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Abstract
INTRODUCTION When cross-sucking persists beyond calf-hood, it represents an important problem in dairy heifers and cows. It can cause teat injuries and severe mastitis and lead to significant economic losses. The «SuckStop Müller,» a novel anti-sucking device, is designed to give the calf a negative feedback when cross-sucking on a conspecific. The aim of this study was to assess whether wearing a SuckStop would result in behavioral changes other than cross-sucking and thus, impair welfare in the short- and longer-term. Sixteen group-housed calves were observed in groups of four on five days, before and after fitting the SuckStop: day -2, day -1, day 0, day 1, and day 9. Maintenance behaviors (e.g., feeding, drinking, lying) were recorded using instantaneous scan sampling. In addition, the frequency of contact behaviors (e.g., exploring the feeding fence, touching own body) was recorded by means of continuous focal animal observations. Contact behaviors were classified as «impaired» or «normal» depending on whether or not the calf flinched in response to the contact. Finally, the number of visits to the milk and concentrate feeders was extracted from the computer-controlled feeding system. Fitting a SuckStop resulted in a higher proportion of observations spent lying and less exploration behavior on day 0 and day 1 than on day -2, day -1, and day 9. On day 0 and day 1, 6,3 % of exploration behaviors were classified as impaired, compared to 0,4 % (day -2, day -1) before and 0,2 % (day 9) after fitting the SuckStop. On day 9, all calves had superficial ulcerations on the nasal septum. In four calves, these ulcerations were moderately severe, whereas all other calves had slight ulcerations. In summary, the calves habituated quickly to this novel anti-sucking device. Follow-up studies are necessary to assess the long-term relevance of tissue alterations in the nasal septum for calf welfare as well as the effect of the SuckStop on cross-sucking behavior.
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Affiliation(s)
- C Bisang
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern
| | - C Rufener
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office (FSVO), Agroscope, Ettenhausen, Switzerland
| | - A Steiner
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern
| | - B Wechsler
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office (FSVO), Agroscope, Ettenhausen, Switzerland
| | - N M Keil
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office (FSVO), Agroscope, Ettenhausen, Switzerland
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Gerster U, Sidler X, Wechsler B, Nathues C. Prevalence of tail lesions in Swiss finishing pigs. SCHWEIZ ARCH TIERH 2022; 164:339-349. [PMID: 35383031 DOI: 10.17236/sat00352] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Tail biting and lesions are common problems in modern pig production. In 2008 tail docking to prevent tail biting was banned in Switzerland. Since then pigs have been raised with intact tails. This study aimed to assess the current prevalence of tail lesions at Swiss abattoirs and comparing abattoir data with farm-specific data regarding potential risk factors for tail lesions. Data collection was performed in repetitive cycles of two weeks at four abattoirs during all consecutive seasons of one year. Gender, tail length and the tail tip condition were evaluated among other parameters. During 32 weeks in total, 195 704 pigs from 6112 batches from 2510 herds were evaluated. Overall, 63,2 % of the animals included in the analysis were slaughtered with a complete tail (lowest tail length score [TLS]), whereas 36,8 % showed a partial or total loss of the tail. The condition of the tail tip (tail tip condition score [TTCS]) was judged as being intact in 63,0 %, as a healed lesion in 23,7 %, an acute lesion in 1,3 % and a chronic lesion in 12,0 % of all cases. Male animals had significantly higher values for TLS and TTCS than female animals (P ≤ 0,05). TLS values were significantly higher in winter than in spring and summer (P < 0,001). TTCS values were significantly higher in fall than in spring and summer. TLS and TTCS values differed significantly (P < 0,001) between the four abattoirs. Only few significant correlations were found between values of TLS and TTCS and farm-specific data. Recording tail lesions at abattoirs is an accurate method to investigate the prevalence of tail lesions in fattening pigs. However, to monitor animal welfare on herd level, this method is very labor intensive. Moreover, data on tail lesions collected at the abattoir cannot replace veterinary on-farm examination for risk factor identification.
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Affiliation(s)
- U Gerster
- Swine Clinic, Department of Clinical Veterinary Medicine, University of Bern, Switzerland
| | - X Sidler
- Department for Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich
| | - B Wechsler
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office FSVO, Agroscope Tänikon, Switzerland
| | - C Nathues
- Swine Clinic, Department of Clinical Veterinary Medicine, University of Bern, Switzerland
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Sell A, Vidondo B, Wechsler B, Burla J, Nathues H. Risk factors for tail lesions in undocked fattening pigs reared on Swiss farms. SCHWEIZ ARCH TIERH 2021; 162:683-695. [PMID: 33140727 DOI: 10.17236/sat00278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/06/2022]
Abstract
INTRODUCTION Tail lesions caused by tail biting are a major welfare and economic concern in fattening pigs. The aims of this study were to describe the prevalence and incidence of tail lesions in undocked pigs on individual animal level during the fattening period, to elucidate potential risk factors associated with tail lesions, and to describe the stockpersons' attitudes towards tail biting on Swiss farms. Thirty-eight farms were visited three times during the fattening period (beginning, mid-point, end). During each farm visit, tail lesions were scored on 30-126 individually marked pigs per farm (total: 2209 pigs), information on potential risk factors for tail lesions was recorded, and a standardized interview with the farmer was conducted to explore his/her opinion on tail biting. Potential risk factors were defined by indices when adequate, and their influence on the occurrence of tail lesions was analyzed using mixed effects logistic regression models. During the first and the second half of the fattening period, on average 14,1 and 15,4 pigs, respectively, out of 100 developed new tail lesions or aggravation of old lesions. The risk for new or aggravated tail lesions increased with higher scores for a «disease index» and with increasing group size, and it decreased with higher space allowances and with restrictive compared with ad libitum feeding. The prevalence of tail lesions on arrival was not associated with the incidence of tail lesions in the first and the second half of the fattening period, neither at farm level nor at pen level. In the interviews, farmers expressed their interest in getting professional advice on how to reduce tail biting on their farms. In conclusion, our study identified several risk factors for tail lesions in undocked fattening pigs indicating that the incidence of tail lesions could be reduced by improving animal health and housing conditions.
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Affiliation(s)
- A Sell
- Federal Food Safety and Veterinary Office, Centre for Proper Housing of Ruminants and Pigs, Switzerland
| | - B Vidondo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern
| | - B Wechsler
- Federal Food Safety and Veterinary Office, Centre for Proper Housing of Ruminants and Pigs, Switzerland
| | - J Burla
- Federal Food Safety and Veterinary Office, Centre for Proper Housing of Ruminants and Pigs, Switzerland
| | - H Nathues
- Clinic for Swine, Vetsuisse Faculty, University of Bern
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Dirksen N, Gygax L, Traulsen I, Wechsler B, Burla JB. Body size in relation to cubicle dimensions affects lying behavior and joint lesions in dairy cows. J Dairy Sci 2020; 103:9407-9417. [PMID: 32861488 DOI: 10.3168/jds.2019-16464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/11/2019] [Accepted: 04/28/2020] [Indexed: 11/19/2022]
Abstract
Adequate cubicle dimensions are important for dairy cows to allow for species-appropriate lying behavior. Even though cow body size has increased in the last 2 decades, the cubicle dimensions of housing systems built many years ago have not been adjusted on most farms. Therefore, cows may be impaired in their lying behaviors, and thus the present study aimed to determine the influence of the ratio of body size to cubicle dimension on lying behavior and joint lesions. We investigated the lying behavior of 144 cows with withers heights of 140 to 163 cm on 8 Swiss dairy farms. Among the farms, the cubicle bed length varied from 187 to 200 cm and lunge space length varied from 47 to 202 cm. Specific behaviors of lying down and standing up movements, as well as lying positions, were observed on 3 d per farm. As outcome variables, the occurrences of these behaviors were calculated as proportions in relation to the respective total number of observations per cow. In addition, the presence of joint lesions was scored once. Data of the individual cows were analyzed in relation to the given cubicle dimensions on the farms by mixed-effects models. The bed length ratio [bed length (cm) on the farm/withers height (cm) of the observed cow] and the lunge space ratio [lunge space length (cm) on the farm/withers height (cm) of the observed cow] were used as explanatory variables. An increase in the bed length ratio was associated with decreased proportions of lying down movements with (1) repeated head pendulum movements, (2) repeated stepping with front legs, and (3) hitting against cubicle elements; decreased proportions of standing up movements with (1) shifting backward, (2) hesitant head lunge movements, and (3) hitting against cubicle elements; and an increased proportion of lying positions without physical contact with cubicle elements. An increase in the lunge space ratio was associated with a decreased proportion of standing up movements with sideways directed head lunge movements. Furthermore, an increase in the bed length ratio decreased the proportion of cows with tarsal joint lesions. To summarize, the lying behavior of large-framed cows was clearly modified given the cubicle dimensions in use on the study farms. In view of the consistency of the obtained results, we recommend adjusting the dimensions of cubicles so that they are suitable for cows whose body size meets the breeding goals of the farm.
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Affiliation(s)
- N Dirksen
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office FSVO, Agroscope Tänikon, 8356 Ettenhausen, Switzerland; Livestock Systems, Department of Animal Science, Georg-August-Universität Göttingen, Albrecht-Thaer-Weg 3, 37075 Göttingen, Germany
| | - L Gygax
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office FSVO, Agroscope Tänikon, 8356 Ettenhausen, Switzerland; Animal Husbandry and Ethology, Albrecht Daniel Thaer-Institute of Agricultural and Horticultural Sciences, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - I Traulsen
- Livestock Systems, Department of Animal Science, Georg-August-Universität Göttingen, Albrecht-Thaer-Weg 3, 37075 Göttingen, Germany
| | - B Wechsler
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office FSVO, Agroscope Tänikon, 8356 Ettenhausen, Switzerland
| | - J-B Burla
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office FSVO, Agroscope Tänikon, 8356 Ettenhausen, Switzerland.
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Aerni V, Brinkhof M, Wechsler B, Oester H, Fröhlich E. Productivity and mortality of laying hens in aviaries: a systematic review. WORLD POULTRY SCI J 2019. [DOI: 10.1079/wps200450] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- V. Aerni
- Bächlerenweg 20, CH-3044 Säriswil, Switzerland
| | - M.W.G. Brinkhof
- Department of Social and Preventive Medicine, Division of Epidemiology and Biostatistics, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
| | - B. Wechsler
- Swiss Federal Veterinary Office, Centre for Proper Housing of Ruminants and Pigs, CH-8356 Ettenhausen, Switzerland
| | - H. Oester
- Swiss Federal Veterinary Office, Centre for Proper Housing of Poultry and Rabbits, Burgerweg 22, CH-3052 Zollikofen, Switzerland
| | - E. Fröhlich
- Swiss Federal Veterinary Office, Centre for Proper Housing of Poultry and Rabbits, Burgerweg 22, CH-3052 Zollikofen, Switzerland
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Roriz M, Crassard I, Lechtman S, Saadoun D, Champion K, Wechsler B, Chabriat H, Sène D. Can anticoagulation therapy in cerebral venous thrombosis associated with Behçet's disease be stopped without relapse? Rev Neurol (Paris) 2018. [PMID: 29523353 DOI: 10.1016/j.neurol.2017.06.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Indexed: 11/15/2022]
Abstract
There is as yet no consensus on the treatment of cerebral venous thrombosis (CVT) in Behçet's disease, and the place of anticoagulation is also still being debated. This report is of a series of seven patients with Behçet's disease (BD)-associated CVT, for which anticoagulation was stopped, and discusses the possibility of stopping anticoagulation during follow-up while receiving optimal treatment for BD. The diagnosis of BD was established during follow-up, which lasted a median of 120 [range: 60-1490] days after CVT diagnosis. The median duration of anticoagulation therapy was 29.5 months. On stopping anticoagulation, concomitant treatment then included colchicine, steroids and azathioprine, all introduced after BD was diagnosed. With a median follow-up of 25 months after anticoagulation interruption, only one relapse of CVT was observed. No relapse of CVT or other venous thrombosis was observed in the six patients treated by steroids associated with an immunosuppressant or colchicine. Our results emphasize that corticosteroids are essential for the treatment of BD-associated CVT, and that anticoagulant therapy may be safely stopped during follow-up in the presence of optimal BD treatment (steroids alone or with immunosuppressive drugs).
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Affiliation(s)
- M Roriz
- Internal Medicine Department, Lariboisière Hospital, Paris VII University, 2 rue Ambroise Paré, 75475 Paris, France.
| | - I Crassard
- Neurology Department, Lariboisière Hospital, Paris VII University, DHU NeuroVasc, 2 rue Ambroise Paré, 75475 Paris, France
| | - S Lechtman
- Internal Medicine Department, Lariboisière Hospital, Paris VII University, 2 rue Ambroise Paré, 75475 Paris, France
| | - D Saadoun
- Internal Medicine Department, La Pitié-Salpétrière Hospital, Paris VI University, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - K Champion
- Internal Medicine Department, Lariboisière Hospital, Paris VII University, 2 rue Ambroise Paré, 75475 Paris, France
| | - B Wechsler
- Internal Medicine Department, La Pitié-Salpétrière Hospital, Paris VI University, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - H Chabriat
- Neurology Department, Lariboisière Hospital, Paris VII University, DHU NeuroVasc, 2 rue Ambroise Paré, 75475 Paris, France
| | - D Sène
- Internal Medicine Department, Lariboisière Hospital, Paris VII University, 2 rue Ambroise Paré, 75475 Paris, France
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Weigele H, Gygax L, Steiner A, Wechsler B, Burla JB. Moderate lameness leads to marked behavioral changes in dairy cows. J Dairy Sci 2018; 101:2370-2382. [DOI: 10.3168/jds.2017-13120] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/08/2017] [Indexed: 11/19/2022]
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Helmreich S, Wechsler B, Hauser R, Gygax L. Effects of milking frequency in automatic milking systems on salivary cortisol, immunoglobulin A, somatic cell count and melatonin. SCHWEIZ ARCH TIERH 2016; 158:179-86. [PMID: 27518313 DOI: 10.17236/sat00054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 11/06/2022]
Abstract
INTRODUCTION In barns with an automatic milking system (AMS), both the milking frequency and the number of nighttime milkings vary between cows. A low milking frequency might indicate problems in gaining access to the milking unit. Also, nighttime lighting in the waiting area of the AMS and in the milking unit increases exposure to light at night and could suppress nocturnal melatonin synthesis. These effects could result in increased stress, suppressed immune response, and poor udder health. A total of 125 cows (14-16/farm) on 8 farms with AMS were selected based on their average milking frequency. Eight to 10 saliva samples per cow were taken over the course of 4 days, and cortisol, IgA and melatonin concentrations were determined. Somatic cell counts (SCC) were determined in milk samples. Milking frequency had no significant relationship with mean cortisol and IgA levels, but a higher milking frequency tended to be associated with lower SCC levels. Nocturnal melatonin levels tended to be negatively associated with the number of nighttime milkings. In conclusion, no indication of increased stress or reduced immune defense was found in relation to milking frequency on farms with an AMS.
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Affiliation(s)
- S Helmreich
- Food Safety and Veterinary Office FSVO, Centre for Proper Housing of Ruminants and Pigs, Switzerland
| | - B Wechsler
- Food Safety and Veterinary Office FSVO, Centre for Proper Housing of Ruminants and Pigs, Switzerland
| | - R Hauser
- Food Safety and Veterinary Office FSVO, Centre for Proper Housing of Ruminants and Pigs, Switzerland
| | - L Gygax
- Food Safety and Veterinary Office FSVO, Centre for Proper Housing of Ruminants and Pigs, Switzerland
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Alghamdi A, Bodaghi B, Wechsler B, Cacoub P, LeHoang P, Saadoun D, Touitou V. Neuro-ophthalmological manifestations of Behcet's disease. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0695] [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] [Indexed: 12/01/2022]
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Desbois AC, Wechsler B, Cacoub P, Saadoun D. Atteintes aortiques inflammatoires associées à la maladie de Behçet. Rev Med Interne 2016; 37:230-8. [DOI: 10.1016/j.revmed.2015.10.351] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/27/2015] [Indexed: 11/27/2022]
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Comarmond C, Mirault T, Biard L, Nizard J, Lambert M, Wechsler B, Hachulla E, Chiche L, Koskas F, Gaudric J, Cluzel P, Messas E, Resche-Rigon M, Piette JC, Cacoub P, Saadoun D. Takayasu Arteritis and Pregnancy. Arthritis Rheumatol 2015; 67:3262-9. [DOI: 10.1002/art.39335] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/13/2015] [Indexed: 01/26/2023]
Affiliation(s)
- C. Comarmond
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - T. Mirault
- AP-HP, Hôpital Européen Georges-Pompidou, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux Universitaires Paris Ouest, and Université Paris Descartes, Paris 5, Sorbonne Paris Cité; Paris France
| | - L. Biard
- AP-HP, SBIM, Hôpital Saint-Louis and Université Paris Diderot, Paris 7, INSERM, CRESS UMR-S 1153; Paris France
| | - J. Nizard
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Sorbonne Universités, Université Pierre et Marie Curie, Paris 6, CNRS UMR 7222, INSERM U1150; Paris France
| | - M. Lambert
- Hôpital Claude Huriez, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre Hospitalier Régional Universitaire de Lille, and Université de Lille 2; Lille France
| | - B. Wechsler
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - E. Hachulla
- Hôpital Claude Huriez, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre Hospitalier Régional Universitaire de Lille, and Université de Lille 2; Lille France
| | - L. Chiche
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6; Paris France
| | - F. Koskas
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6; Paris France
| | - J. Gaudric
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6; Paris France
| | - P. Cluzel
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6, INSERM-CNRS-LIB; Paris France
| | - E. Messas
- AP-HP, Hôpital Européen Georges-Pompidou, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux Universitaires Paris Ouest, and Université Paris Descartes, Paris 5, Sorbonne Paris Cité; Paris France
| | - M. Resche-Rigon
- AP-HP, SBIM, Hôpital Saint-Louis and Université Paris Diderot, Paris 7, INSERM, CRESS UMR-S 1153; Paris France
| | - J. C. Piette
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - P. Cacoub
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
| | - D. Saadoun
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6; Paris France
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Kutzer T, Steilen M, Gygax L, Wechsler B. Habituation of dairy heifers to milking routine—Effects on human avoidance distance, behavior, and cardiac activity during milking. J Dairy Sci 2015; 98:5241-51. [DOI: 10.3168/jds.2014-8773] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 04/15/2015] [Indexed: 11/19/2022]
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13
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Vallet H, Riviere S, Sanna A, Deroux A, Moulis G, Addimanda O, Salvarani C, Lambert M, Bielefeld P, Seve P, Sibilia J, Pasquali J, Fraison J, Marie I, Perard L, Bouillet L, Cohen F, Sene D, Schoindre Y, Lidove O, Le Hoang P, Hachulla E, Fain O, Mariette X, Papo T, Wechsler B, Bodaghi B, Rigon MR, Cacoub P, Saadoun D. Efficacy of anti-TNF alpha in severe and/or refractory Behçet's disease: Multicenter study of 124 patients. J Autoimmun 2015; 62:67-74. [PMID: 26162757 DOI: 10.1016/j.jaut.2015.06.005] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/06/2015] [Accepted: 06/07/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To report the efficacy and safety of anti-TNF agents in patients with severe and/or refractory manifestations of Behçet's disease (BD). METHODS We performed a multicenter study of main characteristics and outcomes of anti-TNF alpha treatments [mainly infliximab (62%), and adalimumab (30%)] in 124 BD patients [48% of men; median age of 33.5 (28-40) years]. RESULTS Overall response (i.e. complete and partial) rate was 90.4%. Clinical responses were observed in 96.3%, 88%, 70%, 77.8%, 92.3% and 66.7% of patients with severe and/or refractory ocular, mucocutaneous, joint, gastro-intestinal manifestations, central nervous system manifestations and cardiovascular manifestations, respectively. No significant difference was found with respect to the efficacy of anti-TNF used as monotherapy or in association with an immunosuppressive agent. The incidence of BD flares/patient/year was significantly lower during anti-TNF treatment (0.2 ± 0.5 vs 1.7 ± 2.4 before the use of anti-TNF, p < 0.0001). The prednisone dose was significantly reduced at 6 and 12 months (p < 0.0001). In multivariate analysis, retinal vasculitis was negatively associated with complete response to anti-TNF (OR = 0.33 [0.12-0.89]; p = 0.03). The efficacy and relapse free survival were similar regardless of the type of anti-TNF agent used. After a median follow-up of 21 [7-36] months, side effects were reported in 28% of patients, including infections (16.3%) and hypersensitivity reactions (4.1%). Serious adverse events were reported in 13% of cases. CONCLUSION Anti-TNF alpha therapy is efficient in all severe and refractory BD manifestations. Efficacy appears to be similar regardless of the anti-TNF agent used (infliximab or adalimumab).
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Affiliation(s)
- H Vallet
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière hospital, 83, boulevard de l'Hôpital, Paris 75013, France; Centre national de référence maladies systémiques et autoimmunes rares, DHU Inflammation, Immunopathologie, Biothérapie, Université Paris VI-Pierre et Marie Curie, Paris, France
| | - S Riviere
- Department of Internal Medicine, Saint Eloi Hospital, Montpellier, France
| | - A Sanna
- Department of Clinical Epidemiology and Biostatistics, Saint Louis Hospital, France
| | - A Deroux
- Department of Internal Medicine, University Hospital, Grenoble, France
| | - G Moulis
- Department of Internal Medicine, University Hospital, Toulouse, France
| | - O Addimanda
- Department of Rheumatology, Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - C Salvarani
- Department of Rheumatology, Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - M Lambert
- Department of Internal Medicine, University Hospital, Lille, France
| | - P Bielefeld
- Department of Internal Medicine, University Hospital, Dijon, France
| | - P Seve
- Department of Internal Medicine, Croix Rousse Hospital, Lyon, France
| | - J Sibilia
- Department of Rheumatology, University Hospital, Strasbourg, France
| | - Jl Pasquali
- Department of Internal Medicine, University Hospital, Strasbourg, France
| | - Jb Fraison
- Department of Internal Medicine, Jean Verdier Hospital, Bondy, France
| | - I Marie
- Department of Internal Medicine, University Hospital, Rouen, France
| | - L Perard
- Department of Internal Medicine, Edouard Herriot Hospital, Lyon, France
| | - L Bouillet
- Department of Internal Medicine, University Hospital, Grenoble, France
| | - F Cohen
- Department of Internal Medicine, E3M Institut, Pitié Salpêtrière Hospital, Paris, France
| | - D Sene
- Department of Internal Medicine, Lariboisière Hospital, Paris, France
| | - Y Schoindre
- Department of Internal Medicine, Pitié Salpêtrière Hospital, Paris, France
| | - O Lidove
- Department of Internal Medicine, Croix Saint Simon Hospital, Paris, France
| | - P Le Hoang
- Department of Ophtalmology, Pitié Salpêtrière Hospital, Paris, France
| | - E Hachulla
- Department of Internal Medicine, University Hospital, Lille, France
| | - O Fain
- Department of Internal Medicine, Saint Antoine Hospital, Paris, France
| | - X Mariette
- Department of Rheumatology, Kremlin Bicetre University Hospital, Kremlin Bicetre, France
| | - T Papo
- Department of Internal Medicine, Bichat Hospital, Paris, France
| | - B Wechsler
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière hospital, 83, boulevard de l'Hôpital, Paris 75013, France; Centre national de référence maladies systémiques et autoimmunes rares, DHU Inflammation, Immunopathologie, Biothérapie, Université Paris VI-Pierre et Marie Curie, Paris, France
| | - B Bodaghi
- Department of Ophtalmology, Pitié Salpêtrière Hospital, Paris, France
| | - M Resche Rigon
- Department of Clinical Epidemiology and Biostatistics, Saint Louis Hospital, France
| | - P Cacoub
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière hospital, 83, boulevard de l'Hôpital, Paris 75013, France; Centre national de référence maladies systémiques et autoimmunes rares, DHU Inflammation, Immunopathologie, Biothérapie, Université Paris VI-Pierre et Marie Curie, Paris, France
| | - D Saadoun
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière hospital, 83, boulevard de l'Hôpital, Paris 75013, France; Centre national de référence maladies systémiques et autoimmunes rares, DHU Inflammation, Immunopathologie, Biothérapie, Université Paris VI-Pierre et Marie Curie, Paris, France.
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Orquevaux P, Masseau A, Le Guern V, Gayet V, Vauthier D, Boutin D, Wechsler B, Morel N, Guettrot-Imbert G, Pennaforte JL, Piette JC, Costedoat-Chalumeau N. [In vitro fertilization and systemic lupus erythematosus or antiphospholipid syndrome: An update]. Rev Med Interne 2014; 36:154-8. [PMID: 25217451 DOI: 10.1016/j.revmed.2014.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 06/05/2014] [Accepted: 08/13/2014] [Indexed: 11/15/2022]
Abstract
Fertility is not impaired in systemic lupus erythematosus or antiphospholipid syndrome, but, similarly to the general population, these patients may undergo in vitro fertilization. This type of treatment increases the risk of lupus flare, thrombosis, and ovarian hyperstimulation syndrome. This review will focus on in vitro fertilization in systemic lupus erythematosus or antiphospholipid syndrome. Literature data are relatively scant with only 3 reported studies. The first one included 17 patients and 63 cycles of induction ovulation/in vitro fertilization leading to 25 % of lupus flare, no thrombosis, and 3 % of ovarian hyperstimulation syndrome. The second study included 10 patients and 40 cycles of in vitro fertilization showing 31 % of lupus flare, no thrombosis and no ovarian hyperstimulation syndrome. The last one included 34 patients and 83 procedures of in vitro fertilization leading to 8 % of flares, 5 % of thrombosis and no ovarian hyperstimulation syndrome. Interestingly, in this last study, half of the complications were explained by poor adherence to treatment. These data are reassuring but it is important to remember that in vitro fertilization should be scheduled and carefully supervised in the same way as the high-risk pregnancies occurring in these patients.
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Affiliation(s)
- P Orquevaux
- Service de médecine interne, centre de compétence maladies auto-immunes et systémiques rares, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France
| | - A Masseau
- Service de médecine interne, centre de compétence maladies auto-immunes et systémiques rares, Hôtel Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - V Le Guern
- Service de médecine interne, centre de référence maladies auto-immunes et systémiques rares, pôle médecine, université René-Descartes, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
| | - V Gayet
- Service de gynécologie-obstétrique, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
| | - D Vauthier
- Service de gynécologie-obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - D Boutin
- Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - B Wechsler
- Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - N Morel
- Service de médecine interne, centre de référence maladies auto-immunes et systémiques rares, pôle médecine, université René-Descartes, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
| | - G Guettrot-Imbert
- Service de médecine interne, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France
| | - J-L Pennaforte
- Service de médecine interne, centre de compétence maladies auto-immunes et systémiques rares, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France
| | - J-C Piette
- Service de médecine interne, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - N Costedoat-Chalumeau
- Service de médecine interne, centre de référence maladies auto-immunes et systémiques rares, pôle médecine, université René-Descartes, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
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15
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Vögeli S, Wechsler B, Gygax L. Welfare by the ear: comparing relative durations and frequencies of ear postures by using an automated tracking system in sheep. Anim Welf 2014. [DOI: 10.7120/09627286.23.3.267] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Vallet H, Riviere S, Lambert M, Deroux A, Bielfeld P, Seve P, Fraison J, Perard L, Schoindre Y, Papo T, Kaplanski G, Sellam J, Le Hoang T, Fain O, Marie I, Sene D, Mariette X, Blaison G, Hachulla E, Perlat A, Wechsler B, Cacoub P, Bodaghi B, Saadoun D. SAT0269 Efficacy and Safety of Anti-TNF Alpha in BehÇEt Disease: Preliminary Results of A French Multicenter Registry of 92 Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5903] [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: 11/03/2022]
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17
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Vallet H, Seve P, Riviere S, Perard L, Bielefeld P, Abad S, Rigolet A, Perlat A, Fain O, Bienvenu B, Le Hoang T, Sene D, Tieulie N, Wechsler B, Chapelon C, Fraison J, Schoindre Y, Bodaghi B, Cacoub P, Saadoun D. THU0379 Efficacy and Safety of Anti-TNF Alpha in NON Infectious Inflammatory Uveitis: Preliminary Results of A French Multicenter Registry of 162 Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.6013] [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: 11/04/2022]
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18
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Haufe H, Friedli K, Gygax L, Wechsler B. Influence of floor surface and access to pasture on claw characteristics in dairy cows kept in cubicle housing systems. SCHWEIZ ARCH TIERH 2014; 156:171-7. [DOI: 10.1024/0036-7281/a000572] [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] [Indexed: 11/19/2022]
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19
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Wechsler B, Cacoub P, Saadoun D. La maladie de Behçet : actualités en 2014. Rev Med Interne 2014; 35:79-80. [DOI: 10.1016/j.revmed.2013.12.009] [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: 11/30/2013] [Accepted: 12/02/2013] [Indexed: 10/25/2022]
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20
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Comarmond C, Wechsler B, Cacoub P, Saadoun D. Traitement de la maladie de Behçet. Rev Med Interne 2014; 35:126-38. [DOI: 10.1016/j.revmed.2013.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 12/02/2013] [Indexed: 12/14/2022]
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21
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Desbois AC, Wechsler B, Cluzel P, Helft G, Boutin D, Piette JC, Cacoub P, Saadoun D. [Cardiovascular involvement in Behçet's disease]. Rev Med Interne 2014; 35:103-11. [PMID: 24434015 DOI: 10.1016/j.revmed.2013.12.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 12/02/2013] [Indexed: 12/15/2022]
Abstract
Vascular involvement is a common complication of Behçet's disease (BD) and affects up to 40% of BD patients. These complications worsen the prognosis of BD. The concept of vasculo-Behçet has been adopted for cases in which vascular complications dominate the clinical features. Vascular manifestations affect particularly young men, during the first years following onset of the disease. Venous complications are the most frequent vascular complications, affecting 14 to 40% of BD patients. Superficial and deep lower limb thrombosis is the most frequent venous complications but one third of venous thrombosis concern large vessels (such as cerebral venous thrombosis, pulmonary embolism, and inferior or superior vena cava, etc.). Budd-Chiari syndrome is the worst prognostic factor increasing mortality by 9 times. Arterial complications (2 to 17% of BD patients) include aneurysms and occlusions/stenosis. Main locations of arterial lesions are aortic (abdominal and thoracic), femoral, pulmonary and iliac arteries. Aneurysms are the most severe arterial complications, particularly pulmonary aneurysms associated with a high risk of massive bleeding. Cardiac complications (up to 6% of BD patients) include pericarditis, endocardial lesions (aortic regurgitation and less often mitral insufficiency), myocardial lesions (myocardial infarction, myocarditis and endomyocardial fibrosis) and intracardiac thrombosis (right ventricle and atrium). Coronary lesions complicated to myocardial infarction are the most severe cardiac complications. Treatment is based on corticosteroids and immunosuppressive drugs. The use of anticoagulation in venous thrombosis is still controversial.
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Affiliation(s)
- A-C Desbois
- Service de médecine interne, centre de référence des maladies autoimmunes rares, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France; DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, AP-HP, 75013 Paris, France
| | - B Wechsler
- Service de médecine interne, centre de référence des maladies autoimmunes rares, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - P Cluzel
- Service de radiologie, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - G Helft
- Service de cardiologie, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - D Boutin
- Service de médecine interne, centre de référence des maladies autoimmunes rares, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - J-C Piette
- Service de médecine interne, centre de référence des maladies autoimmunes rares, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - P Cacoub
- Service de médecine interne, centre de référence des maladies autoimmunes rares, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France; DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, AP-HP, 75013 Paris, France
| | - D Saadoun
- Service de médecine interne, centre de référence des maladies autoimmunes rares, groupe hospitalier Pitié-Salpêtrière, 75013 Paris, France; DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, AP-HP, 75013 Paris, France.
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22
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Vallet H, Bodaghi B, Seve P, Wechsler B, Heron E, Perlat A, Tieulie N, Perard L, Schoindre Y, Cacoub P, Saadoun D. Efficacité et tolérance des anti-TNFα dans le traitement des uvéites inflammatoires non infectieuses : registre multicentrique national sur 136 patients. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.023] [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: 10/26/2022]
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23
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Papo M, Bodaghi B, Wechsler B, Darugar A, Muselier A, Bielefeld P, Vallet H, Papo T, Cacoub P, Saadoun D. Efficacité et tolérance du tocilizumab dans les uvéites inflammatoires non infectieuses sévères et réfractaires : une étude rétrospective sur 8 cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.024] [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: 11/29/2022]
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24
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Noel N, Drier A, Wechsler B, Piette JC, De Paz R, Dormont D, Cacoub P, Saadoun D. [Neurological manifestations of Behçet's disease]. Rev Med Interne 2013; 35:112-20. [PMID: 24290030 DOI: 10.1016/j.revmed.2013.10.332] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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: 10/09/2013] [Accepted: 10/12/2013] [Indexed: 11/17/2022]
Abstract
Neurological manifestations of Behçet's disease (BD) occur in 5.3 to more than 50% of patients. They are divided into two major forms: "parenchymal" lesions, which include mainly meningoencephalitis as opposed to "extra-parenchymal" lesions (i.e. cerebral venous thrombosis and arterial aneurysms). Myelitis or peripheral neuropathy is exceptional. The neuro-Behçet syndrome (NBS) should be considered in the setting of neurological manifestations, particularly headache and pyramidal signs, in a young man diagnosed with BD. However, its recognition may be difficult when neurological manifestations are the presenting features of BD (one third of cases), and requires a thorough knowledge of clinical manifestations and morphological lesions. Thus, parenchymal NB lesions classically exhibit inflammatory characteristics on MRI and are located at the meso-diencephalic junction and in the brainstem, rarely with a supratentorial extension. Meningitis is not systematically associated, and may be absent in about 30% of cases. The pathogenesis of these lesions is incompletely understood, but inflammatory infiltrates include mainly neutrophils and activated T cells (mainly Th17). Differential diagnoses include infectious diseases (herpes, listeria, tuberculosis), and inflammatory diseases (i.e. multiple sclerosis and sarcoidosis). A prompt recognition of NBS should lead to initiate adequate therapies in order to limit the risk of sequelae, relapses or death.
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Affiliation(s)
- N Noel
- Service de médecine interne 2, centre de référence des maladies autoimmunes rares, DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - A Drier
- Service de neuroradiologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - B Wechsler
- Service de médecine interne 2, centre de référence des maladies autoimmunes rares, DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - J-C Piette
- Service de médecine interne 2, centre de référence des maladies autoimmunes rares, DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75013 Paris, France
| | - R De Paz
- Service de neurologie, groupe hospitalier Pitié-Salpétrière, AP-HP, 75013 Paris, France
| | - D Dormont
- Service de neuroradiologie, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75013 Paris, France
| | - P Cacoub
- Service de médecine interne 2, centre de référence des maladies autoimmunes rares, DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75013 Paris, France
| | - D Saadoun
- Service de médecine interne 2, centre de référence des maladies autoimmunes rares, DHU i2B, immunopathologie, inflammation, biothérapie, université Pierre-et-Marie-Curie, Paris 6, groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75013 Paris, France.
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25
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Orquevaux P, Masseau A, Le Guern V, Gayet V, Vauthier D, Boutin-Le Thi Huong D, Wechsler B, Morel N, Pennaforte JL, Piette JC, Costedoat-Chalumeau N. Fécondation in vitro chez des patientes ayant un lupus érythémateux systémique et/ou un syndrome des antiphospholipides. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.311] [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: 10/26/2022]
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26
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Noel N, Wechsler B, Bernard R, Resche-Rigon M, Le Thi Huong Boutin D, Dormont D, Cacoub P, Saadoun D. Facteurs pronostiques du neuro-Behçet : analyse d’une série monocentrique de 115 patients. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.310] [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: 10/26/2022]
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27
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Saadoun D, Resche Rigon M, Wechsler B, Boutin-Le Thi Huong D, Piette JC, Cacoub P. L’origine géographique dans la maladie de Behçet influence le phénotype clinique et le pronostic. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.308] [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: 10/26/2022]
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28
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Noel N, Wechsler B, Nizard J, Costedoat-Chalumeau N, Le Thi Huong Boutin D, Vauthier-Brouzes D, Dommergues M, Cacoub P, Saadoun D. Behçet's disease and pregnancy. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.096] [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] [Indexed: 11/16/2022] Open
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29
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Desbois A, Rautou P, Plessier A, Belmatoug N, Pineton De Chambrun M, Wechsler B, Resche-Rigon M, Fantin B, Valla D, Cacoub P, Saadoun D. Behçet's disease in Budd-Chiari Syndrome. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.061] [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] [Indexed: 11/25/2022] Open
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30
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Hauser R, Wechsler B. [Assessment of noise exposure in sheep]. SCHWEIZ ARCH TIERH 2013; 155:129-34. [PMID: 23385071 DOI: 10.1024/0036-7281/a000429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The behaviour of sheep was recorded as a reaction to the sound pressure levels caused by shooting with heavy machine guns. The reactions varied in intensity depending on the distance of the source of the noise from the fold. In the case of salvoes that were fired in the immediate vicinity of the fold and were associated with sound pressure levels higher than 120 dB (LCpeak), the sheep reacted with marked fright reactions, and no adaptation to the shooting noise was observed. It is concluded that the tolerable maximum noise level for sheep with this kind of noise source is likely to be less than 120 dB (LCpeak).
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Affiliation(s)
- R Hauser
- Bundesamt für Veterinärwesen, Zentrum für tiergerechte Haltung: Wiederkäuer und Schweine, Bern
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31
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Mathian A, Devilliers H, Krivine A, Costedoat-Chalumeau N, Haroche J, Huong DBLT, Wechsler B, Hervier B, Miyara M, Morel N, Le Corre N, Arnaud L, Piette JC, Musset L, Autran B, Rozenberg F, Amoura Z. Factors influencing the efficacy of two injections of a pandemic 2009 influenza A (H1N1) nonadjuvanted vaccine in systemic lupus erythematosus. ACTA ACUST UNITED AC 2013; 63:3502-11. [PMID: 21811996 DOI: 10.1002/art.30576] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the factors influencing the efficacy of 2 injections of a pandemic 2009 influenza A (H1N1) vaccine in patients with systemic lupus erythematosus (SLE). METHODS We conducted a single-center, observational prospective study of 111 patients who were vaccinated with a monovalent, inactivated, nonadjuvanted, split-virus vaccine during December 2009 and January 2010 and received a second dose of vaccine 3 weeks later. The antibody response was evaluated using the hemagglutination inhibition assay according to the guidelines recommended for the pandemic vaccine, consisting of 3 immunogenicity criteria (i.e., a seroprotection rate of 70%, a seroconversion rate of 40%, and a geometric mean ratio [GMR] of 2.5). RESULTS The 3 immunogenicity criteria were met on day 42 (seroprotection rate 80.0% [95% confidence interval (95% CI) 72.5-87.5%], seroconversion rate 71.8% [95% CI 63.4-80.2%], and GMR 10.3 [95% CI 2.9-14.2]), while only 2 criteria were met on day 21 (seroprotection rate 66.7% [95% CI 57.9-75.4%], seroconversion rate 60.4% [95% CI 51.3-69.5%], and GMR 8.5 [95% CI 3.2-12.0]). The vaccine was well tolerated. Disease activity, assessed by the Safety of Estrogens in Lupus Erythematosus National Assessment version of the SLE Disease Activity Index, the British Isles Lupus Assessment Group score, and the Systemic Lupus Activity Questionnaire, did not increase. In the multivariate analysis, vaccination failure was significantly associated with immunosuppressive treatment or a lymphocyte count of ≤ 1.0 × 10⁹/liter. The second injection significantly increased the immunogenicity in these subgroups, but not high enough to fulfill the seroprotection criterion in patients receiving immunosuppressive treatment. CONCLUSION Our findings indicate that the efficacy of the vaccine was impaired in patients who were receiving immunosuppressive drugs or who had lymphopenia. A second injection increased vaccine immunogenicity without reaching all efficacy criteria for a pandemic vaccine in patients receiving an immunosuppressive agent. These results open possibilities for improving anti-influenza vaccination in SLE.
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Affiliation(s)
- A Mathian
- Centre de Référence National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945, Paris, France.
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Mellema SC, Doherr MG, Wechsler B, Thüer S, Steiner A. Einfluss der Lokalanästhesie auf Schmerz und Stress verursacht durch unblutige Kastrationsmethoden beim jungen Lamm. SCHWEIZ ARCH TIERH 2012; 149:213-25. [PMID: 17557613 DOI: 10.1024/0036-7281.149.5.213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/19/2022]
Abstract
Behavioural and cortisol responses of lambs were used as indicators of pain and distress to assess short- and long-term effects of bloodless castration methods with and without local anaesthesia. Eighty lambs, aged 2-7 days, were control handled or castrated by crushing- Burdizzo- or rubber ring method with and without local anaesthesia. Either 4 mg/kg diluted lidocaine, or corresponding volumes of physiologic sodium chloride solution were distributed in both spermatic cords and the scrotal neck. The serum cortisol response was monitored for 48 h, behavioural- and clinical traits over a 3-month period. The crushing castration method was excluded from the study after 10 lambs had been castrated, since this method showed severe local reactions. Local anaesthesia significantly reduced behavioural and cortisol responses after rubber ring castration and tendentially after Burdizzo castration. Prolonged or chronic pain after rubber ring castration with anaesthesia was not evident. If combined with local anaesthesia, both the rubber ring and the Burdizzo method are acceptable methods for castration of lambs up to one week of age.
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Affiliation(s)
- S C Mellema
- Wiederkäuerklinik, Departement für klinische Veterinärmedizin der Universität Bern
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Desbois AC, Plessier A, Rautou PE, Chambrun MPD, Wechsler B, Belmatoug N, Cacoub P, Saadoun D. Les syndromes de Budd-Chiari secondaires à la maladie de Behçet. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.124] [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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Desbois AC, Wechsler B, Resche-Rigon M, Piette JC, Huong DLT, Amoura Z, Koskas F, Desseaux K, Cacoub P, Saadoun D. Immunosuppressants reduce venous thrombosis relapse in Behçet's disease. ACTA ACUST UNITED AC 2012; 64:2753-60. [DOI: 10.1002/art.34450] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wechsler B, Canuel C, Geffray L, Hanslik T, Kettaneh A, Pavic M, Vignes S, Lévesque H, Pouchot J. Communications orales à l’honneur présentées au cours du 64e congrès de la Société nationale française de médecine interne (Paris, 14–16 décembre 2011). Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.02.006] [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: 10/28/2022]
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Costedoat-Chalumeau N, Guettrot-Imbert G, Leguern V, Leroux G, Le Thi Huong D, Wechsler B, Morel N, Vauthier-Brouzes D, Dommergues M, Cornet A, Aumaître O, Pourrat O, Piette JC, Nizard J. Grossesse et syndrome des antiphospholipides. Rev Med Interne 2012; 33:209-16. [DOI: 10.1016/j.revmed.2012.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 01/04/2012] [Indexed: 10/14/2022]
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Lebeaux D, Frances C, Barete S, Wechsler B, Dubourg O, Renoux J, Maisonobe T, Benveniste O, Gatfosse M, Bourgeois P, Amoura Z, Cacoub P, Piette JC, Sene D. Eosinophilic fasciitis (Shulman disease): new insights into the therapeutic management from a series of 34 patients. Rheumatology (Oxford) 2011; 51:557-61. [DOI: 10.1093/rheumatology/ker366] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lebeaux D, Frances C, Wechsler B, Barete S, Dubourg O, Benveniste O, Gatfossé M, Costedoat-Chalumeau N, Amoura Z, Cacoub P, Piette JC, Sène D. Fasciite à éosinophiles : caractéristiques clinicobiologiques et histologiques ; analyse de la prise en charge thérapeutique et identification de facteurs pronostiques à partir d’une série de 34 patients. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.027] [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: 11/16/2022]
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Noel N, Hutie M, Wechsler B, Vignes S, Boutin-Le Thi Huong D, Amoura Z, Dormont D, Delcey V, Cacoub P, Saadoun D. Maladie de Behçet à expression neurologique pseudotumorale. À propos de 5 cas et revue de la littérature. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.072] [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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Desbois AC, Wechsler B, Boutin-Le Thi Huong D, Piette JC, Koskas F, Amoura Z, Resche-Rigon M, Cacoub P, Saadoun D. Les atteintes veineuses de la maladie de Behcet : étude d’une série de 296 patients. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.071] [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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Terrier B, Geri G, Wechsler B, Rosenzwajg M, Adam C, Tran TA, Boutin-Le Thi Huong D, Bodaghi B, Soumelis V, Klatzmann D, Cacoub P, Saadoun D. Rôle majeur de l’interleukine-21 dans les perturbations de l’homéostasie lymphocytaire T au cours de la maladie de Behçet : rationnel pour une nouvelle voie thérapeutique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.067] [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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Mathian A, Devilliers H, Costedoat-Chalumeau N, Haroche J, Boutin-Le Thi Huong D, Wechsler B, Hervier B, Miyara M, Morel N, Arnaud L, Piette JC, Amoura Z. Étude des facteurs influençant l’efficacité de deux injections d’un vaccin sans adjuvant contre le virus de la grippe pandémique A (H1N1) 2009 dans le lupus systémique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.129] [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: 11/28/2022]
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Saadoun D, Asli B, Wechsler B, Geri G, Piette JC, Boutin-Le Thi Huong D, Koskas F, Amoura Z, Houman M, Resche Rigon M, Cacoub P. Lésions artérielles de la maladie de Behçet : spectre clinique et évolution. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.100] [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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Abstract
OBJECTIVE To report the long-term mortality in patients with Behçet's disease (BD). METHODS A cohort of 817 patients fulfilling the international criteria for BD from a single center in France were analyzed for causes of death, the standardized mortality ratio (SMR), and the factors associated with mortality. RESULTS Among the 817 patients with BD, 41 (5%) died after a median followup of 7.7 years, of whom 95.1% were male. The mean ± SD age at death was 34.8 ± 11.9 years. Main causes of death included major vessel disease (mainly, arterial aneurysm and Budd-Chiari syndrome) (43.9%), cancer and malignant hemopathy (14.6%), central nervous system involvement (12.2%), and sepsis (12.2%). The mortality rate at 1 year and 5 years was 1.2% and 3.3%, respectively. There was an increased mortality among patients ages 15-24 years (SMR 2.99, 95% confidence interval [95% CI] 1.54-5.39) and those ages 25-34 years (SMR 2.90, 95% CI 1.80-4.49) as compared with age-and sex-matched healthy controls. The mortality decreased in patients older than age 35 years (SMR 1.23, 95% CI 0.75-1.92). In multivariate analyses, male sex (hazard ratio [HR] 4.94, 95% CI 1.53-16.43), arterial involvement (HR 2.51, 95% CI 1.07-5.90), and a high number of BD flares (HR 2.37, 95% CI 1.09-5.14) were independently associated with the risk of mortality. CONCLUSION The overall mortality in our BD cohort was 5% after a median followup of 7.7 years. Male sex, arterial involvement, and the number of flares were associated with mortality in BD.
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Affiliation(s)
- D Saadoun
- Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, and Université Pierre et Marie Curie-Paris 6, Paris, France.
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Saadoun D, Wechsler B, Terrada C, Hajage D, Le Thi Huong D, Resche-Rigon M, Cassoux N, Le Hoang P, Amoura Z, Bodaghi B, Cacoub P. Azathioprine in severe uveitis of Behçet's disease. Arthritis Care Res (Hoboken) 2010; 62:1733-8. [PMID: 20665749 DOI: 10.1002/acr.20308] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 07/20/2010] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate the efficacy and tolerance of azathioprine in severe uveitis related to Behçet's disease (BD). METHODS We reported 157 consecutive patients with severe uveitis (active posterior uveitis or panuveitis) fulfilling the international criteria for BD and treated with corticosteroids (0.5-1 mg/kg/day) and azathioprine (2.5 mg/kg/day). Long-term outcome and factors associated with complete remission were assessed. RESULTS Mean±SD age at diagnosis was 29.9±10.1 years, with 71.3% men. At baseline, 59 patients (37.6%) had loss of useful vision, 54 (34.4%) had retinal vasculitis, 66 (42.0%) had panuveitis, and 132 (84.1%) had bilateral uveitis. Following azathioprine therapy, 81 patients (51.6%) were complete responders, 65 (41.4%) were partial responders, and 11 (7%) were nonresponders. The visual acuity significantly improved (P<0.001), and a significant decrease in the mean oral prednisone dosage (55.3 to 10.5 mg/day; P<0.001) was observed after therapy. Patients with retinal vasculitis (odds ratio [OR] 0.45 [95% confidence interval (95% CI) 0.2-0.9], P=0.02) and severe visual loss (OR 0.28 [95% CI 0.2-0.7], P<0.0001) at diagnosis were less likely to be complete responders. Azathioprine was well tolerated, with only 3 withdrawals due to hepatotoxic effects (n=2) and bacterial septicemia (n=1). CONCLUSION Azathioprine represents an effective and safe therapy in patients with severe uveitis of BD.
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Affiliation(s)
- D Saadoun
- Hôpital Pitié-Salpétrière and Pierre et Marie Curie-Paris VI University, Paris, France.
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Mathian A, Devilliers H, Costedoat-Chalumeau N, Haroche J, Huong DBLT, Wechsler B, Hervier B, Miyara M, Morel N, Piette JC, Amoura Z. Étude de la tolérance d’un vaccin contre le virus influenza A (H1N1)2009 chez des patients suivis pour un lupus systémique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.381] [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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Desbois AC, Hervier B, Haroche J, Lucidarme O, Wechsler B, Charlotte F, Renard-Penna R, Coastedoat-Chalumeau N, Le Thi Huong Boutin D, Cacoub P, Chapelon-Abric C, Amoura Z. Fibrose rétropéritonéale « idiopathique » : à propos de 31 cas. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.354] [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] [Indexed: 12/01/2022]
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Hervier B, Haroche J, Galicier L, Charlotte F, Brousse N, Fieschi C, Bloch Queyrat C, Saadoun D, Frances C, Leguenno G, Wechsler B, Amoura Z. Maladie de Rosai-Dorfman-Destombes : à propos de 12 cas. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.362] [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] [Indexed: 11/26/2022]
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Geri G, Saadoun D, Guillevin R, Crozier S, Lubetzki C, Mokhtari K, Amoura Z, Wechsler B, Le Thi Huong Boutin D, Costedoat-Chalumeau N, Samson Y, Cacoub P. Vascularites du système nerveux central (VascSNC) : étude monocentrique de 77 patients. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.435] [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: 11/25/2022]
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