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Chol O, Deroux A, Bosseray A, Dumestre-Perard C, Quetant S, Bocquet A, Bouillet L. [Profiles of autoimmune myositis with or without pulmonary involvement: A retrospective single-center study of 40 patients]. Rev Med Interne 2023; 44:105-111. [PMID: 36535846 DOI: 10.1016/j.revmed.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 11/16/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Idiopathic inflammatory myopathies (IMM) are rare diseases with clinico-biological heterogeneity. Pulmonary involvement is frequent and associated with some distinctive manifestations. The aim of this study was to describe the clinico-biological profile of patients with autoimmune myositis with and without pulmonary involvement. METHODS This retrospective descriptive study included patients with idiopathic inflammatory myopathies and a positive antibody test performed at Grenoble Alpes University Hospital between 2010 and 2020. RESULTS Forty patients were included, the majority were women. The anti-Jo1 autoantibody was the most frequently found (37.5%). The prevalence of pulmonary involvement was 70%. Mechanics' hands and Raynaud's syndrome were the extra-respiratory signs significantly more present in the group with lung involvement (P <0.05), in contrast to creatine kinase levels which were lower in this group (P <0.05). Glucocorticoids and rituximab were significantly more often used in the group with lung involvement (P <0.05). The 5-year survival rate was 76.2% in patients with lung involvement and 100% in patients without lung involvement (P=0.50). CONCLUSION We report a high prevalence of lung involvement probably explained by the presence of many patients with anti-synthetase syndrome. Our study highlights a lower severity of muscle involvement in myositis patients with lung disease, which deserves to be confirmed in a larger study.
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Affiliation(s)
- O Chol
- Service de médecine interne, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France; Faculté de médecine, université Grenoble Alpes, 38700 La Tronche, France.
| | - A Deroux
- Service de médecine interne, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France
| | - A Bosseray
- Service de médecine interne, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France
| | - C Dumestre-Perard
- Laboratoire d'immunologie, institut de biologie et pathologie, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France; Institut de biologie structurale (IBS), université Grenoble Alpes, CEA, CNRS, Grenoble, France; Faculté de médecine, université Grenoble Alpes, 38700 La Tronche, France
| | - S Quetant
- Service de pneumologie, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France
| | - A Bocquet
- Service de médecine interne, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France; Faculté de médecine, université Grenoble Alpes, 38700 La Tronche, France
| | - L Bouillet
- Service de médecine interne, CHU de Grenoble Alpes, CS 10271, 38043 Grenoble cedex 9, France; Faculté de médecine, université Grenoble Alpes, 38700 La Tronche, France
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Pineton de Chambrun M, Moyon Q, Faguer S, Urbanski G, Mathian A, Zucman N, Werner M, Luyt CE, Verlicchi F, Amoura Z, Gousseff M, Mauhin W, Hot A, Lega JC, Lambert M, Riviere S, Dossier A, Ruivard M, Lhote F, Blaison G, Merceron S, Zapella N, Alric L, Agard C, Lacout M, Saadoun D, Graveleau J, Soubrier M, Haroche J, Boileau J, Lucchini-Lecomte MJ, Hanslik T, Christides C, Levesque H, Talasczka A, Bulte C, Hachulla E, Decaux O, Sonneville R, Ibouanga F, Arnulf B, Benedit M, Viallard JF, Tieulie N, Haddad F, Moulin B, Cohen-Aubert F, Lovey PY, le Moal S, Bibes B, Rivard GE, Rondeau E, Malizia G, Debourdeau P, Abgueguen P, Bosseray A, Devaquet J, Presne C, Liferman F, Limal N, Argaud L, Hernu R, de la Salle S, Faguer S, Urbanski G, Zucman N, Werner M, Luyt CE, Moyon Q, Verlicchi F, Troncoso JÁ, Harty J, Godmer P, Hie M, Papo T, Hatron PY, Mathian A, Amoura Z. The consequences of COVID-19 pandemic on patients with monoclonal gammopathy-associated systemic capillary leak syndrome (Clarkson disease). J Allergy Clin Immunol Pract 2022; 10:626-629. [PMID: 34890829 PMCID: PMC8648572 DOI: 10.1016/j.jaip.2021.11.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Marc Pineton de Chambrun
- Service de Médecine Intensive-Réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Sorbonne Université, Paris, France,Institut de Cardiométabolisme et Nutrition (ICAN), INSERM, UMRS_1166-ICAN, Sorbonne Université, Paris, France,Service de Médecine Interne 2, Institut E3M, APHP, Hôpital La Pitié-Salpêtrière, Sorbonne Université Centre de Référence National Lupus Systémique, Syndrome des Anticorps Anti-Phospholipides et Autres Maladies Auto-Immunes Systémiques Rares, Paris, France,Corresponding author: Marc Pineton de Chambrun, MD, MSc, Service de Médecine Intensive-Réanimation, Hôpital La Pitié-Salpêtrière, 47-83, boulevard de l’Hôpital, 75651 Paris Cedex 13, France
| | - Quentin Moyon
- Service de Médecine Intensive-Réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Sorbonne Université, Paris, France,Service de Médecine Interne 2, Institut E3M, APHP, Hôpital La Pitié-Salpêtrière, Sorbonne Université Centre de Référence National Lupus Systémique, Syndrome des Anticorps Anti-Phospholipides et Autres Maladies Auto-Immunes Systémiques Rares, Paris, France
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d'Organes, Centre de Référence Des Maladies Rénales Rares, INSERM U1297 (I2MC, Équipe 12), Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Geoffrey Urbanski
- Service de Médecine Interne et d’Immunologie Clinique, Centre Hospitalier Universitaire, Angers, France
| | - Alexis Mathian
- Service de Médecine Interne 2, Institut E3M, APHP, Hôpital La Pitié-Salpêtrière, Sorbonne Université Centre de Référence National Lupus Systémique, Syndrome des Anticorps Anti-Phospholipides et Autres Maladies Auto-Immunes Systémiques Rares, Paris, France
| | - Noémie Zucman
- Service de Médecine Intensive Réanimation, Hôpital Louis Mourier, APHP, DMU ESPRIT, Université de Paris, Colombes, France
| | - Marie Werner
- Service de Réanimation Chirurgicale Adulte, AP-HP, Hôpital Bicêtre, Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - Charles-Edouard Luyt
- Service de Médecine Intensive-Réanimation, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Sorbonne Université, Paris, France,Institut de Cardiométabolisme et Nutrition (ICAN), INSERM, UMRS_1166-ICAN, Sorbonne Université, Paris, France
| | | | - Zahir Amoura
- Service de Médecine Interne 2, Institut E3M, APHP, Hôpital La Pitié-Salpêtrière, Sorbonne Université Centre de Référence National Lupus Systémique, Syndrome des Anticorps Anti-Phospholipides et Autres Maladies Auto-Immunes Systémiques Rares, Paris, France
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Vangout M, Bouillet L, Bosseray A, Viglino D, Dumanoir P, Bocquet A. Étude de la discordance des diagnostics infectieux entre les urgences et les services de médecine interne au CHUGA : recherche de facteurs prédictifs et évaluation d’impact. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Belbézier A, Deroux A, Sarrot-Reynauld F, Colombe B, Bosseray A, Wintenberger C, Dumanoir P, Lugosi M, Boccon-Gibod I, Leroy V, Maignan M, Collomb-Muret R, Viglino D, Vaillant M, Minotti L, Lagrange E, Epaulard O, Dumestre-Perard C, Lhomme S, Lupo J, Larrat S, Morand P, Schwebel C, Vilotitch A, Bosson JL, Bouillet L. Screening of hepatitis E in patients presenting for acute neurological disorders. J Infect Public Health 2020; 13:1047-1050. [PMID: 32224109 DOI: 10.1016/j.jiph.2019.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/13/2019] [Accepted: 12/21/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury. METHOD A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data on patients with acute (<3 months) non-traumatic, non-metabolic, non-vascular neurological injuries. Acute hepatitis E was defined as anti-HEV IgM-positive serum in immunocompetent patient, and as anti-HEV IgM-positive serum or HEV RNA-positive serum in immunocompromised patients. RESULTS One hundred fifty-nine patients were included. Anti-HEV IgM seroprevalence in our cohort of non-traumatic, non-metabolic, non-vascular neurological injuries was 6.9% (eleven patients, including 4 Parsonage-Turner syndrome (PTS) and 2 Guillain-Barré syndrome (GBS)). Elevated transaminases were observed in only 64% of hepatitis E patients and cholestasis in 64%. CONCLUSION In this study, 6·9% of patients with acute non-traumatic, non-metabolic, non-vascular neurological injuries had a probable recent HEV infection. HEV serology should be systematically performed in this population, even in patients with normal transaminase level.
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Affiliation(s)
- Aude Belbézier
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France.
| | - Alban Deroux
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | | | - Barbara Colombe
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Annick Bosseray
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Claire Wintenberger
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Perrine Dumanoir
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | - Maxime Lugosi
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France
| | | | - Vincent Leroy
- Department of Hepatology, Grenoble University Hospital, Grenoble, France
| | - Maxime Maignan
- Department of Emergency, Grenoble University Hospital, Grenoble, France
| | | | - Damien Viglino
- Department of Emergency, Grenoble University Hospital, Grenoble, France
| | - Mathieu Vaillant
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Lorella Minotti
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Emeline Lagrange
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Olivier Epaulard
- Univ. Grenoble Alpes, Department of Infectious Disease, Grenoble University Hospital, Grenoble, France
| | - Chantal Dumestre-Perard
- Univ. Grenoble Alpes, CNRS, Laboratory of Immunology CHU Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France
| | - Sébastien Lhomme
- INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France
| | - Julien Lupo
- Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France
| | - Sylvie Larrat
- Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France
| | - Patrice Morand
- Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France
| | - Carole Schwebel
- Univ. Grenoble Alpes, Laboratory of Bioclinical Pharmaceutic CHU Grenoble Alpes, INSERM U1039, 38000 Grenoble, France
| | - Antoine Vilotitch
- Department of Public Health, Grenoble University Hospital, Grenoble, France
| | - Jean-Luc Bosson
- Department of Public Health, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, CNRS, Public Health Department CHU Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France
| | - Laurence Bouillet
- Department of Internal Medicine, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, Department of Internal Medicine CHU Grenoble, Inserm (U1036), CEA, BIG-BCI, France
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Belbézier A, Bosseray A, Colombe B, Leroy V, Leclercq P, Bouillet L. Guillain-Barré syndrome in AIDS patient secondary to an acute and confirmed hepatitis C virus. Presse Med 2019; 48:981-982. [DOI: 10.1016/j.lpm.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/03/2019] [Accepted: 08/02/2019] [Indexed: 02/07/2023] Open
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Vangout M, Gourbeyre-Masson K, Ruel M, Mansard C, Bosseray A, Bocquet A, Bouillet L. Étude CONCORDIAG : concordance des diagnostics initiaux portés aux urgences et des diagnostics finaux retenus après une hospitalisation en service de médecine interne. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Million M, Bardin N, Bessis S, Nouiakh N, Douliery C, Edouard S, Angelakis E, Bosseray A, Epaulard O, Branger S, Chaudier B, Blanc-Laserre K, Ferreira-Maldent N, Demonchy E, Roblot F, Reynes J, Djossou F, Protopopescu C, Carrieri P, Camoin-Jau L, Mege JL, Raoult D. Thrombosis and antiphospholipid antibody syndrome during acute Q fever: A cross-sectional study. Medicine (Baltimore) 2017; 96:e7578. [PMID: 28723794 PMCID: PMC5521934 DOI: 10.1097/md.0000000000007578] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Q fever is a neglected and potentially fatal disease. During acute Q fever, antiphospholipid antibodies are very prevalent and have been associated with fever, thrombocytopenia, acquired heart valve disease, and progression to chronic endocarditis. However, thrombosis, the main clinical criterion of the 2006 updated classification of the antiphospholipid syndrome, has not been assessed in this context. To test whether thrombosis is associated with antiphospholipid antibodies and whether the criteria for antiphospholipid syndrome can be met in patients with acute Q fever, we conducted a cross-sectional study at the French National Referral Center for Q fever.Patients included were diagnosed with acute Q fever in our Center between January 2007 and December 2015. Each patient's history and clinical characteristics were recorded with a standardized questionnaire. Predictive factors associated with thrombosis were assessed using a rare events logistic regression model. IgG anticardiolipin antibodies (IgG aCL) assessed by an enzyme-linked immunosorbent assay were tested on the Q fever diagnostic serum. A dose-dependent relationship between IgG aCL levels and thrombosis was tested using a receiver operating characteristic (ROC) analysis.Of the 664 patients identified for inclusion in the study, 313 (47.1%) had positive IgG aCL and 13 (1.9%) were diagnosed with thrombosis. Three patients fulfilled the antiphospholipid syndrome criteria. After multiple adjustments, only positive IgG aCL (relative risk, 14.46 [1.85-113.14], P = .011) were independently associated with thrombosis. ROC analysis identified a dose-dependent relationship between IgG aCL levels and occurrence of thrombosis (area under curve, 0.83, 95%CI [0.73-0.93], P < .001).During acute Q fever, antiphospholipid antibodies are associated with thrombosis, thrombocytopenia, and acquired valvular heart disease. Antiphospholipid antibodies should be systematically assessed in acute Q fever patients. Hydroxychloroquine, which has been previously shown to antagonize IgG aCL pathogenic properties, should be tested in acute Q fever patients with anticardiolipin antibodies to prevent antiphospholipid-associated complications.Key Point: In addition to fever, thrombocytopenia and acquired valvular heart disease, antiphospholipid antibodies are associated with thrombosis during acute Q fever.
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Affiliation(s)
- Matthieu Million
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Nathalie Bardin
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
- Aix Marseille Univ, APHM, INSERM, VRCM, UMR_S 1076, Laboratoire d’Immunologie, Marseille
| | - Simon Bessis
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Nadia Nouiakh
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Charlaine Douliery
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Sophie Edouard
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | - Emmanouil Angelakis
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
| | | | - Olivier Epaulard
- Service de maladies infectieuses, Centre Hospitalier Universitaire de Grenoble, Grenoble
| | | | - Bernard Chaudier
- Service de médecine interne et tropicale, Hôpital d’Instruction des Armées Laveran, Marseille
| | | | | | | | - France Roblot
- Service de médecine interne et maladies infectieuses, CHU de Poitiers, Inserm, Poitiers
| | - Jacques Reynes
- Service de maladies infectieuses, CHU de Montpellier, Montpellier
| | | | | | | | - Laurence Camoin-Jau
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
- Laboratoire d’Hématologie, CHU Timone, APHM, Marseille, France
| | - Jean-Louis Mege
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
- Aix Marseille Univ, APHM, INSERM, VRCM, UMR_S 1076, Laboratoire d’Immunologie, Marseille
| | - Didier Raoult
- URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection
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Simon N, Colombe B, Bosseray A. Traitement d’un pyoderma gangrenosum réfractaire… 8e ligne ! Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rivoisy C, Besse B, Girard N, Lioger B, Viallard JF, Lega JC, Rullier P, Perlat A, Lerouge D, Clement-Duchene C, Ebbo M, Bosseray A, Godeau B, Lambotte O. Thymic Epithelial Tumor-Associated Cytopenia: A 10-Year Observational Study in France. J Thorac Oncol 2016; 11:391-9. [PMID: 26768832 DOI: 10.1016/j.jtho.2015.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/26/2015] [Accepted: 11/18/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Thymic epithelial tumor (TET)-associated cytopenia is rare but difficult to treat. METHODS We performed a multicenter, retrospective study of TET and associated forms of cytopenia in France. Cases were collected by the French National Reference Center for Autoimmune Cytopenia and the French National Thymic Malignancy Interest Group (Réseau Tumeurs Thymiques et Cancer) and through a call for cases by the French Society of Internal Medicine. RESULTS Thirty-six cases were recorded between 2002 and 2014 and followed up for a median of 38 months (interquartile range, 23-106 months). Thirty-two patients underwent surgery for TET, and 14 of the latter were in complete remission at last follow-up. Cytopenia can occur before, simultaneously, or after diagnosis of TET. The most common types of cytopenia were pure red cell aplasia (in 30% of cases) and Good syndrome (GS) (also in 30% of cases). Eleven patients displayed two or more episodes of cytopenia. Eighteen patients received steroids as their first-line treatment, leading to a complete response in nine. Other first-line treatments (cyclosporine and rituximab) were less effective but should be considered as treatment options. Infections developed in 84% of the patients with GS; this did not appear to be related to the presence or absence of immunosuppressive treatment or chemotherapy. Eight patients died during the follow-up period (two died of cytopenia and five of infections). CONCLUSIONS The optimal treatment for TET-associated cytopenia has not been clearly defined and the outcome does not appear to be correlated with TET progression. For GS, prophylactic immunoglobulin replacement therapy and prophylactic antibiotic therapy can be recommended.
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Affiliation(s)
- Claire Rivoisy
- Department of Internal Medicine, Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Benjamin Besse
- Department of Cancer Medicine, Gustave Roussy Institute, Villejuif, France Paris-Sud University, Paris, France
| | - Nicolas Girard
- Department of Respiratory Medicine, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | - Bertrand Lioger
- Department of Internal Medicine, University Medical Center Tours, Tours, France
| | | | - Jean-Christophe Lega
- UMR, Unite Mixte de Recherche 5558, Department of Internal and Vascular Medicine, University Medical Center Lyon Sud, Claude Bernard University Lyon 1, France; Biometry and Evolutionary Biology Laboratory, Centre National de la Recherche Scientifique, Claude Bernard University Lyon 1, France
| | - Patricia Rullier
- Department of Internal Medicine, University Medical Center Montpellier, Montpellier, France
| | - Antoinette Perlat
- Department of Internal Medicine, University Medical Center Rennes, Rennes, France
| | - Delphine Lerouge
- Deparment of Pneumology and Thoracic Oncology, University Medical Center Caen, France
| | - Christelle Clement-Duchene
- Chest Department, University Medical Center Nancy, Nancy, France; Research Team EA, Equipe Avenir 7298, INGRES, Lorraine University, Lorraine, France
| | - Mikael Ebbo
- Department of Internal Medicine, La Conception Hospital, University Medical Center Marseille, Aix-Marseille University, Marseille, France
| | - Annick Bosseray
- Department of Internal Medicine, University Medical Center Grenoble, Grenoble, France
| | - Bertrand Godeau
- Department of Internal Medicine, National Reference Centre for Autoimmune Cytopenia in Adults, Henri-Mondor University Hospital, University Medical Center Paris, Paris-Est Créteil University, Créteil, France
| | - Olivier Lambotte
- Department of Internal Medicine, Bicêtre Hospital, Le Kremlin Bicêtre, France; Paris Sud University, UMR, Unite Mixte de Recherche 1184, France; CEA, DSV/iMETI, Division of Immuno-Virology, Infectious Disease Models and Innovative Therapies, Le Kremlin Bicêtre, France; Inserm, U1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin Bicêtre, France.
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Dartevel A, Colombe B, Bosseray A, Larrat S, Sarrot-Reynauld F, Belbezier A, Lagrange E, Bouillet L. Hepatitis E and neuralgic amyotrophy: Five cases and review of literature. J Clin Virol 2015. [PMID: 26209399 DOI: 10.1016/j.jcv.2015.06.091] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Hepatitis E virus infection - mainly genotype 3 - is increasingly common in industrialized countries. Infection is usually asymptomatic, but cases of central or peripheral neurological symptoms with hepatitis E have been described. The most frequent is Guillain-Barre but somes cases of neuralgic amyotrophy have been described. In our center, since 2010, we have identified five cases of neuralgic amyotrophy associated with acute hepatitis E in immunocompetent patients. For all these patients, neuralgic amyotrophy was diagnosed with electromyogram and positive IgM for hepatitis E, and detectable HEV RNA in 4 of the cases. Including our patients, we count 26 cases in literature. The mean age of the patients was 44 years old, with a large predominance of males (88%). The disorder is bilateral and asymmetric in 69% of cases. Peripheral nerves other than the brachial plexus were affected in 6 patients (23%). In industrialized countries, any neuralgic amyotrophy, particularly if there is bilateral, asymmetric associated with involvement of nerves outside the brachial plexus, should lead physicians to consider a diagnosis of acute hepatitis E.
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Affiliation(s)
- Anaïs Dartevel
- Internal Medicine Department, Grenoble University Hospital, France.
| | - Barbara Colombe
- Internal Medicine Department, Grenoble University Hospital, France
| | - Annick Bosseray
- Internal Medicine Department, Grenoble University Hospital, France
| | - Sylvie Larrat
- Virology Department, Reference Center of Neuromuscular Disease, Grenoble University Hospital, France
| | | | - Aude Belbezier
- Internal Medicine Department, Grenoble University Hospital, France
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11
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Maillet M, Maubon D, Brion JP, François P, Molina L, Stahl JP, Epaulard O, Bosseray A, Pavese P. Pneumocystis jirovecii (Pj) quantitative PCR to differentiate Pj pneumonia from Pj colonization in immunocompromised patients. Eur J Clin Microbiol Infect Dis 2013; 33:331-6. [PMID: 23990137 PMCID: PMC7101903 DOI: 10.1007/s10096-013-1960-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 08/12/2013] [Indexed: 12/12/2022]
Abstract
Conventional polymerase chain reaction (PCR) in respiratory samples does not differentiate between Pneumocystis pneumonia (PCP) and Pneumocystis jirovecii (Pj) colonization. We used Pj real-time quantitative PCR (qPCR) with the objective to discriminate PCP from Pj colonization in immunocompromised patients. All positive Pj qPCR [targeting the major surface glycoprotein (MSG) gene] obtained in respiratory samples from immunocompromised patients presenting pneumonia at the Grenoble University Hospital, France, were collected between August 2009 and April 2011. Diagnoses were retrospectively determined by a multidisciplinary group of experts blinded to the Pj qPCR results. Thirty-one bronchoalveolar lavages and four broncho aspirations positive for the Pj qPCR were obtained from 35 immunocompromised patients. Diagnoses of definite, probable, and possible PCP, and pneumonia from another etiology were retrospectively made for 7, 4, 5, and 19 patients, respectively. Copy numbers were significantly higher in the “definite group” (median 465,000 copies/ml) than in the “probable group” (median 38,600 copies/ml), the “possible group” (median 1,032 copies/ml), and the “other diagnosis group” (median 390 copies/ml). With the value of 3,160 copies/ml, the sensitivity and specificity of qPCR for the diagnosis of PCP were 100 % and 70 %, respectively. With the value of 31,600 copies/ml, the sensitivity and specificity were 80 % and 100 %, respectively. The positive predictive value was 100 % for results with more than 31,600 copies/ml and the negative predictive value was 100 % for results with fewer than 3,160 copies/ml. qPCR targeting the MSG gene can be helpful to discriminate PCP from Pj colonization in immunocompromised patients, using two cut-off values, with a gray zone between them.
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Affiliation(s)
- M. Maillet
- Infectious Diseases Department, CHU de Grenoble, BP 218, 38 043 Grenoble cedex 9, France
| | - D. Maubon
- Infectious Agents Department, Parasitology-Mycology Laboratory, CHU Grenoble, Grenoble, France
| | - J. P. Brion
- Infectious Diseases Department, CHU de Grenoble, BP 218, 38 043 Grenoble cedex 9, France
| | - P. François
- Public Health Department, CHU Grenoble, Grenoble, France
| | - L. Molina
- Hematology Department, CHU Grenoble, Grenoble, France
| | - J. P. Stahl
- Infectious Diseases Department, CHU de Grenoble, BP 218, 38 043 Grenoble cedex 9, France
| | - O. Epaulard
- Infectious Diseases Department, CHU de Grenoble, BP 218, 38 043 Grenoble cedex 9, France
| | - A. Bosseray
- Internal Medicine Department, CHU Grenoble, Grenoble, France
| | - P. Pavese
- Infectious Diseases Department, CHU de Grenoble, BP 218, 38 043 Grenoble cedex 9, France
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12
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Goutier S, Ferquel E, Pinel C, Bosseray A, Hoen B, Couetdic G, Bourahoui A, Lapostolle C, Pelloux H, Garnier M, Sertour N, Pelloux I, Pavese P, Cornet M. Borrelia crocidurae meningoencephalitis, West Africa. Emerg Infect Dis 2013; 19:301-4. [PMID: 23347436 PMCID: PMC3559064 DOI: 10.3201/eid1902.121325] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Borrelia crocidurae–associated relapsing fever is endemic to West Africa and is considered benign. We report 4 patients with B. crocidurae–associated neurologic symptoms; 2 of their cases had been misdiagnosed. Frequency and severity of this disease could be underestimated; molecular methods and serodiagnostic tests for Lyme disease might be helpful in its detection.
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13
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Morel N, Berthoux E, Colombe B, Bosseray A, Massot C. Micro-angiopathie thrombotique avec anticorps anti-ADAMTS 13 révélant une fièvre Q aiguë. Rev Med Interne 2012; 33:640-2. [DOI: 10.1016/j.revmed.2012.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 07/18/2012] [Accepted: 08/12/2012] [Indexed: 11/25/2022]
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14
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Deroux A, Berthoux E, Carras S, Colombe B, Bosseray A, Massot C. Organising pneumonia and mesenteric plasmocytoma: a fortuitous association? Presse Med 2011; 41:434-7. [PMID: 21885234 DOI: 10.1016/j.lpm.2011.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 06/21/2011] [Accepted: 07/05/2011] [Indexed: 11/24/2022] Open
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15
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Berthoux E, Padilla M, Chavez L, Colombe B, Bosseray A, Massot C. Unusual evolution in Wegener's granulomatosis: recovery of pulmonary involvement while renal disease progressed to end-stage. Ren Fail 2011; 33:1032-6. [PMID: 21864201 DOI: 10.3109/0886022x.2011.610547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 54-year-old male patient was admitted for acute respiratory distress with fever. He was suffering from chronic sinusitis/rhinitis and had persistent otitis for the past 2 months before admission despite several antibiotics courses. He developed a complex pulmonary involvement (embolism and diffuse alveolar hemorrhage) with acute glomerular disease (proteinuria and hematuria but initially no renal failure). Clinical suspicion of Wegener's granulomatosis was confirmed by the positive high titer of antineutrophil cytoplasmic antibodies (c-ANCA with antiproteinase 3 specificity) and despite a negative nasal biopsy. Treatment including cyclophosphamide and methylprednisolone intravenous pulses permitted pulmonary recovery over 4 weeks contrasting with the development of rapidly progressive glomerulonephritis and polyneuropathy of lower limbs. Renal biopsy showed pauci-immune crescentic and necrotizing glomerulonephritis. However, despite additional plasma exchanges, acute kidney injury worsened and the patient ended up in dialysis. Such a dissociated evolution was unexpected in this case since pulmonary and renal involvements reflected the same pathological process (small vessels vasculitis/capillaritis) and the same pathogenic mechanism (antiproteinase 3 autoantibodies).
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Affiliation(s)
- Emilie Berthoux
- Clinique de Médecine Interne, Hôpital Michallon, CHU de Grenoble, Grenoble, France.
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16
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Wintenberger C, Bosseray A, Colombe B, Gestin B, Grand S, Massot C. La maladie de Whipple : une cause curable d’encéphalite. Rev Med Interne 2011; 32:513-6. [DOI: 10.1016/j.revmed.2011.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 10/26/2010] [Accepted: 02/13/2011] [Indexed: 11/24/2022]
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17
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Bernard S, Colombe B, Leclercq P, Feretti G, Bosseray A. [A chronic cough in a patient with HIV infection]. Presse Med 2011; 40:986-9. [PMID: 21507597 DOI: 10.1016/j.lpm.2011.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 03/16/2011] [Indexed: 10/17/2022] Open
Affiliation(s)
- Sylvain Bernard
- CHU de Grenoble, clinique de médecine interne, 38000 Grenoble, France.
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18
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Deroux A, Maillet M, Dentan C, Bosseray A, Colombe B, Mathieu N, Massot C. Syndrome de la côte glissante ou syndrome de Cyriax. Presse Med 2011; 40:318-9. [DOI: 10.1016/j.lpm.2010.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Revised: 11/27/2010] [Accepted: 12/07/2010] [Indexed: 10/18/2022] Open
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19
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Deroux A, Berthoux E, Pegourié B, Bosseray A, Colombe B, Massot C. Pneumopathie organisée associée à un plasmocytome mésentérique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Berthoux E, Morel N, Bosseray A, Colombe B, Massot C. Microangiopathie thrombotique avec anticorps anti ADAMTS13 au cours d’une infection à Coxiella burnetii. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Fagedet D, Bernard S, Colombe B, Bosseray A, Baudet A, Bouillet L, Massot C. [Acute respiratory distress syndrome as the presenting manifestation of an antisynthetase syndrome]. Rev Med Interne 2008; 30:634-6. [PMID: 18976836 DOI: 10.1016/j.revmed.2008.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Revised: 08/14/2008] [Accepted: 09/20/2008] [Indexed: 11/15/2022]
Abstract
The antisynthetase syndrome is a subgroup of idiopathic inflammatory muscle diseases. Its characteristics are interstitial lung disease, myositis, polyarthritis, mechanic's hand like cutaneous involvement, and the presence of antisynthetase antibodies (anti-Jo1). The lung disease is the presenting feature in 50% of cases. We report a patient with an antisynthetase syndrome, revealed by an acute respiratory distress syndrome. This patient was already followed-up for a scleroderma and presented a probable overlap syndrome. The disease course was favourable with anti-CD20 therapy.
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Affiliation(s)
- D Fagedet
- Clinique de médecine interne, CHU de Grenoble, BP 217, 38700 la Tronche cedex 09, France.
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22
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Fagedet D, Bernard S, Colombe B, Bosseray A, Bouillet L, Massot C. Pneumopathie aiguë sévère révélatrice d'un syndrome des anticorps anti synthètase. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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Sturm N, Guillou L, Laverrière MH, Pinel N, Bosseray A, Létoublon C, Brambilla E. Inflammatory pseudotumour of the liver: a variant rich in giant atypical reactive dendritic cells. Histopathology 2007; 50:400-3. [PMID: 17257145 DOI: 10.1111/j.1365-2559.2007.02593.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Blaise S, Colombe B, Millet C, Poulain C, Bosseray A, Carpentier PH, Debru JL. [Jugular thrombosis with fever: what about Lemierre syndrome?]. ACTA ACUST UNITED AC 2005; 30:231-2. [PMID: 16292201 DOI: 10.1016/s0398-0499(05)88208-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Ranque S, Marchou B, Malvy D, Adehossi E, Laganier R, Tissot-Dupont H, Lotte A, Dydymsky S, Durant J, Stahl JP, Bosseray A, Gaillat J, Sotto A, Cazorla C, Ragneau JM, Brouqui P, Delmont J. Treatment of imported malaria in adults: a multicentre study in France. QJM 2005; 98:737-43. [PMID: 16126742 DOI: 10.1093/qjmed/hci110] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Data about anti-malarial drugs prescription practices in Europe and the safety of imported malaria treatments are scanty. In 1999, a French consensus development conference published guidelines for the prevention and treatment of imported P. falciparum malaria. The impact of these guidelines has not been evaluated. AIM To investigate the impact of these guidelines on the prescription of anti-malarials, and to evaluate the incidence of acute drug events (ADEs) leading to discontinuation of treatment. DESIGN Cross-sectional survey. METHODS Members of the medical staff in 14 French infectious and tropical disease wards completed a standardized form for each patient treated for imported malaria in 2001. A propensity score matching technique was used to estimate the risk of ADEs leading to discontinuation of the regimen. RESULTS In the 474 patients studied, quinine was the first-line anti-malarial most often prescribed. Only 3% of patients received halofantrine. Mefloquine was associated with a RR of 4.9 (95%CI 3.2-7.4, p < 0.00001) risk of discontinuation of treatment due to ADEs. DISCUSSION The very limited use of halofantrine indicates that the main practice recommendations of the guidelines have been taken into account. Mefloquine was associated with a substantial risk of discontinuing the treatment because of ADEs. This is a serious limitation for the use of mefloquine in the treatment of out-patients with imported malaria.
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Affiliation(s)
- S Ranque
- Service des Maladies infectieuses et tropicales, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
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26
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Colombe B, Bosseray A, Massot C. Une cause très rare d'empyème sous dural. Rev Med Interne 2005; 26:69-70. [DOI: 10.1016/j.revmed.2004.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2004] [Accepted: 03/15/2004] [Indexed: 10/26/2022]
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27
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Badiaga S, Barrau K, Brouqui P, Durant J, Malvy D, Janbon F, Bonnet E, Bosseray A, Sotto A, Peyramont D, Dydymski S, Cazorla C, Tolou H, Durant JP, Delmont J. Imported Dengue in French University Hospitals: a 6-year survey. J Travel Med 2003; 10:286-9. [PMID: 14531982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Dengue fever (DF) is a mosquito-transmitted acute disease caused by any of four dengue flavivirus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) which is becoming a major public health problem in intertropical areas.1 DF is increasingly observed in febrile travelers returning from tropical areas,2 especially those returning from the Caribbean islands and Southeast Asia, but it is rarely diagnosed in travelers returning from Africa.3-8 Diagnosis is often serologic, and in most cases is not confirmed; virus isolation remains exceptional. In a retrospective study of 44 cases of imported DF diagnosed in France, we found that the epidemiologic, clinical and diagnostic characteristics of these cases were similar to those reported in other previous published studies; diagnosis was carried out with serology, and no virus isolation was reported. To draw the attention of physicians from nonendemic areas to the possible occurrence of dengue infection in febrile travelers from all tropical countries, including those in Africa, and to reinforce recommendations required to establish diagnosis with certainty, we report herein a prospective study from 1998-1999 which we compiled with our previously published data.
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Affiliation(s)
- Sékéné Badiaga
- Service des Maladies Infectieuses et Tropicales, Hôpital Nord, Marseille, and Infectio-Sud formation et recherche, 18 avenue des Baumettes, Nice, France
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28
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Colombe B, Derradji M, Bosseray A, Bouillet L, Massot C. [Cutaneous vasculitis revealing sarcoidosis: an unusual presentation]. Rev Med Interne 2003; 24:480-1. [PMID: 12829225 DOI: 10.1016/s0248-8663(03)00150-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Colombe B, Blanc-Derradji M, Bosseray A, Favre M, Massot C. Évolution exceptionnellement favorable d'une endocardite à Staphylococcus lugdunensis traitée par chirurgie conservatrice. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Abstract
PURPOSE Chronic meningitis are very uncommon and account for less than 10% of all meningitis cases. Their symptoms are uncunth and there outcome is insidious. Therefore, they remain often unknown. There are only a few published reports on this disease, so diagnosis and therapeutic approachs are difficult. CURRENT KNOWLEDGE AND KEY POINTS Positive chronic meningitis diagnosis is easy. However, determining the cause of chronic meningitis remains dilemma, as many infectious and noninfectious processes (including inflammatory, neoplastic or autoimmune aetiologies or as a result of a chemical exposure) can result in the chronic meningitis syndrome. In order to institute a pertinent treatment, sometimes urgently needed, diagnostic approach must be extremely rigourous and accutely orientated. Nevertheless, although extensive investigations, 30% of the aetiologies remain undetermined. Only two choices are left for the medical physician: an aggressive attitude based on complementary investigations or a contemplated therapy with a close clinical and biological control. On the other hand, when the patient's condition is quickly deterioring without a clear and proved aetiology, it is sometimes necessary to institute an empirical treatment, not always properly determined and sometimes contreversial. Besides, few reports on prognosis and outcome od idiopathic chronic meningitis have been published. FUTURE PROSPECTS AND PROJECTS After a review of aetiologies and diagnostic investigations chronic meningitis, we propose a practical experience attitude about management and treatment of chronic meningitis. Thus, large-scale studies about the follow up chronic meningitis in long term, in particular those without aetiology, treated or no, should improve the outcome of this chronic syndrome.
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Affiliation(s)
- B Colombe
- Département pluridisciplinaire de médecine, centre hospitalo-universitaire de Grenoble, France.
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31
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Bosseray A, Bonadona A, Morand P. [What's new in vaccines against herpes simplex infections?]. Pathol Biol (Paris) 2002; 50:483-92. [PMID: 12469517 DOI: 10.1016/s0369-8114(02)00339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Herpes simplex viruses (HSV) can cause a variety of infections, including genital herpes. Despite effective antiviral therapy HSV infections remain a public health problem. Vaccines offer the possibility for controlling the spread and limiting HSV disease, two strategies for herpes vaccination: prophylactic immunization or therapeutic immunization. The article discusses the results of different studies, in particular, concerning recombinant vaccines, DISC vaccines and DNA vaccines.
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Affiliation(s)
- A Bosseray
- Département pluridisciplinaire de Médecine, CHU Grenoble, 38043 Grenoble, France
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32
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Affiliation(s)
- G Richalet
- Service de Bactériologie-Virologie, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble Cedex 09, France.
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33
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Gavazzi G, Bouchard O, Leclercq P, Morel-Baccard C, Bosseray A, Dutertre N, Micoud M, Morand P. Change in transaminases in hepatitis C virus- and HIV-coinfected patients after highly active antiretroviral therapy: differences between complete and partial virologic responders? AIDS Res Hum Retroviruses 2000; 16:1021-3. [PMID: 10933615 DOI: 10.1089/08892220050075264] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Patients with HIV and hepatitis C virus (HCV) coinfection have more severe hepatitis-related disease than do patients with HCV infection alone. Highly active antiretroviral therapy (HAART) with protease inhibitor appears to restore pathogen-specific immune responses, especially in patients with persistent undetectable HIV viral load. To evaluate the potent impact of immune restoration induced by HAART on the course of HCV-related disease, HCV viremia and levels of transaminases were compared between two groups of patients: 10 HIV/HCV-coinfected patients with persistently undetectable HIV viremia (group A) and 12 HIV/HCV-coinfected patients with persistent detectable HIV viremia. No difference was detected in HCV viral load in either group. An increase in transaminases was found only in patients with persistent undetectable HIV viral load, which was correlated with the increase in CD8+ T cells. This may suggest that the restoration of CD8+ T cell cytotoxicity could lead to an enhancement of hepatitis C-related disease in HCV/HIV-coinfected patients receiving HAART.
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Affiliation(s)
- G Gavazzi
- Laboratoire de Virologie, Centre Hospitalier Universitaire A Michallon, Grenoble, France.
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Bouchard O, Bosseray A, Queyrel V, Gavazzi G, Croize J, Leclercq P, Micoud M. [Experience with an "isolation unit" for patients infected with multi-resistant bacteria. Retrospective study of 49 patients]. Presse Med 1999; 28:1405-8. [PMID: 10518961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
OBJECTIVES Perform a retrospective analysis of care in a hospital "isolation unit" for patients infected with multirestant bacteria (MRB), i.e. meticillin-resistant staphylococcus aureus (SAMR), broad spectrum beta-lactamase secreting enterobacteria. (BLSE). PATIENTS AND METHODS Forty-nine patients infected with MRB were cared for in our hospital isolation unit between January 1, 1996 and January 1, 1997. Each patient was in a separate room equipped with a sink and soap distributor, single-use towels, and individual material for patient care (stethoscope, mobile equipment, writing material, etc.). The personnel were given special training in the prevention of nosocomial infections. At admission, and in all patients, bacteriological samples to search for SAMR were acquired from nasal discharge, urine, perineal swabs, wounds and bed sores. Wound, urine and fecal samples were also taken to search for BLSE. Search for other sites of infection depended on the clinical situation. The management protocol in the isolation unit included: isolation, daily antiseptic baths, topical application of antibiotics or antiseptics on all bacteriologically proven sites of SAMR infection, selective decontamination of the digestive tract for patients with BLSE positive stools. Systemic antibiotics were given case by case. RESULTS Mean duration of stay in the isolation unit was 17 days for SAMR infections and 14 days for BLSE infections. Mean delay to sterilization of the infected sites varied depending on the localization: 2.3 days for blood and 19.4 days for stools. Seven patients died. After leaving the isolation unit, the bacteriological course was followed in 23 patients: there were 7 cases of recurrence at least one site within a mean delay of 34.5 days. CONCLUSION Use of isolation units provides an interesting solution for health care centers to control spread of multiresistant bacteria. Considering the endemic state of multiresistant bacteria infections in French hospitals, each health care unit should have correctly equipped facilities for isolating infected patients.
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Affiliation(s)
- O Bouchard
- Service de Médecine Interne et Maladies Infectieuses, CHU Michallon, Grenoble
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35
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Bouchard O, Derradji M, Queyrel V, Morand P, Buisson M, Bosseray A, Quirin N, Gavazzi G, Leclercq P, Micoud M. [A flash of lightning that makes one anuric]. Rev Med Interne 1999; 20 Suppl 2:294s-296s. [PMID: 10422176 DOI: 10.1016/s0248-8663(99)80471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- O Bouchard
- Service de médecine interne et maladies infectieuses, CHU Michallon, Grenoble
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36
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Badiaga S, Delmont J, Brouqui P, Janbon F, Durant J, Bosseray A, Malvy D, Bonnet E, Sotto A, Dydymski S, Peyramond D. [Imported dengue: study of 44 cases observed from 1994 to 1997 in 9 university hospital centers. Infectio-Sud-France group]. Pathol Biol (Paris) 1999; 47:539-42. [PMID: 10418036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Imported dengue is increasingly observed in non endemic countries. We report a retrospective study of 44 cases of dengue fever diagnosed in nine french university hospitals between 1994 and 1997. The patients were aged between 13 and 67 years. Most of them were tourists and had been traveling for a few weeks, in French West Indies and French Guyana (18), South-East Asia (10), India (7) or Polynesia (4). Only, two contracted the disease in Africa. The onset of symptoms preceded the return or followed it within 7 days. The most frequent clinical presentation was a febrile and painful syndrome. Cutaneous manifestations (rash or macular exanthem) were observed in 59% of cases, digestive symptoms in 50%, pharyngitis and/or cough in 25%, microadenopathy in 20%, moderate mucous haemorrhagic manifestations in 16% and neuropsychiatric manifestations in 14%. The common biological abnormalities were thrombocytopenia (84%), leukopenia (59%), and elevated transminases (57%). The diagnosis, orientated by negativity of malaria smears, the knowledge of an epidemic in the visited country, or occurrence of similar cases in the entourage, were argued by serological results: presence of anti-DEN IgM in 25 cases, serological conversion (anti- DEN IgG) in 7 cases or very high seropositivity (anti-DEN IgG > 1/1280) in 12 cases. No virus isolation was obtained.
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Affiliation(s)
- S Badiaga
- Service des Maladies Tropicales et Infectieuses, Hôpital Felix Houphouët-Boigny, Marseille, France
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37
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Gavazzi G, Leclercq P, Bouchard O, Bosseray A, Morand P, Micoud M. Association between primary cytomegalovirus infection and severe hemolytic anemia in an immunocompetent adult. Eur J Clin Microbiol Infect Dis 1999; 18:299-301. [PMID: 10385022 DOI: 10.1007/s100960050282] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Hemolysis is a rare complication of cytomegalovirus infection in the immunocompetent adult, and the mechanisms responsible for it remain obscure. Guidelines for treatment have yet to be established, and the effectiveness of antiviral therapy has not been proven. In this report, an unusual case of primary cytomegalovirus infection manifested by severe hemolysis in an immunocompetent adult is presented. Treatment with ganciclovir (5 mg/kg b.i.d.) for 10 days and prednisolone (2 mg/kg/day) for more than 3 months suggests that both virological and immunological mechanisms are probably responsible for the hemolysis.
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Affiliation(s)
- G Gavazzi
- Service de Médecine Interne et de Maladies Infectieuses, Centre Hospitalier Universitaire A. Michallon de Grenoble, France
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38
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Queyrel V, Bouchard O, Bosseray A, Leclercq P, Micoud M. [Difficult headaches]. Rev Med Interne 1998; 19 Suppl 2:315s-317s. [PMID: 9775106 DOI: 10.1016/s0248-8663(98)80856-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- V Queyrel
- Clinique des maladies infectieuses et de médecine interne, hôpital A-Michallon, La Tronche
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39
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Bouchard O, Bosseray A, Leclercq P, Micoud M. [Meningoencephalitis caused by Toxocara canis]. Ann Med Interne (Paris) 1998; 149:391-2. [PMID: 9853051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- O Bouchard
- Service de Médecine Interne et Maladies Infectieuses, CHU Michallon, Grenoble
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40
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Le Risbé C, Bosseray A, Leclerq P, Pégourié B, Mégraud F, Croizé J. [Relapsing Campylobacter coli bacteremia in a hypogammaglobulinemic patient]. Presse Med 1998; 27:1103-4. [PMID: 9767813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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41
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Gavazzi G, Bouchard O, Bosseray A, Leclerq P, Micoud M. [Cerebral and pulmonary miliary tuberculosis in an immunocompetent patient: aggravation in an adequately treated patient]. Presse Med 1998; 27:958-62. [PMID: 9767836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Extrapulmonary localizations are observed in 20% of tuberculosis cases, mainly in immunosuppressed patients. Prognosis is poor in case of relatively uncommon cerebral localizations and miliary dissemination, especially if treatment is initiated in late stages. We report a case of disseminated tuberculosis associated with cerebral and pulmonary localizations in an immunocompetent patient. THe disease progressed despite adapted treatment. CASE REPORT A young immunocompetent man with an uneventful history developed miliary tuberculosis with pulmonary localizations visualized on the computed tomography (CT) of the thorax. Brain CT was normal, but magnetic resonance imaging revealed several intracranial lesions. The disease course was marked by development of neurological symptoms and progression of the cerebral lesions after one month of treatment. No evidence of therapeutic failure (insufficient dosing, non-compliance, primary resistance) could be identified. DISCUSSION Magnetic resonance imaging provides a more precise evaluation of tuberculosis lesions in the brain. Early antituberculosis therapy associated with corticosteroids can improve prognosis. Clinicians should be aware that cerebral lesions may continue to progress despite appropriate treatment, a course which is not satisfactorily explained by any current pathogenic hypothesis.
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Affiliation(s)
- G Gavazzi
- Service de Médecine interne et Maladies infectieuses, CHU A. Michallon, Grenoble
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42
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Bouchard O, Bosseray A, Leclercq P, Micoud M. [Portal thrombosis and anticardiolipin antibodies association in an HIV-2 infected patient]. Presse Med 1998; 27:965. [PMID: 9767838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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43
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Gavazzi G, Bouchard O, Queyrel V, Bosseray A, Leclercq P, Micoud M. Vascularite et miliaire cérébrale d'origine tuberculeuse: aggravation sous traitement adapté. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80272-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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44
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Gavazzi G, Richallet G, Morand P, Bouchard O, Bosseray A, Leclercq P, Micoud M. [Effects of double and triple antiretroviral agents on the HCV viral load in patients coinfected with HIV and HCV]. Pathol Biol (Paris) 1998; 46:412-5. [PMID: 9769871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
HIV infection accelerates natural course of HCV infection, but impact of antiretroviral treatment on HCV infection is not well known. The aim of this study is to compare the change of HCV viral load in patients on combination of 2 nucleoside analogues and in patients on combination of 2 nucleoside analogues and protease inhibitor. HCV and HIV viral load, lymphocyte CD4 counts, alanine aminotransferase (ALT) and aspartate amino transferase (AST) were measured before and 3 months after starting treatment in 2 groups: Group 1 (n = 15) treated with 2 nucleoside analogues and Group 2 (n = 15) treated with 2 nucleoside analogues and a protease inhibitor. Results show a significant increase in lymphocyte and a significant decrease in HIV viral load in the both group but no significant change in HCV viral load and in ALT and AST. In conclusion efficiency of anti-HIV therapy (combination of 2 nucleoside analogues with or without a protease inhibitor) doesn't seem to have any impact on the course of HCV viremia in HIV-coinfected patients.
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Affiliation(s)
- G Gavazzi
- Service de Médecine Interne et Maladies Infectieuses, CHU A. Michallon, Grenoble, France
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45
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Mallaret M, Le Coziffenecker A, Luu Duc D, Brut A, Veyre M, Chaize P, Roussel M, Bosseray A, Micoud M. Observance du lavage des mains en milieu hospitalier: analyse de la littérature. Med Mal Infect 1998. [DOI: 10.1016/s0399-077x(98)80051-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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46
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Maillard B, Bosseray A, Alimardani M, Fabre M, Leclercq P, Micoud M. [Lung abscess caused by Pasteurella multocida, an unexpected germ...]. Presse Med 1998; 27:113. [PMID: 9768040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
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47
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Gavazzi G, Queyrel V, Bouchard O, Bosseray A, Leclercq P, Micoud M. Primo-infections sévères à cytomégalovirus chez des sujets immunocompétents : traitement par ganciclovir. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90191-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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48
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Mallaret M, Olive F, Fauconnier J, Bosseray A, Brion J, Croizé J, Micoud M. Surveillance épidémiologique des infections de cathéters à chambre implantable. Med Mal Infect 1996. [DOI: 10.1016/s0399-077x(96)80029-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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49
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Bouchard O, Bosseray A, Leclercq P, Micoud M. [Visceral localizations of cat-scratch disease in an immunocompetent patient]. Presse Med 1996; 25:199-201. [PMID: 8729380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Locoregional expression of cat scratch disease is well known, but despite advances in microbiology over the last 10 years leading to the description of two new bacteria (Afipia felis, Bartonella henselae) the infective agent responsible for cat scratch syndrome remains unknown. Until the 80s, only one systemic disease was attributed to infection with a germ in the Bartonella genus: trench fever. With the onset of the AIDS epidemic, new clinical syndromes caused by Bartonella bacteria have been described: bacillary angiomatosis, hepatic peliosis, cases of recurrent septicemia, cases of endocarditis, etc. More recently, atypical forms of cat scratch disease including systemic diseases have been reported in immunocompetent subjects. Although quite rare (1% of the cases), such types of expression can raise questions as to diagnosis both in terms of clinical signs and in terms of bacteriological findings. Clinical and experimental data do not provide a clear direction for treatment but would suggest that prolonged use of aminoglycosides is useful.
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Bosseray A, Bouchard O, Mallaret M, Leclercq P, Lemoine J, Micoud M. La listériose pose-t-elle des problèmes aux cliniciens ? Résultats d'une enquête prospective. Med Mal Infect 1995. [DOI: 10.1016/s0399-077x(05)81065-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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