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Hugues B, Ben Amer H, Bril F, Groh M, Huang F. Interleukin-1/6 Blockade for the Treatment of Severe Steroid-Refractory BNT162b2 Vaccine-Induced Adult-Onset Still’s Disease. Eur J Case Rep Intern Med 2022; 9:003469. [PMID: 36093302 PMCID: PMC9451514 DOI: 10.12890/2022_003469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Several immune-mediated side effects have been reported with COVID-19 vaccines, including myocarditis. Case description A 27-year-old woman with a past medical history of mild COVID-19, developed adult-onset Still’s disease (AOSD) with salmon-pink flagellate erythema, polyarthritis, a sore throat, myocarditis and haemophagocytic lymphohistiocytosis after receiving two doses of the BNT162b2 vaccine (Pfizer®, BioNTech®). Despite the initial efficacy of high-dose pulses of methylprednisolone, inflammatory markers rose as soon as de-escalation of corticosteroids was attempted, warranting initiation of biologics targeting the interleukin (IL)-1/6 axis, which allowed sustained remission of the disease despite withdrawal of corticosteroids. Discussion To our knowledge, this is the first case of AOSD with both haemophagocytic lymphohistiocytosis and cardiac magnetic resonance imaging-proven myocarditis triggered by COVID-19 vaccination, successfully treated with steroids and biologics targeting the IL-1/IL-6 axis. The pathophysiological process by which COVID-19 vaccination can lead to AOSD is still unknown, although it has been reported that the spike protein may act as a pathogen-associated molecular pattern and thus induce an overproduction of pro-inflammatory cytokines of the innate immune system (e.g., IL-1, IL-6 or IL-18). Conclusion Targeting the IL-1/6 axis is effective for the treatment of severe steroid-refractory BNT162b2 vaccine-induced adult-onset Still’s disease. At a population level, the favourable benefit/risk ratio of COVID-19 vaccination remains indisputable. LEARNING POINTS
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Audemard-Verger A, Le Gouge A, Pestre V, Courjon J, Langlois V, Vareil MO, Devaux M, Bienvenu B, Leroy V, Goulabchand R, Colombain L, Bigot A, Guimard T, Douadi Y, Urbanski G, Faucher JF, Maulin L, Lioger B, Talarmin JP, Groh M, Emmerich J, Deriaz S, Ferreira-Maldent N, Cook AR, Lengellé C, Bourgoin H, Mekinian A, Aouba A, Maillot F, Caille A. Efficacy and safety of anakinra in adults presenting deteriorating respiratory symptoms from COVID-19: A randomized controlled trial. PLoS One 2022; 17:e0269065. [PMID: 35925914 PMCID: PMC9351999 DOI: 10.1371/journal.pone.0269065] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/12/2022] [Indexed: 01/08/2023] Open
Abstract
Objective We aimed to investigate whether anakinra, an interleukin-1receptor inhibitor, could improve outcome in moderate COVID-19 patients. Methods In this controlled, open-label trial, we enrolled adults with COVID-19 requiring oxygen. We randomly assigned patients to receive intravenous anakinra plus optimized standard of care (oSOC) vs. oSOC alone. The primary outcome was treatment success at day 14 defined as patient alive and not requiring mechanical ventilation or extracorporeal membrane oxygenation. Results Between 27th April and 6th October 2020, we enrolled 71 patients (240 patients planned to been enrolled): 37 were assigned to the anakinra group and 34 to oSOC group. The study ended prematurely by recommendation of the data and safety monitoring board due to safety concerns. On day 14, the proportion of treatment success was significantly lower in the anakinra group 70% (n = 26) vs. 91% (n = 31) in the oSOC group: risk difference—21 percentage points (95% CI, -39 to -2), odds ratio 0.23 (95% CI, 0.06 to 0.91), p = 0.027. After a 28-day follow-up, 9 patients in the anakinra group and 3 in the oSOC group had died. Overall survival at day 28 was 75% (95% CI, 62% to 91%) in the anakinra group versus 91% (95% CI, 82% to 100%) (p = 0.06) in the oSOC group. Serious adverse events occurred in 19 (51%) patients in the anakinra group and 18 (53%) in the oSOC group (p = 0·89). Conclusion This trial did not show efficacy of anakinra in patients with COVID-19. Furthermore, contrary to our hypothesis, we found that anakinra was inferior to oSOC in patients with moderate COVID-19 pneumonia.
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Abud AA, Abi B, Acciarri R, Acero MA, Adames MR, Adamov G, Adamowski M, Adams D, Adinolfi M, Aduszkiewicz A, Aguilar J, Ahmad Z, Ahmed J, Aimard B, Ali-Mohammadzadeh B, Alion T, Allison K, Monsalve SA, AlRashed M, Alt C, Alton A, Alvarez R, Amedo P, Anderson J, Andreopoulos C, Andreotti M, Andrews M, Andrianala F, Andringa S, Anfimov N, Ankowski A, Antoniassi M, Antonova M, Antoshkin A, Antusch S, Aranda-Fernandez A, Arellano L, Arnold LO, Arroyave MA, Asaadi J, Asquith L, Aurisano A, Aushev V, Autiero D, Lara VA, Ayala-Torres M, Azfar F, Back A, Back H, Back JJ, Backhouse C, Bagaturia I, Bagby L, Balashov N, Balasubramanian S, Baldi P, Baller B, Bambah B, Barao F, Barenboim G, Alzas PB, Barker G, Barkhouse W, Barnes C, Barr G, Monarca JB, Barros A, Barros N, Barrow JL, Basharina-Freshville A, Bashyal A, Basque V, Batchelor C, Chagas EBD, Battat JBR, Battisti F, Bay F, Bazetto MCQ, Alba JLLB, Beacom JF, Bechetoille E, Behera B, Beigbeder C, Bellantoni L, Bellettini G, Bellini V, Beltramello O, Benekos N, Montiel CB, Neves FB, Berger J, Berkman S, Bernardini P, Berner RM, Bersani A, Bertolucci S, Betancourt M, Rodríguez AB, Bevan A, Bezawada Y, Bezerra TJC, Bhardwaj A, Bhatnagar V, Bhattacharjee M, Bhattarai D, Bhuller S, Bhuyan B, Biagi S, Bian J, Biassoni M, Biery K, Bilki B, Bishai M, Bitadze A, Blake A, Blaszczyk F, Blazey GC, Blucher E, Boissevain J, Bolognesi S, Bolton T, Bomben L, Bonesini M, Bongrand M, Bonilla-Diaz C, Bonini F, Booth A, Boran F, Bordoni S, Borkum A, Bostan N, Bour P, Bourgeois C, Boyden D, Bracinik J, Braga D, Brailsford D, Branca A, Brandt A, Bremer J, Breton D, Brew C, Brice SJ, Brizzolari C, Bromberg C, Brooke J, Bross A, Brunetti G, Brunetti M, Buchanan N, Budd H, Butorov I, Cagnoli I, Cai T, Caiulo D, Calabrese R, Calafiura P, Calcutt J, Calin M, Calvez S, Calvo E, Caminata A, Campanelli M, Caratelli D, Carber D, Carceller JC, Carini G, Carlus B, Carneiro MF, Carniti P, Terrazas IC, Carranza H, Carroll T, Forero JFC, Castillo A, Castromonte C, Catano-Mur E, Cattadori C, Cavalier F, Cavallaro G, Cavanna F, Centro S, Cerati G, Cervelli A, Villanueva AC, Chalifour M, Chappell A, Chardonnet E, Charitonidis N, Chatterjee A, Chattopadhyay S, Neyra MSSC, Chen H, Chen M, Chen Y, Chen Z, Chen-Wishart Z, Cheon Y, Cherdack D, Chi C, Childress S, Chirco R, Chiriacescu A, Chisnall G, Cho K, Choate S, Chokheli D, Chong PS, Christensen A, Christian D, Christodoulou G, Chukanov A, Chung M, Church E, Cicero V, Clarke P, Cline G, Coan TE, Cocco AG, Coelho JAB, Colton N, Conley E, Conley R, Conrad J, Convery M, Copello S, Cova P, Cremaldi L, Cremonesi L, Crespo-Anadón JI, Crisler M, Cristaldo E, Crnkovic J, Cross R, Cudd A, Cuesta C, Cui Y, Cussans D, Dalager O, da Motta H, Da Silva Peres L, David C, David Q, Davies GS, Davini S, Dawson J, De K, De S, Debbins P, De Bonis I, Decowski MP, De Gouvêa A, De Holanda PC, De Icaza Astiz IL, Deisting A, De Jong P, Delbart A, Delepine D, Delgado M, Dell’Acqua A, Delmonte N, De Lurgio P, de Mello Neto JRT, DeMuth DM, Dennis S, Densham C, Deptuch GW, De Roeck A, De Romeri V, De Souza G, Devi R, Dharmapalan R, Dias M, Diaz F, Díaz JS, Domizio SD, Giulio LD, Ding P, Noto LD, Dirkx G, Distefano C, Diurba R, Diwan M, Djurcic Z, Doering D, Dolan S, Dolek F, Dolinski M, Domine L, Donon Y, Douglas D, Douillet D, Dragone A, Drake G, Drielsma F, Duarte L, Duchesneau D, Duffy K, Dunne P, Dutta B, Duyang H, Dvornikov O, Dwyer D, Dyshkant A, Eads M, Earle A, Edmunds D, Eisch J, Emberger L, Emery S, Englezos P, Ereditato A, Erjavec T, Escobar C, Eurin G, Evans JJ, Ewart E, Ezeribe AC, Fahey K, Falcone A, Fani’ M, Farnese C, Farzan Y, Fedoseev D, Felix J, Feng Y, Fernandez-Martinez E, Menendez PF, Morales MF, Ferraro F, Fields L, Filip P, Filthaut F, Fiorini M, Fischer V, Fitzpatrick RS, Flanagan W, Fleming B, Flight R, Fogarty S, Foreman W, Fowler J, Fox W, Franc J, Francis K, Franco D, Freeman J, Freestone J, Fried J, Friedland A, Robayo FF, Fuess S, Furic IK, Furman K, Furmanski AP, Gabrielli A, Gago A, Gallagher H, Gallas A, Gallego-Ros A, Gallice N, Galymov V, Gamberini E, Gamble T, Ganacim F, Gandhi R, Gandrajula R, Gao F, Gao S, Garcia-Gamez D, García-Peris MÁ, Gardiner S, Gastler D, Gauvreau J, Ge G, Geffroy N, Gelli B, Gendotti A, Gent S, Ghorbani-Moghaddam Z, Giammaria P, Giammaria T, Giangiacomi N, Gibin D, Gil-Botella I, Gilligan S, Girerd C, Giri AK, Gnani D, Gogota O, Gold M, Gollapinni S, Gollwitzer K, Gomes RA, Bermeo LVG, Fajardo LSG, Gonnella F, Gonzalez-Diaz D, Gonzalez-Lopez M, Goodman MC, Goodwin O, Goswami S, Gotti C, Goudzovski E, Grace C, Gran R, Granados E, Granger P, Grant A, Grant C, Gratieri D, Green P, Greenler L, Greer J, Grenard J, Griffith WC, Groh M, Grudzinski J, Grzelak K, Gu W, Guardincerri E, Guarino V, Guarise M, Guenette R, Guerard E, Guerzoni M, Guffanti D, Guglielmi A, Guo B, Gupta A, Gupta V, Guthikonda KK, Gutierrez R, Guzowski P, Guzzo MM, Gwon S, Ha C, Haaf K, Habig A, Hadavand H, Haenni R, Hahn A, Haiston J, Hamacher-Baumann P, Hamernik T, Hamilton P, Han J, Harris DA, Hartnell J, Hartnett T, Harton J, Hasegawa T, Hasnip C, Hatcher R, Hatfield KW, Hatzikoutelis A, Hayes C, Hayrapetyan K, Hays J, Hazen E, He M, Heavey A, Heeger KM, Heise J, Henry S, Morquecho MAH, Herner K, Hewes J, Hilgenberg C, Hill T, Hillier SJ, Himmel A, Hinkle E, Hirsch LR, Ho J, Hoff J, Holin A, Hoppe E, Horton-Smith GA, Hostert M, Hourlier A, Howard B, Howell R, Hoyos J, Hristova I, Hronek MS, Huang J, Hulcher Z, Iles G, Ilic N, Iliescu AM, Illingworth R, Ingratta G, Ioannisian A, Irwin B, Isenhower L, Itay R, Jackson CM, Jain V, James E, Jang W, Jargowsky B, Jediny F, Jena D, Jeong YS, Jesús-Valls C, Ji X, Jiang L, Jiménez S, Jipa A, Johnson R, Johnson W, Johnston N, Jones B, Jones S, Judah M, Jung CK, Junk T, Jwa Y, Kabirnezhad M, Kaboth A, Kadenko I, Kakorin I, Kalitkina A, Kalra D, Kamiya F, Kaneshige N, Kaplan DM, Karagiorgi G, Karaman G, Karcher A, Karolak M, Karyotakis Y, Kasai S, Kasetti SP, Kashur L, Kazaryan N, Kearns E, Keener P, Kelly KJ, Kemp E, Kemularia O, Ketchum W, Kettell SH, Khabibullin M, Khotjantsev A, Khvedelidze A, Kim D, King B, Kirby B, Kirby M, Klein J, Klustova A, Kobilarcik T, Koehler K, Koerner LW, Koh DH, Kohn S, Koller PP, Kolupaeva L, Korablev D, Kordosky M, Kosc T, Kose U, Kostelecký VA, Kothekar K, Kralik R, Kreczko L, Krennrich F, Kreslo I, Kropp W, Kroupova T, Kubota S, Kudenko Y, Kudryavtsev VA, Kulagin S, Kumar J, Kumar P, Kunze P, Kurita N, Kuruppu C, Kus V, Kutter T, Kvasnicka J, Kwak D, Lambert A, Land B, Lane CE, Lang K, Langford T, Langstaff M, Larkin J, Lasorak P, Last D, Laundrie A, Laurenti G, Lawrence A, Lazanu I, LaZur R, Lazzaroni M, Le T, Leardini S, Learned J, LeBrun P, LeCompte T, Lee C, Lee SY, Miotto GL, Lehnert R, de Oliveira MAL, Leitner M, Lepin LM, Li SW, Li Y, Liao H, Lin CS, Lin Q, Lin S, Lineros RA, Ling J, Lister A, Littlejohn BR, Liu J, Liu Y, Lockwitz S, Loew T, Lokajicek M, Lomidze I, Long K, Lord T, LoSecco JM, Louis WC, Lu XG, Luk KB, Lunday B, Luo X, Luppi E, Lux T, Luzio VP, Maalmi J, MacFarlane D, Machado AA, Machado P, Macias CT, Macier JR, Maddalena A, Madera A, Madigan P, Magill S, Mahn K, Maio A, Major A, Maloney JA, Mandrioli G, Mandujano RC, Maneira J, Manenti L, Manly S, Mann A, Manolopoulos K, Plata MM, Manyam VN, Manzanillas L, Marchan M, Marchionni A, Marciano W, Marfatia D, Mariani C, Maricic J, Marie R, Marinho F, Marino AD, Marsden D, Marshak M, Marshall C, Marshall J, Marteau J, Martín-Albo J, Martinez N, Caicedo DAM, Miravé PM, Martynenko S, Mascagna V, Mason K, Mastbaum A, Matichard F, Matsuno S, Matthews J, Mauger C, Mauri N, Mavrokoridis K, Mawby I, Mazza R, Mazzacane A, Mazzucato E, McAskill T, McCluskey E, McConkey N, McFarland KS, McGrew C, McNab A, Mefodiev A, Mehta P, Melas P, Mena O, Mendez H, Mendez P, Méndez DP, Menegolli A, Meng G, Messier MD, Metcalf W, Mettler T, Mewes M, Meyer H, Miao T, Michna G, Miedema T, Mikola V, Milincic R, Miller G, Miller W, Mills J, Mineev O, Minotti A, Miranda OG, Miryala S, Mishra CS, Mishra SR, Mislivec A, Mitchell M, Mladenov D, Mocioiu I, Moffat K, Moggi N, Mohanta R, Mohayai TA, Mokhov N, Molina J, Bueno LM, Montagna E, Montanari A, Montanari C, Montanari D, Zetina LMM, Moon SH, Mooney M, Moor AF, Moreno D, Moretti D, Morris C, Mossey C, Mote M, Motuk E, Moura CA, Mousseau J, Mouster G, Mu W, Mualem L, Mueller J, Muether M, Mufson S, Muheim F, Muir A, Mulhearn M, Munford D, Muramatsu H, Murphy S, Musser J, Nachtman J, Nagu S, Nalbandyan M, Nandakumar R, Naples D, Narita S, Nath A, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Negishi K, Nelson JK, Nesbit J, Nessi M, Newbold D, Newcomer M, Newton H, Nichol R, Nicolas-Arnaldos F, Nikolica A, Niner E, Nishimura K, Norman A, Norrick A, Northrop R, Novella P, Nowak JA, Oberling M, Ochoa-Ricoux J, Olivier A, Olshevskiy A, Onel Y, Onishchuk Y, Ott J, Pagani L, Palacio G, Palamara O, Palestini S, Paley JM, Pallavicini M, Palomares C, Vazquez WP, Pantic E, Paolone V, Papadimitriou V, Papaleo R, Papanestis A, Paramesvaran S, Parke S, Parozzi E, Parsa Z, Parvu M, Pascoli S, Pasqualini L, Pasternak J, Pater J, Patrick C, Patrizii L, Patterson RB, Patton SJ, Patzak T, Paudel A, Paulos B, Paulucci L, Pavlovic Z, Pawloski G, Payne D, Pec V, Peeters SJM, Perez AP, Pennacchio E, Penzo A, Peres OLG, Perry J, Pershey D, Pessina G, Petrillo G, Petta C, Petti R, Pia V, Piastra F, Pickering L, Pietropaolo F, Pimentel VL, Pinaroli G, Plows K, Plunkett R, Poling R, Pompa F, Pons X, Poonthottathil N, Poppi F, Pordes S, Porter J, Potekhin M, Potenza R, Potukuchi BVKS, Pozimski J, Pozzato M, Prakash S, Prakash T, Prest M, Prince S, Psihas F, Pugnere D, Qian X, Raaf JL, Radeka V, Rademacker J, Radics B, Rafique A, Raguzin E, Rai M, Rajaoalisoa M, Rakhno I, Rakotonandrasana A, Rakotondravohitra L, Rameika R, Delgado MAR, Ramson B, Rappoldi A, Raselli G, Ratoff P, Raut S, Razakamiandra RF, Rea EM, Real JS, Rebel B, Rechenmacher R, Reggiani-Guzzo M, Reichenbacher J, Reitzner SD, Sfar HR, Renshaw A, Rescia S, Resnati F, Ribas M, Riboldi S, Riccio C, Riccobene G, Rice LCJ, Ricol JS, Rigamonti A, Rigaut Y, Rincón EV, Ritchie-Yates H, Rivera D, Robert A, Rochester L, Roda M, Rodrigues P, Alonso MJR, Bonilla ER, Rondon JR, Rosauro-Alcaraz S, Rosenberg M, Rosier P, Roskovec B, Rossella M, Rossi M, Rout J, Roy P, Rubbia A, Rubbia C, Russell B, Ruterbories D, Rybnikov A, Saa-Hernandez A, Saakyan R, Sacerdoti S, Safford T, Sahu N, Sakashita K, Sala P, Samios N, Samoylov O, Sanchez MC, Sandberg V, Sanders DA, Sankey D, Santana S, Santos-Maldonado M, Saoulidou N, Sapienza P, Sarasty C, Sarcevic I, Savage G, Savinov V, Scaramelli A, Scarff A, Scarpelli A, Schefke T, Schellman H, Schifano S, Schlabach P, Schmitz D, Schneider AW, Scholberg K, Schukraft A, Segreto E, Selyunin A, Senise CR, Sensenig J, Sergi A, Sgalaberna D, Shaevitz MH, Shafaq S, Shaker F, Shamma M, Sharankova R, Sharma HR, Sharma R, Sharma RK, Shaw T, Shchablo K, Shepherd-Themistocleous C, Sheshukov A, Shin S, Shoemaker I, Shooltz D, Shrock R, Siegel H, Simard L, Sinclair J, Sinev G, Singh J, Singh J, Singh L, Singh P, Singh V, Sipos R, Sippach FW, Sirri G, Sitraka A, Siyeon K, Skarpaas K, Smith A, Smith E, Smith P, Smolik J, Smy M, Snider E, Snopok P, Snowden-Ifft D, Nunes MS, Sobel H, Soderberg M, Sokolov S, Salinas CJS, Söldner-Rembold S, Soleti SR, Solomey N, Solovov V, Sondheim WE, Sorel M, Sotnikov A, Soto-Oton J, Ugaldi FAS, Sousa A, Soustruznik K, Spagliardi F, Spanu M, Spitz J, Spooner NJC, Spurgeon K, Stancari M, Stanco L, Stanford C, Stein R, Steiner HM, Lisbôa AFS, Stewart J, Stillwell B, Stock J, Stocker F, Stokes T, Strait M, Strauss T, Strigari L, Stuart A, Suarez JG, Sunción JMS, Sullivan H, Summers D, Surdo A, Susic V, Suter L, Sutera CM, Svoboda R, Szczerbinska B, Szelc AM, Tanaka H, Tang S, Tapia A, Oregui BT, Tapper A, Tariq S, Tarpara E, Tata N, Tatar E, Tayloe R, Teklu AM, Tennessen P, Tenti M, Terao K, Ternes CA, Terranova F, Testera G, Thakore T, Thea A, Thompson JL, Thorn C, Timm SC, Tishchenko V, Tomassetti L, Tonazzo A, Torbunov D, Torti M, Tortola M, Tortorici F, Tosi N, Totani D, Toups M, Touramanis C, Travaglini R, Trevor J, Trilov S, Trzaska WH, Tsai Y, Tsai YT, Tsamalaidze Z, Tsang KV, Tsverava N, Tufanli S, Tull C, Tyley E, Tzanov M, Uboldi L, Uchida MA, Urheim J, Usher T, Uzunyan S, Vagins MR, Vahle P, Valder S, Valdiviesso GDA, Valencia E, Valentim R, Vallari Z, Vallazza E, Valle JWF, Vallecorsa S, Berg RV, de Water RGV, Forero DV, Vannerom D, Varanini F, Oliva DV, Varner G, Vasel J, Vasina S, Vasseur G, Vaughan N, Vaziri K, Ventura S, Verdugo A, Vergani S, Vermeulen MA, Verzocchi M, Vicenzi M, de Souza HV, Vignoli C, Vilela C, Viren B, Vrba T, Wachala T, Waldron AV, Wallbank M, Wallis C, Wang H, Wang J, Wang L, Wang MHLS, Wang X, Wang Y, Wang Y, Warburton K, Warner D, Wascko MO, Waters D, Watson A, Wawrowska K, Weatherly P, Weber A, Weber M, Wei H, Weinstein A, Wenman D, Wetstein M, White A, Whitehead LH, Whittington D, Wilking MJ, Wilkinson A, Wilkinson C, Williams Z, Wilson F, Wilson RJ, Wisniewski W, Wolcott J, Wongjirad T, Wood A, Wood K, Worcester E, Worcester M, Wresilo K, Wret C, Wu W, Wu W, Xiao Y, Xie F, Yaeggy B, Yandel E, Yang G, Yang K, Yang T, Yankelevich A, Yershov N, Yonehara K, Yoon YS, Young T, Yu B, Yu H, Yu H, Yu J, Yu Y, Yuan W, Zaki R, Zalesak J, Zambelli L, Zamorano B, Zani A, Zazueta L, Zeller GP, Zennamo J, Zeug K, Zhang C, Zhang S, Zhang Y, Zhao M, Zhivun E, Zhu G, Zimmerman ED, Zucchelli S, Zuklin J, Zutshi V, Zwaska R. Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2022; 82:618. [PMID: 35859696 PMCID: PMC9288420 DOI: 10.1140/epjc/s10052-022-10549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6 × 6 × 6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.
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Berdugo K, Radulescu C, Groh M, Peycelon M, Ciofu C, Clermidi P, Trefond L, Lefèvre G, Lanz C, Yonneau L, Aigrain Y, Chabaud M, Grapin C, Cathébras P, Chartier Kastler E, Berrebi D, Panel K, Kahn J. Cystite à éosinophiles idiopathique : analyse des caractéristiques cliniques, radiologiques, évolutives et de la réponse thérapeutique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ammirati E, Bizzi E, Veronese G, Groh M, Van de Heyning CM, Lehtonen J, Pineton de Chambrun M, Cereda A, Picchi C, Trotta L, Moslehi JJ, Brucato A. Immunomodulating Therapies in Acute Myocarditis and Recurrent/Acute Pericarditis. Front Med (Lausanne) 2022; 9:838564. [PMID: 35350578 PMCID: PMC8958011 DOI: 10.3389/fmed.2022.838564] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
The field of inflammatory disease of the heart or "cardio-immunology" is rapidly evolving due to the wider use of non-invasive diagnostic tools able to detect and monitor myocardial inflammation. In acute myocarditis, recent data on the use of immunomodulating therapies have been reported both in the setting of systemic autoimmune disorders and in the setting of isolated forms, especially in patients with specific histology (e.g., eosinophilic myocarditis) or with an arrhythmicburden. A role for immunosuppressive therapies has been also shown in severe cases of coronavirus disease 2019 (COVID-19), a condition that can be associated with cardiac injury and acute myocarditis. Furthermore, ongoing clinical trials are assessing the role of high dosage methylprednisolone in the context of acute myocarditis complicated by heart failure or fulminant presentation or the role of anakinra to treat patients with acute myocarditis excluding patients with hemodynamically unstable conditions. In addition, the explosion of immune-mediated therapies in oncology has introduced new pathophysiological entities, such as immune-checkpoint inhibitor-associated myocarditis and new basic research models to understand the interaction between the cardiac and immune systems. Here we provide a broad overview of evolving areas in cardio-immunology. We summarize the use of new imaging tools in combination with endomyocardial biopsy and laboratory parameters such as high sensitivity troponin to monitor the response to immunomodulating therapies based on recent evidence and clinical experience. Concerning pericarditis, the normal composition of pericardial fluid has been recently elucidated, allowing to assess the actual presence of inflammation; indeed, normal pericardial fluid is rich in nucleated cells, protein, albumin, LDH, at levels consistent with inflammatory exudates in other biological fluids. Importantly, recent findings showed how innate immunity plays a pivotal role in the pathogenesis of recurrent pericarditis with raised C-reactive protein, with inflammasome and IL-1 overproduction as drivers for systemic inflammatory response. In the era of tailored medicine, anti-IL-1 agents such as anakinra and rilonacept have been demonstrated highly effective in patients with recurrent pericarditis associated with an inflammatory phenotype.
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Delcros Q, Groh M, Nasser M, Kahn JE, Cottin V. Steroid alternatives for managing eosinophilic lung diseases. Expert Opin Orphan Drugs 2021. [DOI: 10.1080/21678707.2021.2003777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gaillet A, Bay P, Peju E, Faguer S, Pineton De Chambrun M, Larcher R, Mekontso-Dessap A, Kahn J, Dargent A, Herault A, Groh M. Épidémiologie, présentation clinique, évolution et facteurs pronostics de survie des patients présentant une éosinophilie en réanimation : étude de cohorte nationale multicentrique rétrospective, à propos de 620 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Delplanque M, Aouba A, Hirsch P, Fenaux P, Graveleau J, Malard F, Roos-Weil D, Belfeki N, Drevon L, Oganesyan A, Groh M, Mahévas M, Razanamahery J, Maigne G, Décamp M, Miranda S, Quemeneur T, Rossignol J, Sailler L, Sébert M, Terriou L, Sevoyan A, Hakobyan Y, Georgin-Lavialle S, Mekinian A. USAID Associated with Myeloid Neoplasm and VEXAS Syndrome: Two Differential Diagnoses of Suspected Adult Onset Still's Disease in Elderly Patients. J Clin Med 2021; 10:jcm10235586. [PMID: 34884286 PMCID: PMC8658409 DOI: 10.3390/jcm10235586] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Patients with solid cancers and hematopoietic malignancy can experience systemic symptoms compatible with adult-onset Still’s disease (AOSD). The newly described VEXAS, associated with somatic UBA1 mutations, exhibits an overlap of clinical and/or biological pictures with auto inflammatory signs and myelodysplastic syndrome (MDS). Objectives: To describe a cohort of patients with signs of undifferentiated systemic autoinflammatory disorder (USAID) concordant with AOSD and MDS/chronic myelomonocytic leukemia (CMML) and the prevalence of VEXAS proposed management and outcome. Methods: A French multicenter retrospective study from the MINHEMON study group also used for other published works with the support of multidisciplinary and complementary networks of physicians and a control group of 104 MDS/CMML. Results: Twenty-six patients were included with a median age at first signs of USAID of 70.5 years with male predominance (4:1). Five patients met the criteria for confirmed AOSD. The most frequent subtypes were MDS with a blast excess (31%) and MDS with multilineage dysplasia (18%). Seven patients presented with acute myeloid leukemia and twelve died during a median follow-up of 2.5 years. Six out of 18 tested patients displayed a somatic UBA1 mutation concordant with VEXAS, including one woman. High-dose corticosteroids led to a response in 13/16 cases and targeted biological therapy alone or in association in 10/12 patients (anakinra, tocilizumab, and infliximab). Azacytidine resulted in complete or partial response in systemic symptoms for 10/12 (83%) patients including 3 VEXAS. Conclusions: Systemic form of VEXAS syndrome can mimic AOSD. The suspicion of USAID or AOSD in older males with atypia should prompt an evaluation of underlying MDS and assessment of somatic UBA1 mutation.
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Gibelin A, Dumas G, Valade S, de Chambrun MP, Bagate F, Neuville M, Schneider F, Baboi L, Groh M, Raphalen JH, Chiche JD, De Prost N, Luyt CE, Guérin C, Maury E, de Montmollin E, Hertig A, Parrot A, Clere-Jehl R, Fartoukh M. Causes of acute respiratory failure in patients with small-vessel vasculitis admitted to intensive care units: a multicenter retrospective study. Ann Intensive Care 2021; 11:158. [PMID: 34817718 PMCID: PMC8613321 DOI: 10.1186/s13613-021-00946-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/02/2021] [Indexed: 12/11/2022] Open
Abstract
RATIONALE Acute respiratory failure (ARF) in patients admitted to the intensive care unit (ICU) with known or de novo small-vessel vasculitis (Svv) may be secondary to the underlying immune disease or to other causes. Early identification of the cause of ARF is essential to initiate the most appropriate treatment in a timely fashion. METHODS A retrospective multicenter study in 10 French ICUs from January 2007 to January 2018 to assess the clinical presentation, main causes and outcome of ARF associated with Svv, and to identify variables associated with non-immune etiology of ARF in patients with known Svv. RESULTS During the study period, 121 patients [62 (50-75) years; 62% male; median SAPSII and SOFA scores 39 (27-52) and 6 (4-8), respectively] were analyzed. An immune cause was identified in 67 (55%), and a non-immune cause in 54 (45%) patients. ARF was associated with several causes in 43% (n = 52) of cases. The main immune cause was diffuse alveolar hemorrhage (DAH) (n = 47, 39%), whereas the main non-immune cause was pulmonary infection (n = 35, 29%). The crude 90-day and 1-year mortality were higher in patients with non-immune ARF, as compared with their counterparts (32% and 38% vs. 15% and 20%, respectively; both p = 0.03), but was marginally significantly higher after adjusted analysis in a Cox model (p = 0.053). Among patients with a known Svv (n = 70), immunosuppression [OR 9.41 (1.52-58.3); p = 0.016], and a low vasculitis activity score [0.84 (0.77-0.93)] were independently associated with a non-immune cause, after adjustment for the time from disease onset to ARF, time from respiratory symptoms to ICU admission, and severe renal failure. CONCLUSIONS An extensive diagnosis workup is mandatory in ARF revealing or complicating Svv. Non-immune causes are involved in 43% of cases, and their short and mid-term prognosis may be poorer than those of immune ARF. Readily identified predictive factors of a non-immune cause could help avoiding unnecessary immunosuppressive therapies.
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Acero MA, Adamson P, Aliaga L, Anfimov N, Antoshkin A, Arrieta-Diaz E, Asquith L, Aurisano A, Back A, Backhouse C, Baird M, Balashov N, Baldi P, Bambah BA, Bashar S, Bays K, Bernstein R, Bhatnagar V, Bhuyan B, Bian J, Blair J, Booth AC, Bowles R, Bromberg C, Buchanan N, Butkevich A, Calvez S, Carroll TJ, Catano-Mur E, Choudhary BC, Christensen A, Coan TE, Colo M, Cremonesi L, Davies GS, Derwent PF, Ding P, Djurcic Z, Dolce M, Doyle D, Dueñas Tonguino D, Dukes EC, Duyang H, Edayath S, Ehrlich R, Elkins M, Ewart E, Feldman GJ, Filip P, Franc J, Frank MJ, Gallagher HR, Gandrajula R, Gao F, Giri A, Gomes RA, Goodman MC, Grichine V, Groh M, Group R, Guo B, Habig A, Hakl F, Hall A, Hartnell J, Hatcher R, Hausner H, Heller K, Hewes J, Himmel A, Holin A, Huang J, Jargowsky B, Jarosz J, Jediny F, Johnson C, Judah M, Kakorin I, Kalra D, Kalitkina A, Kaplan DM, Keloth R, Klimov O, Koerner LW, Kolupaeva L, Kotelnikov S, Kralik R, Kullenberg C, Kubu M, Kumar A, Kuruppu CD, Kus V, Lackey T, Lasorak P, Lang K, Lesmeister J, Lin S, Lister A, Liu J, Lokajicek M, Magill S, Manrique Plata M, Mann WA, Marshak ML, Martinez-Casales M, Matveev V, Mayes B, Méndez DP, Messier MD, Meyer H, Miao T, Miller WH, Mishra SR, Mislivec A, Mohanta R, Moren A, Morozova A, Mu W, Mualem L, Muether M, Mulder K, Naples D, Nayak N, Nelson JK, Nichol R, Niner E, Norman A, Norrick A, Nosek T, Oh H, Olshevskiy A, Olson T, Ott J, Paley J, Patterson RB, Pawloski G, Petrova O, Petti R, Phan DD, Plunkett RK, Porter JCC, Rafique A, Raj V, Rajaoalisoa M, Ramson B, Rebel B, Rojas P, Ryabov V, Samoylov O, Sanchez MC, Sánchez Falero S, Shanahan P, Sheshukov A, Singh P, Singh V, Smith E, Smolik J, Snopok P, Solomey N, Sousa A, Soustruznik K, Strait M, Suter L, Sutton A, Swain S, Sweeney C, Tapia Oregui B, Tas P, Thakore T, Thayyullathil RB, Thomas J, Tiras E, Tripathi J, Trokan-Tenorio J, Tsaris A, Torun Y, Urheim J, Vahle P, Vallari Z, Vasel J, Vokac P, Vrba T, Wallbank M, Warburton TK, Wetstein M, Whittington D, Wickremasinghe DA, Wojcicki SG, Wolcott J, Wu W, Xiao Y, Yallappa Dombara A, Yonehara K, Yu S, Yu Y, Zadorozhnyy S, Zalesak J, Zhang Y, Zwaska R. Search for Active-Sterile Antineutrino Mixing Using Neutral-Current Interactions with the NOvA Experiment. PHYSICAL REVIEW LETTERS 2021; 127:201801. [PMID: 34860065 DOI: 10.1103/physrevlett.127.201801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/30/2021] [Indexed: 06/13/2023]
Abstract
This Letter reports results from the first long-baseline search for sterile antineutrinos mixing in an accelerator-based antineutrino-dominated beam. The rate of neutral-current interactions in the two NOvA detectors, at distances of 1 and 810 km from the beam source, is analyzed using an exposure of 12.51×10^{20} protons-on-target from the NuMI beam at Fermilab running in antineutrino mode. A total of 121 of neutral-current candidates are observed at the far detector, compared to a prediction of 122±11(stat.)±15(syst.) assuming mixing only between three active flavors. No evidence for ν[over ¯]_{μ}→ν[over ¯]_{s} oscillation is observed. Interpreting this result within a 3+1 model, constraints are placed on the mixing angles θ_{24}<25° and θ_{34}<32° at the 90% C.L. for 0.05 eV^{2}≤Δm_{41}^{2}≤0.5 eV^{2}, the range of mass splittings that produces no significant oscillations at the near detector. These are the first 3+1 confidence limits set using long-baseline accelerator antineutrinos.
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Chastagner M, Shourik J, Jachiet M, Battistella M, Lefevre G, Gibier JB, Aubert H, Musquer M, Descamps V, Deschamps L, Chosidow O, Ortonne N, Groh M, Bernier M, Jullien D, Chasset F, Staumont-Salle D, Bouaziz JD, Kanitakis J, Villani AP. Treatment of Eosinophilic Annular Erythema: Retrospective multicenter study and literature review. Ann Dermatol Venereol 2021; 149:123-127. [PMID: 34716028 DOI: 10.1016/j.annder.2021.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/21/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Eosinophilic annular erythema (EAE) is a rare eosinophil-related skin disease which typically manifests with annular erythematous plaques and severe pruritus. Besides the diagnosis, the treatment of EAE is challenging since relevant published data are sparse. METHODS The aim of this study was to assess the underlying diseases, treatments and outcomes of patients with EAE. To this end, we conducted a retrospective multicenter study and a systematic review of the MEDLINE database. RESULTS We included 18 patients with EAE followed in 8 centers. The MEDLINE database search yielded 37 relevant publications reporting 55 cases of EAE with 106 treatment sequences. The most common and efficient treatments included topical or systemic corticosteroids, hydroxychloroquine and dapsone. In refractory patients, a combination of systemic corticosteroids with hydroxychloroquine was associated with 88% of complete clinical response. DISCUSSION To improve the management of EAE patients, we discuss the following treatment strategy: in topical steroid-resistant patients, hydroxychloroquine can be given as first-line systemic treatment. Dapsone, hydroxychloroquine or systemic corticosteroids are second-line options to consider. Last, monoclonal antibodies or JAK inhibitors targeting type 2 inflammation could represent promising last-resort options in refractory patients.
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Tennenbaum J, Groh M, Venditti L, Campos-Gazeau F, Chalayer E, De Broucker T, Hamidou M, Hunault M, Lyoubi A, Meunier R, Muron T, Sène D, Slama B, Guidoux C, Lefèvre G, Kahn JE, Denier C, Rohmer J. FIP1L1-PDGFRA-Associated Hypereosinophilic Syndrome as a Treatable Cause of Watershed Infarction. Stroke 2021; 52:e605-e609. [PMID: 34304603 DOI: 10.1161/strokeaha.121.034191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Ischemic stroke has been reported in various conditions associated with eosinophilia. FIP1L1-PDGFRA fusion ([Fip1-like 1-platelet-derived growth factor receptor alpha]; F/P) leads to the proliferation of the eosinophilic lineage and thus to a clonal hypereosinophilic syndrome that is highly responsive to imatinib. METHODS We previously reported on a nationwide retrospective study of 151 patients with F/P-associated clonal hypereosinophilic syndrome. Patients from this cohort with a clinical history of ischemic stroke (as well as 2 additional cases) were further analyzed to better define their clinical picture and outcomes. RESULTS Sixteen male patients (median age, 51 [43-59] years) with low-to-intermediate cardiovascular risk were included. Median National Institutes of Health Stroke Scale was 4 (range, 1-6). Most cerebral imaging disclosed multiple bilateral infarctions of watershed distribution (69%). Despite frequent cardiac involvement (50%), cardiac thrombus was evidenced in a single patient and, according to the TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment), 62.5% of strokes were presumably of undetermined etiology. Among the 15 patients treated with imatinib, and after a median follow-up of 4.5 years, stroke recurred in only 3 patients (consisting of either cardio embolic or hemorrhagic events, unrelated to the first episode). CONCLUSIONS F/P+ clonal hypereosinophilic syndrome is a diagnosis to consider in patients with unexplained ischemic stroke and hypereosinophilia (especially in the setting of multiple cortical borderzone distribution) and warrants prompt initiation of imatinib.
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Lozano-Sanchez F, Ursu R, Di-Stefano AL, Ducray F, Younan N, Touat M, Groh M, Agguini H, Belin C, Garnier L, Delattre JY, Carpentier A, Idbaih A. Descriptive and retrospective analysis of diffuse glioma patients with symptomatic SARS-CoV2 infection during the first wave of the pandemic. Neurooncol Adv 2021; 3:vdab078. [PMID: 34396128 PMCID: PMC8360904 DOI: 10.1093/noajnl/vdab078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Little is known about diffuse glioma patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Methods We performed a descriptive and retrospective analysis of 41 diffuse glioma patients with symptomatic SARS-CoV2 infection during the first wave of the COVID-19 pandemic. Results Confusion with or without fever was the most common neurological symptom (32%) supporting SARS-CoV2 testing in glioma patients with acute and unexplained confusion. Sixteen patients (39%) died after a median delay of 13 days. While multiple clinical, biological, and pathological features, COVID-19- or diffuse glioma-related, at hospital admission appeared to have a pejorative prognostic impact, none was significantly associated with death. Oncological treatments were interrupted at COVID-19 diagnosis and re-initiated with a median delay of 30 days after the end of COVID-19 symptoms. Conclusions Interestingly, our retrospective study describes for the first time the characteristics of a cohort of diffuse glioma patients with symptomatic COVID-19. Diffuse glioma patients with poorly symptomatic COVID-19 did not come to the attention of physicians and were not enrolled in the study skewing the denominator for prognostic analysis. Further studies are warranted to specify prognosis of overall population of diffuse glioma patients with COVID-19, including asymptomatic patients, and interactions of prognostic factors of both COVID-19 and diffuse gliomas.
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Réau V, Terrier B, Ackermann F, Killian M, Hamidou M, Meyer G, Osorio-Perez F, Rohmer J, Lefèvre G, Kahn J, Groh M. Présentation clinique et facteurs de risque de rechute au cours des thromboses veineuses associées à une hyperéosinophilie : étude multicentrique rétrospective à propos de 54 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rohmer J, Bladé J, Cony Makhoul P, Cottin V, Ebbo M, Fain O, Galicier L, Guffroy A, Hamidou M, Hunault-Berger M, Lengline E, Machelart I, Nicolini F, Tavitian S, Rousselot P, Lhomme F, Lefèvre G, Kahn J, Groh M. Caractéristiques cliniques, évolution à long terme et facteurs prédictifs de rechute après arrêt de l’Imatinib au cours de leucémie chronique à éosinophiles associée au réarrangement FIP1L1-PDGFRA : étude rétrospective à propos de 151 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Groh M, Pineton de Chambrun M, Georges JL, Panel K, Lefèvre G, Kahn JE, Tcherakian C, Convers-Domart R. Recurrent cardiac arrest due to eosinophilia-related coronary vasospasm successfully treated by benralizumab. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3497-3499.e1. [PMID: 34020050 DOI: 10.1016/j.jaip.2021.04.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022]
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Hadjadj J, Gaube G, Groh M, Paule R, Salah S, Hoogewoud F, Blanche P, Mouthon L, Monnet D, Le Jeunne C, Brézin A, Terrier B. The Clinical Spectrum and Outcome of Uveomeningitis: A Comprehensive Analysis of 110 Cases. Ocul Immunol Inflamm 2021; 30:1489-1494. [PMID: 33974484 DOI: 10.1080/09273948.2021.1898000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: Uveitis can be associated with meningitis (uveomeningitis) and the inflammation shared with the central nervous system. We aimed to describe the characteristics and outcome of uveomeningitis.Methods: We retrospectively analyzed 110 consecutive adult patients with uveomeningitis.Results: The main causes of uveomeningitis were Vogt-Koyanagi-Harada (31%), syphilis (16%), sarcoidosis (12%), Behçet's disease (7%), and multiple sclerosis (5%). Sixteen percent of uveomeningitis remained of undetermined origin. Compared to etiology-matched uveitis without meningitis, patients with uveomeningitis were younger, had more frequent neurological manifestations, and had more frequent abnormal cerebral magnetic resonance imaging findings. In contrast, no ocular feature upon examination was significantly associated with the presence of meningitis. Patients with uveomeningitis were more frequently treated with immunosuppressants but uveitis relapse and systemic complications did not differ between groups.Conclusion: Uveomeningitis is associated with a limited spectrum of diseases. Meningitis does not seem to impact ocular and extraocular outcomes. Therefore, lumbar puncture should be performed on an individual basis during the diagnostic workup of uveitis.
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Descamps V, Deschamps L, El Khalifa J, Groh M, Gibier JB, Lefèvre G, Taillé C. Eosinophilic vasculitis associated with persistent dupilumab-induced hypereosinophilia in severe asthma. Respir Med Res 2021; 79:100821. [PMID: 33984814 DOI: 10.1016/j.resmer.2021.100821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 01/01/2023]
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Abi B, Acciarri R, Acero MA, Adamov G, Adams D, Adinolfi M, Ahmad Z, Ahmed J, Alion T, Monsalve SA, Alt C, Anderson J, Andreopoulos C, Andrews MP, Andrianala F, Andringa S, Ankowski A, Antonova M, Antusch S, Aranda-Fernandez A, Ariga A, Arnold LO, Arroyave MA, Asaadi J, Aurisano A, Aushev V, Autiero D, Azfar F, Back H, Back JJ, Backhouse C, Baesso P, Bagby L, Bajou R, Balasubramanian S, Baldi P, Bambah B, Barao F, Barenboim G, Barker GJ, Barkhouse W, Barnes C, Barr G, Monarca JB, Barros N, Barrow JL, Bashyal A, Basque V, Bay F, Alba JLB, Beacom JF, Bechetoille E, Behera B, Bellantoni L, Bellettini G, Bellini V, Beltramello O, Belver D, Benekos N, Neves FB, Berger J, Berkman S, Bernardini P, Berner RM, Berns H, Bertolucci S, Betancourt M, Bezawada Y, Bhattacharjee M, Bhuyan B, Biagi S, Bian J, Biassoni M, Biery K, Bilki B, Bishai M, Bitadze A, Blake A, Siffert BB, Blaszczyk FDM, Blazey GC, Blucher E, Boissevain J, Bolognesi S, Bolton T, Bonesini M, Bongrand M, Bonini F, Booth A, Booth C, Bordoni S, Borkum A, Boschi T, Bostan N, Bour P, Boyd SB, Boyden D, Bracinik J, Braga D, Brailsford D, Brandt A, Bremer J, Brew C, Brianne E, Brice SJ, Brizzolari C, Bromberg C, Brooijmans G, Brooke J, Bross A, Brunetti G, Buchanan N, Budd H, Caiulo D, Calafiura P, Calcutt J, Calin M, Calvez S, Calvo E, Camilleri L, Caminata A, Campanelli M, Caratelli D, Carini G, Carlus B, Carniti P, Terrazas IC, Carranza H, Castillo A, Castromonte C, Cattadori C, Cavalier F, Cavanna F, Centro S, Cerati G, Cervelli A, Villanueva AC, Chalifour M, Chang C, Chardonnet E, Chatterjee A, Chattopadhyay S, Chaves J, Chen H, Chen M, Chen Y, Cherdack D, Chi C, Childress S, Chiriacescu A, Cho K, Choubey S, Christensen A, Christian D, Christodoulou G, Church E, Clarke P, Coan TE, Cocco AG, Coelho JAB, Conley E, Conrad JM, Convery M, Corwin L, Cotte P, Cremaldi L, Cremonesi L, Crespo-Anadón JI, Cristaldo E, Cross R, Cuesta C, Cui Y, Cussans D, Dabrowski M, da Motta H, Peres LDS, David C, David Q, Davies GS, Davini S, Dawson J, De K, De Almeida RM, Debbins P, De Bonis I, Decowski MP, de Gouvêa A, De Holanda PC, De Icaza Astiz IL, Deisting A, De Jong P, Delbart A, Delepine D, Delgado M, Dell’Acqua A, De Lurgio P, de Mello Neto JRT, DeMuth DM, Dennis S, Densham C, Deptuch G, De Roeck A, De Romeri V, De Vries JJ, Dharmapalan R, Dias M, Diaz F, Díaz JS, Di Domizio S, Di Giulio L, Ding P, Di Noto L, Distefano C, Diurba R, Diwan M, Djurcic Z, Dokania N, Dolinski MJ, Domine L, Douglas D, Drielsma F, Duchesneau D, Duffy K, Dunne P, Durkin T, Duyang H, Dvornikov O, Dwyer DA, Dyshkant AS, Eads M, Edmunds D, Eisch J, Emery S, Ereditato A, Escobar CO, Sanchez LE, Evans JJ, Ewart E, Ezeribe AC, Fahey K, Falcone A, Farnese C, Farzan Y, Felix J, Fernandez-Martinez E, Fernandez Menendez P, Ferraro F, Fields L, Filkins A, Filthaut F, Fitzpatrick RS, Flanagan W, Fleming B, Flight R, Fowler J, Fox W, Franc J, Francis K, Franco D, Freeman J, Freestone J, Fried J, Friedland A, Fuess S, Furic I, Furmanski AP, Gago A, Gallagher H, Gallego-Ros A, Gallice N, Galymov V, Gamberini E, Gamble T, Gandhi R, Gandrajula R, Gao S, Garcia-Gamez D, García-Peris MÁ, Gardiner S, Gastler D, Ge G, Gelli B, Gendotti A, Gent S, Ghorbani-Moghaddam Z, Gibin D, Gil-Botella I, Girerd C, Giri AK, Gnani D, Gogota O, Gold M, Gollapinni S, Gollwitzer K, Gomes RA, Bermeo LVG, Fajardo LSG, Gonnella F, Gonzalez-Cuevas JA, Goodman MC, Goodwin O, Goswami S, Gotti C, Goudzovski E, Grace C, Graham M, Gramellini E, Gran R, Granados E, Grant A, Grant C, Gratieri D, Green P, Green S, Greenler L, Greenwood M, Greer J, Griffith WC, Groh M, Grudzinski J, Grzelak K, Gu W, Guarino V, Guenette R, Guglielmi A, Guo B, Guthikonda KK, Gutierrez R, Guzowski P, Guzzo MM, Gwon S, Habig A, Hackenburg A, Hadavand H, Haenni R, Hahn A, Haigh J, Haiston J, Hamernik T, Hamilton P, Han J, Harder K, Harris DA, Hartnell J, Hasegawa T, Hatcher R, Hazen E, Heavey A, Heeger KM, Heise J, Hennessy K, Henry S, Morquecho MAH, Herner K, Hertel L, Hesam AS, Hewes J, Higuera A, Hill T, Hillier SJ, Himmel A, Hoff J, Hohl C, Holin A, Hoppe E, Horton-Smith GA, Hostert M, Hourlier A, Howard B, Howell R, Huang J, Huang J, Hugon J, Iles G, Ilic N, Iliescu AM, Illingworth R, Ioannisian A, Itay R, Izmaylov A, James E, Jargowsky B, Jediny F, Jesùs-Valls C, Ji X, Jiang L, Jiménez S, Jipa A, Joglekar A, Johnson C, Johnson R, Jones B, Jones S, Jung CK, Junk T, Jwa Y, Kabirnezhad M, Kaboth A, Kadenko I, Kamiya F, Karagiorgi G, Karcher A, Karolak M, Karyotakis Y, Kasai S, Kasetti SP, Kashur L, Kazaryan N, Kearns E, Keener P, Kelly KJ, Kemp E, Ketchum W, Kettell SH, Khabibullin M, Khotjantsev A, Khvedelidze A, Kim D, King B, Kirby B, Kirby M, Klein J, Koehler K, Koerner LW, Kohn S, Koller PP, Kordosky M, Kosc T, Kose U, Kostelecký VA, Kothekar K, Krennrich F, Kreslo I, Kudenko Y, Kudryavtsev VA, Kulagin S, Kumar J, Kumar R, Kuruppu C, Kus V, Kutter T, Lambert A, Lande K, Lane CE, Lang K, Langford T, Lasorak P, Last D, Lastoria C, Laundrie A, Lawrence A, Lazanu I, LaZur R, Le T, Learned J, LeBrun P, Miotto GL, Lehnert R, de Oliveira MAL, Leitner M, Leyton M, Li L, Li S, Li SW, Li T, Li Y, Liao H, Lin CS, Lin S, Lister A, Littlejohn BR, Liu J, Lockwitz S, Loew T, Lokajicek M, Lomidze I, Long K, Loo K, Lorca D, Lord T, LoSecco JM, Louis WC, Luk KB, Luo X, Lurkin N, Lux T, Luzio VP, MacFarland D, Machado AA, Machado P, Macias CT, Macier JR, Maddalena A, Madigan P, Magill S, Mahn K, Maio A, Maloney JA, Mandrioli G, Maneira J, Manenti L, Manly S, Mann A, Manolopoulos K, Plata MM, Marchionni A, Marciano W, Marfatia D, Mariani C, Maricic J, Marinho F, Marino AD, Marshak M, Marshall C, Marshall J, Marteau J, Martin-Albo J, Martinez N, Caicedo DAM, Martynenko S, Mason K, Mastbaum A, Masud M, Matsuno S, Matthews J, Mauger C, Mauri N, Mavrokoridis K, Mazza R, Mazzacane A, Mazzucato E, McCluskey E, McConkey N, McFarland KS, McGrew C, McNab A, Mefodiev A, Mehta P, Melas P, Mellinato M, Mena O, Menary S, Mendez H, Menegolli A, Meng G, Messier MD, Metcalf W, Mewes M, Meyer H, Miao T, Michna G, Miedema T, Migenda J, Milincic R, Miller W, Mills J, Milne C, Mineev O, Miranda OG, Miryala S, Mishra CS, Mishra SR, Mislivec A, Mladenov D, Mocioiu I, Moffat K, Moggi N, Mohanta R, Mohayai TA, Mokhov N, Molina J, Bueno LM, Montanari A, Montanari C, Montanari D, Zetina LMM, Moon J, Mooney M, Moor A, Moreno D, Morgan B, Morris C, Mossey C, Motuk E, Moura CA, Mousseau J, Mu W, Mualem L, Mueller J, Muether M, Mufson S, Muheim F, Muir A, Mulhearn M, Muramatsu H, Murphy S, Musser J, Nachtman J, Nagu S, Nalbandyan M, Nandakumar R, Naples D, Narita S, Navas-Nicolás D, Nayak N, Nebot-Guinot M, Necib L, Negishi K, Nelson JK, Nesbit J, Nessi M, Newbold D, Newcomer M, Newhart D, Nichol R, Niner E, Nishimura K, Norman A, Norrick A, Northrop R, Novella P, Nowak JA, Oberling M, Del Campo AO, Olivier A, Onel Y, Onishchuk Y, Ott J, Pagani L, Pakvasa S, Palamara O, Palestini S, Paley JM, Pallavicini M, Palomares C, Pantic E, Paolone V, Papadimitriou V, Papaleo R, Papanestis A, Paramesvaran S, Park JC, Parke S, Parsa Z, Parvu M, Pascoli S, Pasqualini L, Pasternak J, Pater J, Patrick C, Patrizii L, Patterson RB, Patton SJ, Patzak T, Paudel A, Paulos B, Paulucci L, Pavlovic Z, Pawloski G, Payne D, Pec V, Peeters SJM, Penichot Y, Pennacchio E, Penzo A, Peres OLG, Perry J, Pershey D, Pessina G, Petrillo G, Petta C, Petti R, Piastra F, Pickering L, Pietropaolo F, Pillow J, Pinzino J, Plunkett R, Poling R, Pons X, Poonthottathil N, Pordes S, Potekhin M, Potenza R, Potukuchi BVKS, Pozimski J, Pozzato M, Prakash S, Prakash T, Prince S, Prior G, Pugnere D, Qi K, Qian X, Raaf JL, Raboanary R, Radeka V, Rademacker J, Radics B, Rafique A, Raguzin E, Rai M, Rajaoalisoa M, Rakhno I, Rakotondramanana HT, Rakotondravohitra L, Ramachers YA, Rameika R, Delgado MAR, Ramson B, Rappoldi A, Raselli G, Ratoff P, Ravat S, Razafinime H, Real JS, Rebel B, Redondo D, Reggiani-Guzzo M, Rehak T, Reichenbacher J, Reitzner SD, Renshaw A, Rescia S, Resnati F, Reynolds A, Riccobene G, Rice LCJ, Rielage K, Rigaut Y, Rivera D, Rochester L, Roda M, Rodrigues P, Alonso MJR, Rondon JR, Roeth AJ, Rogers H, Rosauro-Alcaraz S, Rossella M, Rout J, Roy S, Rubbia A, Rubbia C, Russell B, Russell J, Ruterbories D, Saakyan R, Sacerdoti S, Safford T, Sahu N, Sala P, Samios N, Sanchez MC, Sanders DA, Sankey D, Santana S, Santos-Maldonado M, Saoulidou N, Sapienza P, Sarasty C, Sarcevic I, Savage G, Savinov V, Scaramelli A, Scarff A, Scarpelli A, Schaffer T, Schellman H, Schlabach P, Schmitz D, Scholberg K, Schukraft A, Segreto E, Sensenig J, Seong I, Sergi A, Sergiampietri F, Sgalaberna D, Shaevitz MH, Shafaq S, Shamma M, Sharma HR, Sharma R, Shaw T, Shepherd-Themistocleous C, Shin S, Shooltz D, Shrock R, Simard L, Simos N, Sinclair J, Sinev G, Singh J, Singh J, Singh V, Sipos R, Sippach FW, Sirri G, Sitraka A, Siyeon K, Smargianaki D, Smith A, Smith A, Smith E, Smith P, Smolik J, Smy M, Snopok P, Nunes MS, Sobel H, Soderberg M, Salinas CJS, Söldner-Rembold S, Solomey N, Solovov V, Sondheim WE, Sorel M, Soto-Oton J, Sousa A, Soustruznik K, Spagliardi F, Spanu M, Spitz J, Spooner NJC, Spurgeon K, Staley R, Stancari M, Stanco L, Steiner HM, Stewart J, Stillwell B, Stock J, Stocker F, Stocks D, Stokes T, Strait M, Strauss T, Striganov S, Stuart A, Summers D, Surdo A, Susic V, Suter L, Sutera CM, Svoboda R, Szczerbinska B, Szelc AM, Talaga R, Tanaka HA, Oregui BT, Tapper A, Tariq S, Tatar E, Tayloe R, Teklu AM, Tenti M, Terao K, Ternes CA, Terranova F, Testera G, Thea A, Thompson JL, Thorn C, Timm SC, Todd J, Tonazzo A, Torti M, Tortola M, Tortorici F, Totani D, Toups M, Touramanis C, Trevor J, Trzaska WH, Tsai YT, Tsamalaidze Z, Tsang KV, Tsverava N, Tufanli S, Tull C, Tyley E, Tzanov M, Uchida MA, Urheim J, Usher T, Vagins MR, Vahle P, Valdiviesso GA, Valencia E, Vallari Z, Valle JWF, Vallecorsa S, Berg RV, de Water RGV, Forero DV, Varanini F, Vargas D, Varner G, Vasel J, Vasseur G, Vaziri K, Ventura S, Verdugo A, Vergani S, Vermeulen MA, Verzocchi M, de Souza HV, Vignoli C, Vilela C, Viren B, Vrba T, Wachala T, Waldron AV, Wallbank M, Wang H, Wang J, Wang Y, Wang Y, Warburton K, Warner D, Wascko M, Waters D, Watson A, Weatherly P, Weber A, Weber M, Wei H, Weinstein A, Wenman D, Wetstein M, While MR, White A, Whitehead LH, Whittington D, Wilking MJ, Wilkinson C, Williams Z, Wilson F, Wilson RJ, Wolcott J, Wongjirad T, Wood K, Wood L, Worcester E, Worcester M, Wret C, Wu W, Wu W, Xiao Y, Yang G, Yang T, Yershov N, Yonehara K, Young T, Yu B, Yu J, Zaki R, Zalesak J, Zambelli L, Zamorano B, Zani A, Zazueta L, Zeller GP, Zennamo J, Zeug K, Zhang C, Zhao M, Zhao Y, Zhivun E, Zhu G, Zimmerman ED, Zito M, Zucchelli S, Zuklin J, Zutshi V, Zwaska R. Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2021; 81:322. [PMID: 34720713 PMCID: PMC8550327 DOI: 10.1140/epjc/s10052-021-09007-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/23/2021] [Indexed: 06/13/2023]
Abstract
The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.
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Grants
- MR/T019530/1 Medical Research Council
- MR/T041323/1 Medical Research Council
- MSMT, Czech Republic
- NRF, South Korea
- Canadian Network for Research and Innovation in Machining Technology, Natural Sciences and Engineering Research Council of Canada
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- SERI, Switzerland
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- U.S. Department of Energy
- CERN
- Türkiye Bilimsel ve Teknolojik Arastirma Kurumu
- The Royal Society, United Kingdom
- Canada Foundation for Innovation
- U.S. NSF
- FCT, Portugal
- CEA, France
- CNRS/IN2P3, France
- European Regional Development Fund
- Science and Technology Facilities Council
- H2020-EU, European Union
- IPP, Canada
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro
- CAM, Spain
- MSCA, European Union
- Instituto Nazionale di Fisica Nucleare
- Fundacção de Amparo à Pesquisa do Estado de Goiás
- Ministerio de Ciencia e Innovación
- Fundacion “La Caixa” Spain
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Diakite S, Bousdira N, Tachon G, Ackermann F, Groh M, Rohmer J. Regression of Coronary Aneurysms With Intravenous Immunoglobulins and Steroids for COVID-19 Adult Multisystem Inflammatory Syndrome. JACC Case Rep 2021; 3:581-585. [PMID: 33782672 PMCID: PMC7989672 DOI: 10.1016/j.jaccas.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 11/26/2022]
Abstract
A multisystem inflammatory syndrome mimicking Kawasaki disease has been increasingly reported, mainly in children, in the context of coronavirus disease-2019 (COVID-19). We report on the first case of coronary aneurysm resolution after treatment with steroids and intravenous immunoglobulins in an adult patient with multisystem inflammatory syndrome temporally associated with COVID-19. (Level of Difficulty: Beginner.).
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Réau V, Vallée A, Terrier B, Plessier A, Abisror N, Ackermann F, Benainous R, Bohelay G, Chabi-Charvillat ML, Cornec D, Desbois AC, Faguer S, Freymond N, Gaillet A, Hamidou M, Killian M, Le Jeune S, Marchetti A, Meyer G, Osorio-Perez F, Panel K, Rautou PE, Rohmer J, Simon N, Tcherakian C, Vasse M, Zuelgaray E, Lefevre G, Kahn JE, Groh M. Venous thrombosis and predictors of relapse in eosinophil-related diseases. Sci Rep 2021; 11:6388. [PMID: 33737704 PMCID: PMC7973521 DOI: 10.1038/s41598-021-85852-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/08/2021] [Indexed: 12/13/2022] Open
Abstract
Eosinophils have widespread procoagulant effects. Eosinophilic cardiovascular toxicity mostly consists of endomyocardial damage or eosinophilic vasculitis, while reported cases of venous thrombosis (VT) are scarce. We aimed to report on the clinical features and treatment outcomes of patients with unexplained VT and eosinophilia, and to identify predictors of relapse. This retrospective, multicenter, observational study included patients aged over 15 years with VT, concomitant blood eosinophilia ≥ 1G/L and without any other moderate-to-strong contributing factors for VT. Fifty-four patients were included. VT was the initial manifestation of eosinophil-related disease in 29 (54%) patients and included pulmonary embolism (52%), deep venous thrombosis (37%), hepatic (11%) and portal vein (9%) thromboses. The median [IQR] absolute eosinophil count at VT onset was 3.3G/L [1.6-7.4]. Underlying eosinophil-related diseases included FIP1L1-PDGFRA-associated chronic myeloid neoplasm (n = 4), Eosinophilic Granulomatosis with Polyangiitis (n = 9), lymphocytic (n = 1) and idiopathic (n = 29) variants of hypereosinophilic syndrome. After a median [IQR] follow-up of 24 [10-62] months, 7 (13%) patients had a recurrence of VT. In multivariate analysis, persistent eosinophilia was the sole variable associated with a shorter time to VT relapse (HR 7.48; CI95% [1.94-29.47]; p = 0.015). Long-term normalization of eosinophil count could prevent the recurrence of VT in a subset of patients with unexplained VT and eosinophilia ≥ 1G/L.
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Canzian A, Venhoff N, Urban ML, Sartorelli S, Ruppert AM, Groh M, Girszyn N, Taillé C, Maurier F, Cottin V, de Moreuil C, Germain V, Samson M, Jachiet M, Denis L, Rieu V, Smets P, Pugnet G, Deroux A, Durel CA, Aouba A, Cathébras P, Deligny C, Faguer S, Gil H, Godeau B, Lifermann F, Phin-Huynh S, Ruivard M, Bonniaud P, Puéchal X, Kahn JE, Thiel J, Dagna L, Guillevin L, Vaglio A, Emmi G, Terrier B. Use of Biologics to Treat Relapsing and/or Refractory Eosinophilic Granulomatosis With Polyangiitis: Data From a European Collaborative Study. Arthritis Rheumatol 2021; 73:498-503. [PMID: 33001543 DOI: 10.1002/art.41534] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 09/08/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To describe the efficacy and safety of biologics for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA). METHODS A retrospective European collaborative study was conducted in patients with EGPA who received treatment with biologics for refractory and/or relapsing disease. RESULTS Among the 147 patients with EGPA included in the study, 63 received rituximab (RTX), 51 received mepolizumab (MEPO), and 33 received omalizumab (OMA). At the time of inclusion, the median Birmingham Vasculitis Activity Score (BVAS) was 8.5 (interquartile range [IQR] 5-13) in the RTX group, while the median BVAS in the OMA group was 2 (IQR 1-4.5) and the median BVAS in the MEPO group was 2 (IQR 1-5). In patients receiving RTX, the median BVAS declined both at 6 months (median 1, IQR 0-4.5) and at 12 months (median 0, IQR 0-2), and the frequency of remission, partial response, treatment failure, and stopping treatment due to adverse events was 49%, 24%, 24%, and 3%, respectively. For the treatment of glucocorticoid (GC)-dependent asthma, patients who received MEPO had a much better GC-sparing effect and overall response than did patients who received OMA. The frequency of remission, partial response, treatment failure, and stopping treatment due to adverse events was 15%, 33%, 48%, and 4%, respectively, in the OMA group and 78%, 10%, 8%, and 4%, respectively, in the MEPO group. Remission rates at 12 months were 76% and 82% among patients receiving MEPO at a doses of 100 mg and 300 mg, respectively. CONCLUSION These results suggest that RTX could be effective in treating relapses of EGPA vasculitis. MEPO is highly effective with a good safety profile in patients with GC-dependent asthma. Our data suggest that 100 mg MEPO monthly could be an acceptable dosage for first-line therapy in selected instances of EGPA, recognizing, however, that this has not been compared to the validated dosage of 300 mg monthly.
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Lafarge A, Joseph A, Pagnoux C, Puéchal X, Cohen P, Samson M, Hamidou M, Karras A, Quemeneur T, Ribi C, Groh M, Mouthon L, Guillevin L, Terrier B. Predictive factors of severe infections in patients with systemic necrotizing vasculitides: data from 733 patients enrolled in five randomized controlled trials of the French Vasculitis Study Group. Rheumatology (Oxford) 2021; 59:2250-2257. [PMID: 31782786 DOI: 10.1093/rheumatology/kez575] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 10/29/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Infections remain a major cause of morbidity and mortality in systemic necrotizing vasculitides (SNV). We aimed to identify factors predicting severe infections (SI) in SNV. METHODS Data from five randomized controlled trials (RCTs) enrolling 733 patients were pooled. The primary end point was the occurrence of SI, defined by the need of a hospitalization and/or intravenous anti-infectious treatment and/or leading to death. RESULTS After a median follow-up of 5.2 (interquartile range 3-9.7) years, 148 (20.2%) patients experienced 189 SI, and 98 (66.2%) presented their first SI within the first 2 years. Median interval from inclusion to SI was 14.9 (4.3-51.7) months. Age ≥65 years (hazard ratio (HR) 1.49 [1.07-2.07]; P=0.019), pulmonary involvement (HR 1.82 [1.26-2.62]; P=0.001) and Five Factor Score ≥1 (HR 1.21 [1.03-1.43]; P=0.019) were independent predictive factors of SI. Regarding induction therapy, the occurrence of SI was associated with the combination of GCs and CYC (HR 1.51 [1.03-2.22]; P = 0.036), while patients receiving only GCs were less likely to present SI (HR 0.69 [0.44-1.07]; P = 0.096). Finally, occurrence of SI had a significant negative impact on survival (P<0.001). CONCLUSION SI in SNV are frequent and impact mortality. Age, pulmonary involvement and Five Factor Score are baseline independent predictors of SI. No therapeutic regimen was significantly associated with SI but patients receiving glucocorticoids and CYC as induction tended to have more SI.
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Papo M, Sinico RA, Teixeira V, Venhoff N, Urban ML, Iudici M, Mahrhold J, Locatelli F, Cassone G, Schiavon F, Seeliger B, Neumann T, Kroegel C, Groh M, Marvisi C, Samson M, Barba T, Jayne D, Troilo A, Thiel J, Hellmich B, Monti S, Montecucco C, Salvarani C, Kahn JE, Bonnotte B, Durel CA, Puéchal X, Mouthon L, Guillevin L, Emmi G, Vaglio A, Terrier B. Significance of PR3-ANCA positivity in eosinophilic granulomatosis with polyangiitis (Churg-Strauss). Rheumatology (Oxford) 2020; 60:4355-4360. [PMID: 33347592 DOI: 10.1093/rheumatology/keaa805] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Only a third of patients with eosinophilic granulomatosis with polyangiitis (EGPA) are ANCA-positive, mainly directed against MPO. ANCA directed against PR3 are rarely found in EGPA. We aimed to examine the significance of PR3-ANCA in EGPA. METHODS We set up a retrospective European multicentre cohort including 845 patients. Baseline characteristics and outcomes were analysed and compared according to ANCA status. RESULTS ANCA status was available for 734 patients: 508 (69.2%) ANCA-negative, 210 (28.6%) MPO-ANCA and 16 (2.2%) PR3-ANCA. At baseline, PR3-ANCA patients, compared with those with MPO-ANCA and ANCA-negative, less frequently had active asthma (69% vs 91% and 93%, P = 0.003, respectively) and peripheral neuropathy (31% vs 71% and 47%, P < 0.0001), more frequently had cutaneous manifestations (63% vs 38% and 34%, P = 0.03) and pulmonary nodules (25% vs 10% and 8%, P = 0.046), and lower median eosinophil count (1450 vs 5400 and 3224/mm3, P < 0.0001). Vasculitis relapse-free survival was shorter for PR3-ANCA (hazard ratio 6.05, P = 0.005) and MPO-ANCA patients (hazard ratio 1.88, P = 0.0002) compared with ANCA-negative patients. CONCLUSION PR3-ANCA EGPA patients differ from those with MPO-ANCA and negative ANCA, and share clinical features with granulomatosis with polyangiitis. This suggests that PR3-ANCA EGPA could be a particular form of PR3-ANCA-associated vasculitis.
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Delcros Q, Rohmer J, Tcherakian C, Groh M. Extensive DVT and Pulmonary Embolism Leading to the Diagnosis of Coronavirus Disease 2019 in the Absence of Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia. Chest 2020; 158:e269-e271. [PMID: 33280767 PMCID: PMC7711172 DOI: 10.1016/j.chest.2020.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/29/2020] [Accepted: 06/15/2020] [Indexed: 12/22/2022] Open
Abstract
There is growing evidence that coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state. To date, all patients reported with venous thromboembolic disease and COVID-19 have shown evidence of viral pneumonia. Here, we report the case of a 31-year-old patient with unexplained extensive DVT and bilateral pulmonary embolism in the absence of COVID-19 pneumonia, leading to the diagnosis of otherwise asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In the context of the COVID-19 pandemic, given the high rates of otherwise asymptomatic patients, testing for SARS-CoV-2 should be performed in all patients with unexplained VTE occurring in COVID-19-endemic areas, even in the absence of other disease manifestations suggestive of SARS-CoV-2 infection.
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