goulet, Laurence Nicolet, Sophie Arista, Antônio Lúcio Teixeira, Jean-François Schved, Laurent Nicolet, Claire Lecomte, Faiza Benddif-Fin, Michel Aumersier, Laurence Burc-Struxiano, Maxime Thouvenin, Samia Harbi, Mathieu Detave, Catherine Rebeyrotte, Jean-Paul Kisterman, Bruno Berdin, Pascal Vincent, Laurent Argaud, Elisabeth Parisi-Duchene, Geneviève Julienne, Fernanda Farto-Bensasson, Georges-Fabrice Blum, Sad Gaizi, Tali-Anne Szwebel, Raphaël Lepeule, Marie-Thérèse Climas, Anne-Françoise Dillies, Amar Boudhane, Umberto Simeoni, Pierre-François Dequin, Gérard Oliviero, Alain Gourlaouen, Caroline Piau, Marie-France Lutz-Murphy, Benoît Claude, Jean-Paul Aubry, Nadine Dubosc-Marchenay, Kamilla Chraibi, Emmanuelle Heusse, Sylvain Le Chevallier, Nathalie Brieu, Farid Sifaoui, Lorraine Letranchant, Hélène Durox, Jean-Pierre Lagasse, Adel Ghedira, Xavier Roubert, Fatma Magdoud, Hélène Jean-Pierre, Etienne Carbonelle, Olivier Dereeper, Lionel Carbillon, Christophe Billy, Mélanie Roblin, Marie-José Kodzin, Philippe Niel, Solène Makdessi, Matteo Vassallo, Maryse Archambaud, Fabian Haccourt, Didier Blaise, Stéphane Bourgeois, Elena Marcu, Charles Kubiak, Brisse Castel, François Guinet, Marie Pouzoullic, Frédérique Nathan-Bonnet, Vincent Gendrin, Céline Becherrawy, Aline Secher, Pierre Abgueguen, Clarence Eloy, Jean-Marc Tourani, Frédéric Klapczynski, Bernard Montmasson, Philippe Real, Joanna Pofelski, Yves Welker, Karim Krechiem, Eric Caumes, Martine Elena-Daumas, Christophe Saigne, Gilles Hittinger, Chantal Delesalle, Jonathan Messika, Fabrice Lesage, Daniela Pop, Daniel Coetmeur, Renato Colamarino, Chetaou Mahaza, Patrick Plésiat, Isabelle Fredenucci, Mylène Baret, Guy Mager, Pascale Chavel, Isabelle Labourdette, Anne-Claude Menguy, Nicolas Fortineau, Ludovic Le Sec, Valérie Gauduchon, Francis Barraud, Nicolas Letellier, Didier Vincent, Janine Frey, Philippe Riegel, Michel Pavic, Jean-Luc Fabre, Jean-Pierre Fauchart, Alain Goudeau, Stéphanie Husson-Wetzel, Philippe Eymerit, Mohamed Camara, Nathalie Seta, Elisabeth Carole Ngo Bell, Philippe Repellin, Laurent Alric, Vincent Leroy, Françoise Delisle Mizon, Jean-Philippe Emond, Marie-Françoise Borie, Lise Crémet, Wladimir Chelle, Elisabeth Brottier-Mancini, Bernard Garrigues, Claire Letellier, Loïc Geffray, Frédéric Méchaï, Julien Bador, Benoit Guery, Alain-Charles Fouilhoux, Corinne Dagada, Pierre Duhaut, Julien Goustille, Arnaud Sément, Francis Carcenac, Isabelle Girard-Buttaz, Claire Chapuzet, Fabienne Jouatte, Bruno Riou, Fabrice Hayoun, Chloé Di Meglio, Youssef Ali, Michel Leneveu, Nathalie Montagne, Yves Garcera, Audrey Moustache, Pierre-Eric Danin, Geneviève Le Lay, Dominique Courouge-Dorcier, Isabelle Worcel, Emmanuel Morelon, Vincent Pestre, Jean-Pierre Vilque, Jean-Christophe Paquet, Lucien Bodson, Anne-Marie Forest, Fabrice Pierre, Christian Pommier, Fabien Dutasta, Pierre Fournel, Stéphanie Courtois, Elodie Dubois, Serge Vanden Einjden, Patrick Honderlick, Pascal Richette, Fabienne Tamion, Véronique Chassy, Richard Megbemado, Anne-Marie Le Reste, Bernard Simian, Henri Osman, Anthony Texier, Badih Ayach, François Simon, Jean-Michel Filloux, Béatrice Dubourdieu, Jean-Claude Semet, Sarah Kubab, Tawfiq Henni, Patrick Dudeffant, Delphine Hequet, Olivier Mimoz, Marc Auburtin, Amélie Chabrol, Mickael Bonnan, Caroline Léonnet, Claire Wintenberger, Serge Ilunga, Patrice Lanba, Sophie Rosello, Alexandre Damage, Flore Bouche, Michel Thibault, Frederic Faibis, Chantal Dhennain, Jean-Philippe Talarmin, Armelle Lamour, Remi Boussier, Fabien Garnier, Marie-Laure Brival, Nourredine Hedjem, Philippe Vande-perre, Raphaël Coint, Jean-Claude Reveil, Eva Weinbronn, Emmanuelle Lavalard, Alexandra Fille, Françoise Le Turdu, Lionel Leroux, Jean-Yves Lefrant, Jean Berthet, Radia Bouaziz, Alain Ravaud, Sylvaine Rousseau, Yacine Merrouche, Alain Le Coustumier, Bertrand Guider, Gisèle Dewulf, Jean-Marc Faucheux, Jacques Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)

Subjects
Bacteremia/epidemiology/mortality, 0301 basic medicine, Male, Pediatrics, bacteraemia, Infectious Disease Transmission, [SDV]Life Sciences [q-bio], Bacteremia, France/epidemiology, Infant, Newborn, Diseases, Foodborne Diseases, Meningoencephalitis, Pregnancy, Risk Factors, Vertical, Medicine, Listeriosis, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ddc:618, diabetes, alcoholism, Hazard ratio, Foodborne Diseases/microbiology, immuno suppressive therapies, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, Infectious Diseases, isolates, Population Surveillance, Female, France, Listeria monocytogenes/classification/isolation & purification, Cohort study, Adult, medicine.medical_specialty, 030106 microbiology, Notifiable disease, Listeriosis/diagnosis/epidemiology/microbiology, Context (language use), macromolecular substances, 03 medical and health sciences, Humans, study, Aged, [ SDV ] Life Sciences [q-bio], business.industry, Public health, cirrhosis, Infant, Newborn, Infant, Diseases/epidemiology/microbiology, HIV, Mandatory Reporting, Newborn, medicine.disease, Listeria monocytogenes, infection, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious/epidemiology/microbiology, Meningoencephalitis/epidemiology/microbiology/mortality, Observational study, business, prognostic, mellitus
Abstract

International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (

Published
2016

18. Autoimmune Hemolytic Anemia in Individuals Aged 75 and Older: A Study of 10 Individuals

Author

Abrar-Ahmad Zulfiqar, Jean-Loup Pennaforte, and Emmanuel Andrès

Subjects
Aged, 80 and over, Male, Pediatrics, medicine.medical_specialty, business.industry, Anemia, MEDLINE, Age Factors, 030204 cardiovascular system & hematology, medicine.disease, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Female, Anemia, Hemolytic, Autoimmune, Geriatrics and Gerontology, Autoimmune hemolytic anemia, business, 030215 immunology, Cohort study, Aged
Published
2016

19. Treatment in idiopathic thrombocytopenic purpura in the elderly: about a retrospective study

Author

Jean-Loup Pennaforte, Emmanuel Andrès, Abrar-Ahmad Zulfiqar, Rachid Mahmoudi, and Jean-Luc Novella

Subjects
Danazol, Aged, 80 and over, Male, medicine.medical_specialty, Purpura, Thrombocytopenic, Idiopathic, business.industry, Anti-Inflammatory Agents, Immunoglobulins, Intravenous, Retrospective cohort study, medicine.disease, Thrombocytopenic purpura, Dermatology, Neuropsychology and Physiological Psychology, Treatment Outcome, Medicine, Humans, Female, Steroids, Neurology (clinical), Geriatrics and Gerontology, business, Biological Psychiatry, medicine.drug, Aged, Retrospective Studies
Abstract

There are no specific recommendations on the care of elderly patients with ITP. A retrospective study over two academic centers (Reims and Strasbourg), focused on patients over 65 who have been diagnosed idiopathic thrombocytopenic purpura in two unit of internal medicine. 41 patients were enrolled, including 27 women (66%). The median age is 76.75 years. On admission, the average thrombocytopenia is 34.45 G/L; 24 patients (58.5%) showed severe bleeding mucosal and/or visceral signs; 37 patients (90%) had a first-line treatment. Corticosteroids established for 23 patients (56%). At 1 and 6 months, complete response was 9 patients (39%) and 2 patients (9%) respectively. Adverse events reported for 20 patients (87%). Polyvalent immunoglobulins were used for 6 (16%) with no response at 6 months. 5 patients were treated with danazol. At 6 months, partial response in 3 patients (60%) and failure in 2 patients (40%). Splenectomy was performed for 8 patients (21%). At 1 month, a complete response observed for 7 patients. At 6 months, a failure observed in 4 patients. After failure of first-line treatments, we noted the use of rituximab for 4 patients (9.7%) with a complete response for 1 patient, partial response in 2 patients and a failure for a patient for whom the "eltrombopag" was set up with a partially response. Monitoring of 41 patients, during 7 years, objectified 3 deaths. The clinical presentation of idiopathic thrombocytopenic purpura in the elderly seems more severe. Therapeutic responses are essentially identical to those observed in younger patients, but greater toxicity. Data on biologics is nonexistent in elderly outside small retrospective series. Studies are underway to better assess their effectiveness, long-term safety as well as their mechanism of action.

Published
2016

20. Systemic Lupus Erythematosus and Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Overlap Syndrome in Patients With Biopsy-Proven Glomerulonephritis

Author

Philippe Halfon, Laurent Chiche, Xavier Puéchal, Nathalie Bardin, Emmanuel Andrès, Vincent Vuiblet, Baptiste Hervier, Daniel Bertin, Laurent Daniel, Noémie Jourde-Chiche, Jean-Loup Pennaforte, Pierre-André Jarrot, Zahir Amoura, Bertrand Dussol, Eric Rondeau, Gilles Kaplanski, Benjamin Terrier, Mohamed Hamidou, Eric Daugas, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie de l'Endothelium, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen [Fondation Ambroise Paré - Marseille], Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Centre National de la Recherche Scientifique (CNRS), Neurobiologie des interactions cellulaires et neurophysiopathologie - NICN (NICN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Interne, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 (UPD5), Institut E3M [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [APHP], Service de médecine interne [CHU Pitié-Salpétrière], Université Pierre et Marie Curie - Paris 6 (UPMC), Urgences néphrologiques et transplantation rénale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Bichat - Claude Bernard, CHU Cochin [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre d'Immunologie de Marseille - Luminy (CIML), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Aix Marseille Université (AMU), Hôpital Civil de Strasbourg, Héritages et Constructions dans le Texte et l'Image (HCTI), Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois des Sciences de l'Homme et de la Société (IBSHS), Université de Brest (UBO)-Université de Brest (UBO), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Vascular research center of Marseille ( VRCM ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ), Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Centre d'Immunologie de Marseille - Luminy ( CIML ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Matrice extracellulaire et dynamique cellulaire - UMR 7369 ( MEDyC ), Université de Reims Champagne-Ardenne ( URCA ) -SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ) -Centre National de la Recherche Scientifique ( CNRS ), Aix Marseille Université ( AMU ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 ( UPD5 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Héritages et Constructions dans le Texte et l'Image ( HCTI ), Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Maison des Sciences de l'Homme de Bretagne-Institut Brestois des Sciences de l'Homme et de la Société ( IBSHS ), Université de Brest ( UBO ) -Université de Brest ( UBO ), Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims ( CHU Reims ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), Institut Brestois des Sciences de l'Homme et de la Société (IBSHS), Université de Brest (UBO)-Université de Brest (UBO)-Université de Bretagne Sud (UBS)-Université de Brest (UBO), Institut National de la Santé et de la Recherche Médicale (INSERM) - Université de la Méditerranée - Aix-Marseille 2 - Aix Marseille Université (AMU), Hôpital Européen Marseille, Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Pitié-Salpêtrière [APHP], Laboratoire d'Anatomopathologie [Aix-Marseille], Assistance Publique - Hôpitaux de Marseille (APHM) - Hôpital de la Timone [CHU - APHM] (TIMONE) - CHU Marseille, Matrice extracellulaire et dynamique cellulaire (MEDyC), Université de Reims Champagne-Ardenne (URCA) - Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Immunologie [APHM-Hôpital de la Conception, Marseille], Assistance Publique - Hôpitaux de Marseille (APHM) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ) - Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Cochin [APHP] - Université Paris Descartes - Paris 5 (UPD5), CHU Tenon [APHP] - Assistance publique - Hôpitaux de Paris (AP-HP), Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), CHU Angers - Hôtel-Dieu de Nantes - Hôpital Laennec - Faculté de Médecine d'Angers - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS) - CHU Nantes, Hôpital Robert Debré - CHU Reims, Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bichat - Claude Bernard [Paris] - Université Paris Diderot - Paris 7 (UPD7), Aix Marseille Université (AMU) - Assistance Publique - Hôpitaux de Marseille (APHM) - Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Institut Cochin, Université Sorbonne Paris Cité (USPC) - Université Paris Descartes - Paris 5 (UPD5) - Centre National de la Recherche Scientifique (CNRS) - Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), CHU Tenon [AP-HP], Université de Brest (UBO), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Neurobiologie des interactions cellulaires et neurophysiopathologie - NICN ( NICN ), Institut National de la Recherche Agronomique ( INRA ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), and Université Pierre et Marie Curie - Paris 6 ( UPMC )

Subjects
Male, ANCA-ASSOCIATED VASCULITIS, Pathology, Anti-nuclear antibody, Biopsy, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Lupus nephritis, Kidney, Gastroenterology, Neutrophil extracellular traps, DISEASE, Glomerulonephritis, 0302 clinical medicine, immune system diseases, Lupus Erythematosus, Systemic, 10. No inequality, skin and connective tissue diseases, SJOGRENS-SYNDROME, medicine.diagnostic_test, Incidence, Overlap syndrome, General Medicine, 3. Good health, [SDV] Life Sciences [q-bio], ANTINUCLEAR ANTIBODY, Population Surveillance, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, CLINICAL-IMPLICATIONS, France, CRESCENTIC GLOMERULONEPHRITIS, Vasculitis, Research Article, Adult, medicine.medical_specialty, Adolescent, Antineutrophil cytoplasmic antibody-associated vasculitis, Observational Study, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, GRANULOPOIESIS SIGNATURES, CLASSIFICATION, Young Adult, 03 medical and health sciences, Internal medicine, NETTING NEUTROPHILS, medicine, Humans, Immune response, NEPHRITIS, Retrospective Studies, Anti-neutrophil cytoplasmic antibody, 030203 arthritis & rheumatology, Lupus erythematosus, [ SDV ] Life Sciences [q-bio], business.industry, medicine.disease, Antineutrophil cytoplasmic autoantibodies, business
Abstract

Supplemental Digital Content is available in the text, The aim of the study was to report the clinical, biological, and pathological characteristics of patients with glomerulonephritis (GN) secondary to systemic lupus erythematosus (SLE)/antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) overlap syndrome. A nationwide survey was conducted to identify cases of SLE/AAV overlap syndrome. Data were collected from SLE and AAV French research groups. Inclusion criteria were diagnosis of both SLE and AAV according to international classification criteria and biopsy-proven GN between 1995 and 2014. Additional cases were identified through a systematic literature review. A cohort of consecutive biopsy-proven GN was used to study the prevalence of overlapping antibodies and/or overlap syndrome. The national survey identified 8 cases of SLE/AAV overlap syndrome. All patients were female; median age was 40 years. AAV occurred before SLE (n = 3), after (n = 3), or concomitantly (n = 2). Six patients had rapidly progressive GN and 3/8 had alveolar hemorrhage. All patients had antinuclear antibodies (ANA); 7/8 had p-ANCA antimyeloperoxidase (MPO) antibodies. Renal biopsies showed lupus nephritis (LN) or pauci-immune GN. Remission was obtained in 4/8 patients. A literature review identified 31 additional cases with a similarly severe presentation. In the GN cohort, ANCA positivity was found in 30% of LN, ANA positivity in 52% of pauci-immune GN, with no correlation with pathological findings. The estimated prevalence for SLE/AAV overlap syndrome was 2/101 (2%). In patients with GN, SLE/AAV overlap syndrome may occur but with a low prevalence. Most patients have an aggressive renal presentation, with usually both ANA and anti-MPO antibodies. Further studies are needed to assess shared pathogenesis and therapeutic options.

Published
2016

21. Manifestations fonctionnelles associées à la prise de corticoïdes chez les sujets âgés

Author

Moustapha Dramé, C. Vanhaecke Collard, Rachid Mahmoudi, Jean Luc Novella, François Blanchard, and Jean-Loup Pennaforte

Subjects
Gynecology, medicine.medical_specialty, Adrenal cortex hormones, business.industry, Gastroenterology, Internal Medicine, medicine, business
Abstract

Resume Introduction La corticotherapie est un traitement frequent chez les sujets âges. Son utilisation est parfois lourde de consequences dans cette population souvent fragile. L’objectif de ce travail etait de decrire les manifestations fonctionnelles rencontrees lors d’une corticotherapie chez des patients de plus de 75 ans et les mesures preventives mises en œuvre. Patients et methodes Etude de type « exposes/non-exposes », prospective, multicentrique, observationnelle, un patient expose etant apparie a deux sujets non exposes sur l’âge (± 2 ans) et le sexe. Le recueil s’est deroule de juin 2006 a novembre 2009. La population etait composee de patients de 75 ans et plus, hospitalises en court sejour geriatrique sous corticotherapie prolongee. Etaient recueillies : les caracteristiques sociodemographiques et geriatriques, l’histoire de la corticotherapie, les manifestations cliniques rencontrees et les mesures preventives prescrites. Resultats Au total, 50 patients exposes et 100 patients non exposes ont ete inclus. L’âge moyen etait de 85 ± 6 ans. Les sujets sous corticotherapie avaient significativement plus de chutes et de complications osteoarticulaires, etaient plus souvent polymediques et presentaient plus d’amyotrophie, de fractures vertebrales, de lipodystrophie, de purpura, d’hematomes et de cataracte. Les mesures preventives etaient significativement plus souvent prescrites chez les patients sous corticoides (supplementation vitaminocalcique et potassique, traitement anti-osteoporotique et protecteur gastrique). Conclusion Les manifestations fonctionnelles de la corticotherapie sont frequentes chez les sujets âges et peuvent etre consequentes dans cette population fragile. Il convient donc de veiller a appliquer les mesures preventives a cette population dans le cadre d’une prise en charge globale.

Published
2012

22. Autoimmune Hemolytic Anemia - A Short Review of the Literature, with a Focus on Elderly Patients

Author

Novella Jl, Jean-Loup Pennaforte, A A Zulfiqar, Mourot-Cottet R, R. Mahdi, and Emmanuel Andrès

Subjects
Erythrocyte membrane, business.industry, Immunology, Extracorpuscular hemolytic anemia, Autoantibody, Medicine, Retrospective cohort study, Autoimmune hemolytic anemia, business, medicine.disease
Abstract

Autoimmune hemolytic anemia (AIHA) is the most common extracorpuscular hemolytic anemia. AIHAs are related to the presence of autoantibodies directed against components of the erythrocyte membrane. To date, data related to AIHA are rare, primarily from retrospective studies of small effective. To our knowledge, data related to AIHA in elderly subjects are almost non-existent. Thus, we report our experience of 10 consecutive patients older than 75 years with a documented AIHA.

Published
2015

23. Hypervitaminemia B12 in elderly patients: Frequency and nature of the associated or linked conditions. Preliminary results of a study in 190 patients

Author

Jean-Luc Novella, Moustapha Dramé, Jean-Loup Pennaforte, Alexandre Sebaux, Abrar-Ahmad Zulfiqar, and Emmanuel Andrès

Subjects
Male, Hematological disorders, medicine.medical_specialty, business.industry, Liver Diseases, Statistics as Topic, MEDLINE, Prognosis, Hematologic Diseases, Autoimmune Diseases, Vitamin B 12, Metabolic Diseases, Neoplasms, Internal medicine, Immunology, Prevalence, Internal Medicine, Humans, Medicine, Female, France, Renal Insufficiency, business, Aged
Published
2015

25. Association pernicious anemia and autoimmune thyroiditis: A case-report and review of literature

Author

Jean Luc Novella, Jean-Loup Pennaforte, Emmanuel Andrès, and Abrar-Ahmad Zulfiqar

Subjects
endocrine system, medicine.medical_specialty, endocrine system diseases, medicine.diagnostic_test, Atrophic gastritis, business.industry, Anemia, Normocytic anemia, medicine.disease, Gastroenterology, Thyroiditis, Autoimmune thyroiditis, Internal medicine, Immunology, medicine, Vitamin B12, Geriatrics and Gerontology, business, Gerontology, Mean corpuscular volume, pernicious anemia
Abstract

Pernicious anemia was first described by Thomas Addison in 1849, anemia has been linked to stomach by Austin Flint in 1860 [1]. A woman aged 85 years, was admitted for investigation of anemia discovered incidentally. She was followed for type 2 diabetes, hypertension, dyslipidemia and rectal adenocarcinoma surgery. Clinical examination found a mucocutaneous pallor. The hemoglobin level was 7.3 g/dL, a mean corpuscular volume to 86 microns, platelets 350 000, reticulocyte 83 giga/L, prothrombin time 81%. This assessment of anemia was supplemented by iron status, which turns normal and vitamin status indicating a vitamin B12 deficiency estimated at 108 pg/mL, without vitamin B9 deficiency. We are in the presence of a regenerative normocytic anemia with vitamin B12 deficiency. Positivity of anti-intrinsic factor antibodies and parietal cell antibodies, and an increased gastrin. The diagnosis of pernicious anemia was confirmed by gastroesophageal gastroduodenal endoscopy; on a macroscopic level, an atrophic fundus lesion with hummocky was found, whose biopsies confirmed the appearance of atrophic gastritis with enterochromaffin-like cell hyperplasia. On the metabolic level, we noted the presence of a disturbed thyroid function with increased TSH. Positivity of anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies, which reveal the presence of autoimmune thyroiditis; it is also reinforced by the thyroid ultrasound finding an aspect of autoimmune thyroiditis consistent with Hashimoto’s thyroiditis. The rest of the immunological balance did not find others autoimmune diseases such as Sjogren disease, or autoimmune diabetes. Therefore, we are faced with a patient with the association of pernicious anemia and Hashimoto’s thyroiditis.

Published
2015

26. LupusQoL-FR is valid to assess quality of life in patients with systemic lupus erythematosus

Author

Jean-François Besancenot, Jean-Loup Pennaforte, Jean-Louis Pasquali, Pierre Kaminsky, Laurent Arnaud, Zahir Amoura, Francis Guillemin, Denis Wahl, Nadine Magy-Bertrand, Christine Binquet, Hervé Devilliers, Bernard Bonnotte, François Maurier, Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques ( CIC-EC ), Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Médecine Interne (SOC 1 et SOC 2) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre National de Référence du Lupus et Syndrome des Antiphospholipides, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Service d'Immunologie Clinique, CHU Strasbourg, Immunologie et chimie thérapeutiques ( ICT ), Cancéropôle du Grand Est-Centre National de la Recherche Scientifique ( CNRS ), Service de Médecine Interne et Vasculaire [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Risque cardiovasculaire, rigidité-fibrose et hypercoagulabilité ( RCV ), Université Henri Poincaré - Nancy 1 ( UHP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de médecine interne, Hôpital Sainte-Blandine-Centre hospitalier régional Metz-Thionville ( CHR Metz-Thionville ), Service de Médecine Interne et Maladies Orphelines [CHRU Nancy], Service de Médecine Interne, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims ( CHU Reims ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Ecole de santé publique, Université Paris Descartes - Paris 5 ( UPD5 ) -Nancy Université, Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Immunologie et chimie thérapeutiques (ICT), Cancéropôle du Grand Est-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Risque cardiovasculaire, rigidité-fibrose et hypercoagulabilité (RCV), Université Henri Poincaré - Nancy 1 (UHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville)-Hôpital Sainte-Blandine, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Service de Médecine interne [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5)-Nancy Université, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) ( HOTE GREFFON ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Sainte-Blandine-Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Saas, Philippe, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC)

Subjects
Male, Psychometrics, MESH: Self Report, MESH : Prospective Studies, MESH : Self Report, Severity of Illness Index, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Lupus Erythematosus, Systemic, MESH : Lupus Erythematosus, Systemic, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Pharmacology (medical), MESH : Female, 030212 general & internal medicine, Prospective Studies, MESH: Translations, MESH: Middle Aged, MESH : Psychometrics, MESH : Questionnaires, Middle Aged, MESH : Adult, MESH: Reproducibility of Results, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, MESH : Severity of Illness Index, Adult, medicine.medical_specialty, SF-36, [SDV.IMM] Life Sciences [q-bio]/Immunology, MESH : Male, MESH : Translations, External validity, 03 medical and health sciences, Rheumatology, Cronbach's alpha, MESH: Psychometrics, MESH: Severity of Illness Index, Humans, Translations, MESH: Lupus Erythematosus, Systemic, MESH : Middle Aged, 030203 arthritis & rheumatology, Rasch model, MESH: Humans, business.industry, MESH: Questionnaires, MESH : Reproducibility of Results, MESH : Humans, Discriminant validity, Construct validity, Reproducibility of Results, MESH: Quality of Life, MESH: Adult, MESH : Quality of Life, MESH: Male, MESH: Prospective Studies, Mann–Whitney U test, Physical therapy, Quality of Life, Self Report, business, MESH: Female
Abstract

International audience; OBJECTIVE: To cross-culturally adapt the LupusQoL into French, to test its measurement properties and to further investigate its domain structure. METHODS: The cultural adaptation process according to guidelines and pre-testing resulted in the LupusQoL-FR. SLE patients completed the LupusQoL-FR at baseline, 15 days, 3 months and 6 months. Validity was studied through content and construct validity (factorial and Rasch analysis for structural validity, Spearman's correlation and Mann-Whitney tests for external validity). Cronbach's α and intra-class correlation coefficients were computed for reliability. The standardized response mean was computed to evaluate responsiveness. RESULTS: In all, 182 patients, age 39.6 (10.6) years, mostly outpatients [mean SELENA-SLEDAI 2.6 (3.5)] were recruited. Factor analysis with eight imposed factors was very close to the original LupusQoL. A screeplot with parallel analysis showed that LupusQoL domains could be aggregated in two physical and mental scales. Both eight- and two-factor structures showed a good Rasch fit, internal consistency (Cronbach's α: 0.85-0.95), and test-retest reliability (intra-class correlation coefficient 0.79-0.95). External convergent (correlation with SF-36, r=0.59-0.78) and divergent validity (according to SELENA-SLEDAI) were also satisfactory. CONCLUSION: The LupusQoL-FR is valid to assess quality of life in SLE patients. A two-factor structure of physical and mental aggregated scales is a valid alternative to the original eight-domain structure.

Published
2012

27. Prevalence of Valvular Involvement in Systemic Lupus erythematosus and Association with Antiphospholipid Syndrome: A Matched Echocardiographic Study

Author

Damien Metz, Jean-Pierre Chabert, Bruno Maillier, Joelle Graciet-Richard, Jacques Elaerts, Pierre Nazeyrollas, Jean-Loup Pennaforte, and Damien Jolly

Subjects
Adult, Male, medicine.medical_specialty, Systemic disease, Adolescent, Heart Valve Diseases, immune system diseases, Antiphospholipid syndrome, Internal medicine, Immunopathology, Prevalence, Humans, Lupus Erythematosus, Systemic, Medicine, Pharmacology (medical), Prospective Studies, skin and connective tissue diseases, Aged, Autoimmune disease, Lupus erythematosus, business.industry, Mitral Valve Insufficiency, Middle Aged, Antiphospholipid Syndrome, medicine.disease, Thrombosis, Connective tissue disease, Tricuspid Valve Insufficiency, Cross-Sectional Studies, Echocardiography, Antibodies, Anticardiolipin, Case-Control Studies, Lupus Coagulation Inhibitor, Immunology, Female, France, Cardiology and Cardiovascular Medicine, business, Anti-SSA/Ro autoantibodies
Abstract

Antiphospholipid antibodies in patients with systemic lupus erythematosus (SLE) are often associated with thrombosis, recurrent abortions and thrombocytopenia. The purpose of this study was to evaluate the prevalence of cardiac valvular abnormalities in patients with SLE and to establish the relationship between the echographic findings and the presence of an antiphospholipid syndrome. A total of 52 consecutive patients with SLE and 52 healthy sex- and age-matched controls were therefore evaluated in a cross-sectional study. All underwent M-mode and two-dimensional echocardiography, color-flow imaging, pulsed and continuous-wave Doppler. In the SLE group, subjects exposed to antiphospholipid syndrome (n = 20) were compared to controls. Patients with SLE had significantly more mitral (p = 0.032; RR 2.48; 1.25-5.6) and tricuspid regurgitations (p = 0.0016; RR 2.41; 1.58-8.85). There was no significant difference between either group for mitral valve thickness (p = 0.66). The antiphospholipid syndrome was significantly associated with increased relative risk for tricuspid.

Published
1994

28. IgG4-related systemic disease: features and treatment response in a French cohort: results of a multicenter registry

Author

Emmanuel Andrès, Olivier Moranne, Véronique Veit, Pierre Aucouturier, Bertrand Godeau, Audrey Benyamine, Karin Mazodier, Christine Silvain, Laurent Daniel, Stéphane Burtey, Pascal Roblot, Gilles Kaplanski, José Boucraut, Pascal Sève, Mohamed Hamidou, Julien Haroche, Cédric Landron, Pierre-Jean Weiller, Anne-Bérengère Beucher, H. Rousset, Jean-Loup Pennaforte, Jean-Marie Berthelot, Jacques Serratrice, Noémie Jourde, Jean-Robert Harlé, Michel Pavic, Nicolas Schleinitz, F. Bernard, Laurent Chiche, Mikael Ebbo, Maïté Longy-Boursier, Marc Ruivard, Jean-Jacques Boffa, Brigitte Granel, Thomas Papo, and Emmanuelle Bernit

Subjects
Adult, Male, medicine.medical_specialty, Systemic disease, Treatment outcome, Cohort Studies, Young Adult, Internal medicine, Hypergammaglobulinemia, parasitic diseases, Follicular phase, medicine, Humans, Registries, Young adult, Aged, Aged, 80 and over, Sclerosis, biology, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Treatment Outcome, Polyclonal antibodies, Immunoglobulin G, Cohort, biology.protein, Female, France, business, Immunosuppressive Agents, Cohort study
Abstract

IgG4-related systemic disease is now recognized as a systemic disease that may affect various organs. The diagnosis is usually made in patients who present with elevated IgG4 in serum and tissue infiltration of diseased organs by numerous IgG4+ plasma cells, in the absence of validated diagnosis criteria. We report the clinical, laboratory, and histologic characteristics of 25 patients from a French nationwide cohort. We also report the treatment outcome and show that despite the efficacy of corticosteroids, a second-line treatment is frequently necessary. The clinical findings in our patients are not different from the results of previous reports from Eastern countries. Our laboratory and histologic findings, however, suggest, at least in some patients, a more broad polyclonal B cell activation than the skewed IgG4 switch previously reported. These observations strongly suggest the implication of a T-cell dependent B-cell polyclonal activation in IgG4-related systemic disease, probably at least in part under the control of T helper follicular cells.

Published
2011

29. Efficacy of vinblastine in central nervous system Langerhans cell histiocytosis: a nationwide retrospective study

Author

Karima Mokhtari, Mohamed Barkaoui, Marie-Anne Barthez, Catherine Garel, Dominique Plantaz, Anne Lambilliotte, Julien Haroche, Gérard Couillault, Jean Donadieu, Nadine Martin-Duverneuil, Khê Hoang-Xuan, Olivier Aumaître, Alain Robert, Perrine Marec Bérard, Ahmed Idbaih, Patrick Lutz, Anne-Sophie Defachelles, Jean Sibilia, Hubert Ducou Le Pointe, Jean-Loup Pennaforte, Ghislain Nokam Talom, Corinne Armari-Alla, Martine Munzer, Martine Gardembas, T Généreau, Judith Landman Parker, Sophie Ng Wing Tin, Renato Fior, Michel Polak, and Maria Ribeiro

Subjects
Adult, Central Nervous System, Male, medicine.medical_specialty, Adolescent, lcsh:Medicine, Vinblastine, Gastroenterology, Young Adult, Langerhans cell histiocytosis, Central Nervous System Diseases, Internal medicine, medicine, Humans, Genetics(clinical), Pharmacology (medical), Child, Adverse effect, Genetics (clinical), Retrospective Studies, Medicine(all), business.industry, Research, Standard treatment, lcsh:R, Infant, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Antineoplastic Agents, Phytogenic, Clinical trial, Histiocytosis, Langerhans-Cell, Histiocytosis, Treatment Outcome, Child, Preschool, Concomitant, Immunology, Female, Steroids, business, medicine.drug
Abstract

Background Vinblastine (VBL) is the standard treatment for systemic Langerhans cell histiocytosis (LCH), but little is known about its efficacy in central nervous system (CNS) mass lesions. Methods A retrospective chart review was conducted. Twenty patients from the French LCH Study Group register met the inclusion criteria. In brief, they had CNS mass lesions, had been treated with VBL, and were evaluable for radiologic response. Results The median age at diagnosis of LCH was 11.5 years (range: 1-50). Intravenous VBL 6 mg/m2 was given in a 6-week induction treatment, followed by a maintenance treatment. The median total duration was 12 months (range: 3-30). Eleven patients received steroids concomitantly. Fifteen patients achieved an objective response; five had a complete response (CR: 25%), ten had a partial response (PR: 50%), four had stable disease (SD: 20%) and one patient progressed (PD: 5%). Of interest, four out of the six patients who received VBL without concomitant steroids achieved an objective response. With a median follow-up of 6.8 years, the 5-year event-free and overall survival was 61% and 84%, respectively. VBL was well-tolerated and there were no patient withdrawals due to adverse events. Conclusion VBL, with or without steroids, could potentially be a useful therapeutic option in LCH with CNS mass lesions, especially for those with inoperable lesions or multiple lesions. Prospective clinical trials are warranted for the evaluation of VBL in this indication.

Published
2011

30. Late-onset lupus in the elderly after 75years: A rare cohort of six patients

Author

Rachid Mahmoudi, Jean Luc Novella, Jean-Loup Pennaforte, Abrar-Ahmad Zulfiqar, and T. Courtel

Subjects
Pediatrics, medicine.medical_specialty, Systemic lupus erythematosus, business.industry, Cohort, Medicine, Late onset, Geriatrics and Gerontology, business, medicine.disease, Gerontology
Published
2014

32. Pernicious anemia and iron deficiency: Possible link?

Author

Moustapha Dramé, Jean-Loup Pennaforte, Emmanuel Andrès, and Abrar-Ahmad Zulfiqar

Subjects
business.industry, Internal Medicine, medicine, Physiology, Iron deficiency, medicine.disease, business, pernicious anemia
Published
2013

36. Late-onset systemic lupus: Clinical and biological characteristics of a series of 13 patients

Author

Abrar-Ahmad Zulfiqar, T. Courtel, Jean Luc Novella, and Jean-Loup Pennaforte

Subjects
medicine.medical_specialty, business.industry, Systemic lupus, medicine.medical_treatment, Cancer, Late onset, Disease, Immunotherapy, medicine.disease, Response to treatment, Gastroenterology, Internal medicine, Internal Medicine, medicine, In patient, Subcutaneous edema, business
Abstract

weeks (shorter than in classical DM). In all cases the CK rises from low values to very high levels. In the few cases where it was documented aldolasewas positively correlatedwith CKvalues. Infive cases (over 15) a cancer was documented. It's remarkable that three of our patients had subcutaneous edema as the unique skin lesion. With respect to the treatment six patients received only corticosteroids as initial treatment. While one of them responded favorably, another one had only partial response, and the rest needed more aggressive immunotherapy including immunosuppressive agents and IVIG. Twelve patients received IVIG, of whom nine had complete resolution of symptoms. Three had no response to treatment and died. Conclusion: Subcutaneous edema is a rare manifestation in DM, usually presenting in patients with very severe and active disease. To promptly initiate aggressive treatment with immunosuppressive agents and IVIG associated to glucocorticoidsmight be helpful. Edematous DMpatients presents with shorter time evolution. Subcutaneous edema could be the only skin lesion at the presentation of the disease. Edematous DM would represent a paraneoplastic condition as well as classical DM, in 25– 30% of the cases.

Published
2013

38. Avascular necrosis of the femoral head as a complication of chronic myelogenous leukaemia

Author

Jean-Paul Eschard, Jean Leone, Jean-Pierre Vilque, J. C. Etienne, Bernard Pignon, Jean-Loup Pennaforte, and Claude Marcus

Subjects
Male, medicine.medical_specialty, medicine.diagnostic_test, Adolescent, business.industry, Magnetic resonance imaging, Avascular necrosis, Femur Head, medicine.disease, Magnetic Resonance Imaging, Surgery, Radiography, Femoral head, medicine.anatomical_structure, Bone scintigraphy, Femur Head Necrosis, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Orthopedic surgery, medicine, Humans, Radiology, Nuclear Medicine and imaging, Femur, business, Complication, Femoral neck
Abstract

A 17-year-old male patient complaining of intense pain in his right hip was found to be suffering from chronic myelogenous leukaemia. Preliminary X-rays and bone scintigraphy did not suggest avascular necrosis of the femoral head. Magnetic resonance imaging (MRI) did, however, reveal leukaemic infiltration of the femoral neck and generalised ischeamia in the femoral head. Further, MRI carried out 4 months later disclosed typical signs of osteonecrosis, despite previous indications of an improvement under chemotherapy. Flattening of the head of the femur appeared in radiographs taken in the 9th month. In the 12th month, recurrence of pain made it necessary to perform a total hip arthroplasty. Anatomo-pathological investigation confirmed both the necrosis and the leukaemic invasion.

Published
1996

39. Total lack of CR1 (C3b/C4b receptor, CD35) on erythrocytes in a lupus patient, homozygous for two SNP in the promoter of CR1 gene

Author

E. Lavalard, Jacques H. M. Cohen, Thierry Tabary, Aymric Kisserli, Wael Mahmoud, Bach-Nga Pham, Béatrice Donvito, M. Tonye Libyh, Valérie Duret, Fadi Haidar, Brigitte Reveil, and Jean-Loup Pennaforte

Subjects
Genetics, Systemic lupus erythematosus, Immunology, Cr1 gene, Cancer research, medicine, SNP, Biology, medicine.disease, Molecular Biology, C3b/C4b Receptor
Published
2009

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