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Gardin A, Ruiz M, Beime J, Cananzi M, Rathert M, Rohmer B, Grabhorn E, Almes M, Logarajah V, Peña-Quintana L, Casswall T, Darmellah-Remil A, Reyes-Domínguez A, Barkaoui E, Hierro L, Baquero-Montoya C, Baumann U, Fischler B, Gonzales E, Davit-Spraul A, Laplanche S, Jacquemin E. ∆ 4-3-oxo-5β-reductase deficiency: favorable outcome in 16 patients treated with cholic acid. Orphanet J Rare Dis 2023; 18:383. [PMID: 38062451 PMCID: PMC10704681 DOI: 10.1186/s13023-023-02984-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Oral cholic acid therapy is an effective therapy in children with primary bile acid synthesis deficiencies. Most reported patients with this treatment have 3β-hydroxy-Δ5-C27-steroid oxidoreductase deficiency. The aim of the study was the evaluation of cholic acid therapy in a cohort of patients with the rarer Δ4-3-oxosteroid 5β-reductase (Δ4-3-oxo-R) deficiency. METHODS Sixteen patients with Δ4-3-oxo-R deficiency confirmed by AKR1D1 gene sequencing who received oral cholic acid were retrospectively analyzed. RESULTS First symptoms were reported early in life (median 2 months of age), with 14 and 3 patients having cholestatic jaundice and severe bleeding respectively. Fifteen patients received ursodeoxycholic acid before diagnosis, with partial improvement in 8 patients. Four patients had liver failure at the time of cholic acid initiation. All 16 patients received cholic acid from a median age of 8.1 months (range 3.1-159) and serum liver tests normalized in all within 6-12 months of treatment. After a median cholic acid therapy of 4.5 years (range 1.1-24), all patients were alive with their native liver. Median daily cholic acid dose at last follow-up was 8.3 mg/kg of body weight. All patients, but one, had normal physical examination and all had normal serum liver tests. Fibrosis, evaluated using liver biopsy (n = 4) or liver elastography (n = 9), had stabilized or improved. Cholic acid therapy enabled a 12-fold decrease of 3-oxo-∆4 derivatives in urine. Patients had normal growth and quality of life. The treatment was well tolerated without serious adverse events and signs of hepatotoxicity. CONCLUSIONS Oral cholic acid therapy is a safe and effective treatment for patients with Δ4-3-oxo-R deficiency.
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Affiliation(s)
- Antoine Gardin
- Pediatric Hepatology and Pediatric Liver Transplantation Unit, National Reference Centre for Biliary Atresia and Genetic Cholestasis, FSMR Filfoie, ERN RARE LIVER, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculty of Medicine Paris-Saclay, Le Kremlin-Bicêtre; INSERM UMR-S1193, Hepatinov, University Paris-Saclay, Orsay, France
| | - Mathias Ruiz
- Pediatric Hepatology, Gastroenterology and Nutrition Unit, Reference Centre for Biliary Atresia and Genetic Cholestasis, Hospices Civils de Lyon - Hôpital Femme Mère Enfant, Bron, France
| | - Jan Beime
- Pediatric Hepatology and Gastroenterology Unit, University Hamburg-Eppendorf, Hamburg, Germany
| | - Mara Cananzi
- Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, Dpt. For Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Margarete Rathert
- Pediatric Hepatology, Gastroenterology and Nutrition Unit, MHH Hannover/University Magdeburg, Hannover, Germany
| | - Barbara Rohmer
- Pediatric Hepatology, Gastroenterology and Nutrition Unit, Reference Centre for Biliary Atresia and Genetic Cholestasis, Hospices Civils de Lyon - Hôpital Femme Mère Enfant, Bron, France
| | - Enke Grabhorn
- Pediatric Hepatology and Gastroenterology Unit, University Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Almes
- Pediatric Hepatology and Pediatric Liver Transplantation Unit, National Reference Centre for Biliary Atresia and Genetic Cholestasis, FSMR Filfoie, ERN RARE LIVER, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculty of Medicine Paris-Saclay, Le Kremlin-Bicêtre; INSERM UMR-S1193, Hepatinov, University Paris-Saclay, Orsay, France
| | - Veena Logarajah
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, KK Women's and Children's Hospital, Singapore, Singapore
| | - Luis Peña-Quintana
- Paediatric Gastroenterology, Hepatology and Nutrition Unit. Complejo Hospitalario Universitario Insular Materno-Infantil, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Thomas Casswall
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Astrid Lindgren's Children's Hospital, CLINTEC, Karolinska Institutet, Karolinska University, Stockholm, Sweden
| | - Amaria Darmellah-Remil
- Pediatric Hepatology and Pediatric Liver Transplantation Unit, National Reference Centre for Biliary Atresia and Genetic Cholestasis, FSMR Filfoie, ERN RARE LIVER, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculty of Medicine Paris-Saclay, Le Kremlin-Bicêtre; INSERM UMR-S1193, Hepatinov, University Paris-Saclay, Orsay, France
| | - Ana Reyes-Domínguez
- Paediatric Gastroenterology, Hepatology and Nutrition Unit. Complejo Hospitalario Universitario Insular Materno-Infantil, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Emna Barkaoui
- Department of Pediatrics, Tunis Children Hospital, Tunis, Tunisia
| | - Loreto Hierro
- Pediatric Hepatology Unit, University Hospital La Paz, Madrid, Spain
| | | | - Ulrich Baumann
- Pediatric Hepatology, Gastroenterology and Nutrition Unit, MHH Hannover/University Magdeburg, Hannover, Germany
| | - Björn Fischler
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Astrid Lindgren's Children's Hospital, CLINTEC, Karolinska Institutet, Karolinska University, Stockholm, Sweden
| | - Emmanuel Gonzales
- Pediatric Hepatology and Pediatric Liver Transplantation Unit, National Reference Centre for Biliary Atresia and Genetic Cholestasis, FSMR Filfoie, ERN RARE LIVER, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculty of Medicine Paris-Saclay, Le Kremlin-Bicêtre; INSERM UMR-S1193, Hepatinov, University Paris-Saclay, Orsay, France
| | - Anne Davit-Spraul
- Biochemistry Department, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Sophie Laplanche
- Biology Unit, Groupe Hospitalier Paris - Saint Joseph, Paris, France
| | - Emmanuel Jacquemin
- Pediatric Hepatology and Pediatric Liver Transplantation Unit, National Reference Centre for Biliary Atresia and Genetic Cholestasis, FSMR Filfoie, ERN RARE LIVER, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculty of Medicine Paris-Saclay, Le Kremlin-Bicêtre; INSERM UMR-S1193, Hepatinov, University Paris-Saclay, Orsay, France.
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Antoine M, Krishnan U, Manfredi M, Cervinskiene J, Viala J, Brendel J, Tzivinikos C, Vanrenterghem A, Dimitrov G, Hauser B, Laverdure N, Rohmer B, Behal H, Nicolas A, Gottrand F. Endoscopic management of esophageal mucosal bridges in children with esophageal atresia. Surg Endosc 2023; 37:9167-9172. [PMID: 37831175 PMCID: PMC10709217 DOI: 10.1007/s00464-023-10492-1] [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: 06/08/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND STUDY AIMS Esophageal mucosal bridge (EMB) may be diagnosed at the anastomotic site in children operated on for esophageal atresia (EA) but so far only a few cases (n = 4) have been reported. This study aimed to characterize EMB in children with EA, risk factors, and treatment. PATIENTS AND METHODS This retrospective multicenter study recorded patient's characteristics, EMB diagnosis circumstances, endoscopic management, follow-up, and EMB recurrence in children with EA aged less than 18 years, compared with paired EA patients without EMB. RESULTS Thirty patients were included (60% male, 90% EA/tracheoesophageal fistula, 43% associated malformations). Compared to 44 paired controls, EMB was associated with a history of nasogastric tube feeding (31% vs. 9.1%, p = 0.02) and severe gastroesophageal reflux disease (history of fundoplication: 41.4% vs. 13.6%, p < 0.01). 77% had symptoms (food impaction and/or dysphagia). Endoscopic management was performed in 53% of patients (83% electrocoagulation) with no technical difficulties or complications. 80% of the symptomatic patients with EMB improved after endoscopic treatment, independently of anastomotic stricture dilatation or not. CONCLUSION EMB endoscopic management by electrocoagulation is safe and often leads to symptom improvement.
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Affiliation(s)
- Matthieu Antoine
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, University of Lille, Inserm, CHU Lille, U1286 - INFINITE, 59000, Lille, France.
- Lille University Jeanne de Flandre Children's Hospital, Avenue Eugène Avinée, 59000, Lille, France.
| | - Usha Krishnan
- Pediatric Gastroenterology, Sydney Children's Hospital, Sydney, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Michael Manfredi
- Gastroenterology, Hepatology & Nutrition, Boston Children's Hospital, Boston, USA
| | - Julija Cervinskiene
- Endoscopy, Children's Hospital, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Jérôme Viala
- Gastroentérologie Pédiatrique, Hôpital Universitaire Robert-Debré, AP-HP, Paris, France
| | - Julia Brendel
- Klinik für Kinderchirurgie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Christos Tzivinikos
- Pediatric Gastroenterology and Nutrition, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
| | | | | | - Bruno Hauser
- Gastroentérologie, Hépatologie et Nutrition Pédiatrique, UZ Brussel, Brussels, Belgique
| | - Noémie Laverdure
- Hépato-Gastroentérologie et Nutrition Pédiatrique, Hôpital Femme Mère Enfant, Lyon, Lyon, France
| | - Barbara Rohmer
- Hépato-Gastroentérologie et Nutrition Pédiatrique, Hôpital Femme Mère Enfant, Lyon, Lyon, France
| | - Hélène Behal
- ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, CHU Lille, 59000, Lille, France
| | - Audrey Nicolas
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, University of Lille, Inserm, CHU Lille, U1286 - INFINITE, 59000, Lille, France
- Lille University Jeanne de Flandre Children's Hospital, Avenue Eugène Avinée, 59000, Lille, France
| | - Frédéric Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, University of Lille, Inserm, CHU Lille, U1286 - INFINITE, 59000, Lille, France
- Lille University Jeanne de Flandre Children's Hospital, Avenue Eugène Avinée, 59000, Lille, France
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3
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Boillot O, Guillaud O, Wischlen E, Ruiz M, Boucaud C, Rohmer B, Lachaux A, Rivet C, Laverdure N, Dumortier J. Determinants of early surgical complications after pediatric liver transplantation: A single center/single surgeon experience over 20 years. Clin Res Hepatol Gastroenterol 2023; 47:102222. [PMID: 37783384 DOI: 10.1016/j.clinre.2023.102222] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND The risk of early surgical complications of liver transplantation (LT) is higher in children when compared with adults. The aims of the present retrospective study from a single center cohort/single surgeon were to identify the predictive factors for surgical complications after pediatric LT. METHODS All children receiving a first LT from October 1990 to October 2010 in our center were included. RESULTS Included 151 children (boys 55.0%), with a mean age of 4.8 ± 4.8 years, and a mean weight of 17.9 ± 14.4 kg. Thirty-seven patients were transplanted within the first year, and 59 patients had a body weight below 10 kg. The main initial liver disease was biliary atresia (49.0%). Living donor LT was performed in 39 cases (25.8%), cadaveric whole liver LT in 50 cases (33.1%), and cadaveric partial liver LT in 62 cases (41.1%). Early surgical complications included reoperation (37.8%), vascular complications (8.6%), i.e. arterial (3.3%) or portal thrombosis/stenosis (7.3%) within the first month, and biliary complications in the first 90 days occurred in 22.5% of the cases. The main indications for surgical revision were abdominal bleeding, treatment of a biliary complication, and bowel perforation. Multivariate analysis disclosed that only graft type (split and moreover from a living donor) was significantly and independently associated with the occurrence of biliary complication, and that indication for LT, period, graft type, and operative time were significantly and independently associated with the necessity of surgical revision. CONCLUSION Our results emphasize that surgical complications are frequent and strongly depend on patient/graft characteristics.
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Affiliation(s)
- Olivier Boillot
- Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; University Claude Bernard Lyon 1, France
| | - Olivier Guillaud
- Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; Ramsay Générale de Santé, Clinique de la Sauvegarde, France
| | - Emma Wischlen
- Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France
| | - Mathias Ruiz
- Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France
| | - Catherine Boucaud
- Department of Anesthesiology, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, Lyon, France
| | - Barbara Rohmer
- Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France
| | - Alain Lachaux
- University Claude Bernard Lyon 1, France; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France
| | - Christine Rivet
- Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France
| | - Noémie Laverdure
- Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France
| | - Jérôme Dumortier
- Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; University Claude Bernard Lyon 1, France.
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4
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Wischlen E, Laverdure N, Erard D, Rohmer B, Boillot O, Dubois R, Lachaux A, Collardeau-Frachon S, Hervieu V, Dumortier J. Iterative antibody-induced bile salt export pump deficiency after successive liver transplantations successfully treated with plasmapheresis and rituximab. Clin Res Hepatol Gastroenterol 2023; 47:102139. [PMID: 37187258 DOI: 10.1016/j.clinre.2023.102139] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Abstract
Post-transplantation evolution of progressive familial intrahepatic cholestasis type 2 patients can be complicated by antibody-induced bile salt export pump deficiency (AIBD). There is no consensus on its management. We describe a patient who presented two episodes, 9 years apart. The first episode was refractory to plasmapheresis and intravenous immunoglobulin (IVIG) started 2 months after AIBD onset, leading to graft loss. The second episode responded to plasmapheresis, IVIG and rituximab initiated less than 2 weeks after the beginning of symptoms, allowing for long-term recovery. This case suggests that intensive treatment with minimum delay after symptoms onset could sponsor a better evolution.
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Affiliation(s)
- Emma Wischlen
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Département d'Hépatogastroentérologie et Nutrition Pédiatrique, and Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques.
| | - Noémie Laverdure
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Département d'Hépatogastroentérologie et Nutrition Pédiatrique, and Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques
| | - Domitille Erard
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Hépatogastroentérologie
| | - Barbara Rohmer
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Département d'Hépatogastroentérologie et Nutrition Pédiatrique, and Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques
| | - Olivier Boillot
- Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives; Université Claude Bernard Lyon 1
| | - Rémi Dubois
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Service de chirurgie uro-viscérale, thoracique et de transplantation de l'enfant
| | - Alain Lachaux
- Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Département d'Hépatogastroentérologie et Nutrition Pédiatrique, and Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques; Université Claude Bernard Lyon 1
| | - Sophie Collardeau-Frachon
- Université Claude Bernard Lyon 1; Hospices civils de Lyon, Groupement Hospitalier Est, Service d'Anatomie Pathologique, Lyon, France
| | - Valérie Hervieu
- Université Claude Bernard Lyon 1; Hospices civils de Lyon, Groupement Hospitalier Est, Service d'Anatomie Pathologique, Lyon, France
| | - Jérôme Dumortier
- Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives; Université Claude Bernard Lyon 1
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Masson E, Ewers M, Paliwal S, Kume K, Scotet V, Cooper DN, Rebours V, Buscail L, Rouault K, Abrantes A, Aguilera Munoz L, Albouys J, Alric L, Amiot X, Archambeaud I, Audiau S, Bastide L, Baudon J, Bellaiche G, Bellon S, Bertrand V, Bideau K, Billiemaz K, Billioud C, Bonnefoy S, Borderon C, Bournet B, Breton E, Brugel M, Buscail L, Cadiot G, Camus M, Carpentier-Pourquier M, Chamouard P, Chaput U, Chen JM, Cholet F, Ciocan DM, Clavel C, Coffin B, Coimet-Berger L, Cosconea S, Creveaux I, Culetto A, Daboussi O, De Mestier L, Degand T, D'engremont C, Denis B, Dermine S, Drouet D'Aubigny A, Enaud R, Fabre A, Férec C, Gargot D, Gelsi E, Gentilcore E, Gincul R, Ginglinger-Favre E, Giovannini M, Gomercic C, Gondran H, Grainville T, Grandval P, Grasset D, Grimaldi S, Grimbert S, Hagege H, Heissat S, Hentic O, Herber-Mayne A, Hervouet M, Hoibian S, Jacques J, Jais B, Kaassis M, Koch S, Lacaze E, Lacroute J, Lamireau T, Laurent L, Le Guillou X, Le Rhun M, Leblanc S, Levy P, Lievre A, Lorenzo D, Maire F, Marcel K, Masson E, Mauillon J, Morgant S, Moussata D, Muller N, Nambot S, Napoleon B, Olivier A, Pagenault M, Pelletier AL, Pennec O, Pinard F, Pioche M, Prost B, Queneherve L, Rebours V, Reboux N, Rekik S, Riachi G, Rohmer B, Roquelaure B, Rosa Hezode I, Rostain F, Saurin JC, Servais L, Stan-Iuga R, Subtil C, Tanneche J, Texier C, Thomassin L, Tougeron D, Vuitton L, Wallenhorst T, Wangerme M, Zanaldi H, Zerbib F, Bhaskar S, Kikuta K, Rao GV, Hamada S, Reddy DN, Masamune A, Chandak GR, Witt H, Férec C, Chen JM. The PRSS3P2 and TRY7 deletion copy number variant modifies risk for chronic pancreatitis. Pancreatology 2023; 23:48-56. [PMID: 36517351 DOI: 10.1016/j.pan.2022.11.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND PRSS1 and PRSS2 constitute the only functional copies of a tandemly-arranged five-trypsinogen-gene cluster (i.e., PRSS1, PRSS3P1, PRSS3P2, TRY7 and PRSS2) on chromosome 7q35. Variants in PRSS1 and PRSS2, including missense and copy number variants (CNVs), have been reported to predispose to or protect against chronic pancreatitis (CP). We wondered whether a common trypsinogen pseudogene deletion CNV (that removes two of the three trypsinogen pseudogenes, PRSS3P2 and TRY7) might be associated with CP causation/predisposition. METHODS We analyzed the common PRSS3P2 and TRY7 deletion CNV in a total of 1536 CP patients and 3506 controls from France, Germany, India and Japan by means of quantitative fluorescent multiplex polymerase chain reaction. RESULTS We demonstrated that the deletion CNV variant was associated with a protective effect against CP in the French, German and Japanese cohorts whilst a trend toward the same association was noted in the Indian cohort. Meta-analysis under a dominant model yielded a pooled odds ratio (OR) of 0.68 (95% confidence interval (CI) 0.52-0.89; p = 0.005) whereas an allele-based meta-analysis yielded a pooled OR of 0.84 (95% CI 0.77-0.92; p = 0.0001). This protective effect is explicable by reference to the recent finding that the still functional PRSS3P2/TRY7 pseudogene enhancers upregulate pancreatic PRSS2 expression. CONCLUSIONS The common PRSS3P2 and TRY7 deletion CNV was associated with a reduced risk for CP. This finding provides additional support for the emerging view that dysregulated PRSS2 expression represents a discrete mechanism underlying CP predisposition or protection.
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Affiliation(s)
- Emmanuelle Masson
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France; Service de Génétique Médicale et de Biologie de la Reproduction, CHRU Brest, F-29200, Brest, France
| | - Maren Ewers
- Paediatric Nutritional Medicine & Else Kröner-Fresenius-Centre for Nutritional Medicine (EKFZ), Technical University Munich (TUM), Freising, Germany
| | - Sumit Paliwal
- Genomic Research on Complex Diseases (GRC Group), CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Kiyoshi Kume
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Virginie Scotet
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - David N Cooper
- Institute of Medical Genetics, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Vinciane Rebours
- Pancreatology and Digestive Oncology Department, Beaujon Hospital, APHP - Clichy, Université Paris Cité, Paris, France
| | - Louis Buscail
- Department of Gastroenterology and Pancreatology, CHU Rangueil and University of Toulouse, Toulouse, France
| | - Karen Rouault
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France; Service de Génétique Médicale et de Biologie de la Reproduction, CHRU Brest, F-29200, Brest, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marc Hervouet
- Hôpital d'instruction des Armées Percy, Clamart, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seema Bhaskar
- Genomic Research on Complex Diseases (GRC Group), CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Kazuhiro Kikuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Shin Hamada
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Giriraj Ratan Chandak
- Genomic Research on Complex Diseases (GRC Group), CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Heiko Witt
- Paediatric Nutritional Medicine & Else Kröner-Fresenius-Centre for Nutritional Medicine (EKFZ), Technical University Munich (TUM), Freising, Germany
| | - Claude Férec
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Jian-Min Chen
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France.
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Boccard M, Conrad A, Mouton W, Valour F, Roure-Sobas C, Frobert E, Rohmer B, Alcazer V, Labussière-Wallet H, Ghesquières H, Venet F, Brengel-Pesce K, Trouillet-Assant S, Ader F. A Simple-to-Perform ifn-γ mRNA Gene Expression Assay on Whole Blood Accurately Appraises Varicella Zoster Virus-Specific Cell-Mediated Immunity After Allogeneic Hematopoietic Stem Cell Transplantation. Front Immunol 2022; 13:919806. [PMID: 35967359 PMCID: PMC9363621 DOI: 10.3389/fimmu.2022.919806] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022] Open
Abstract
Herpes zoster, which is due to the reactivation of Varicella zoster virus (VZV), is a leading cause of morbidity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). While cell-mediated immunity (CMI) is critical to inhibiting VZV reactivation, CMI is not routinely assessed due to a lack of reliable tests. In this study, we aimed to evaluate VZV-specific CMI among allo-HSCT recipients (n = 60) and healthy individuals (HI, n = 17) through a panel of three immune functional assays after ex vivo stimulation by VZV antigen: quantification of (i) IFN-γ release in the supernatants, (ii) T-cell proliferation after a 7-day stimulation of peripheral blood mononuclear cells (PBMC), and (iii) measurement of the ifn-γ mRNA gene expression level after 24 h of stimulation of a whole-blood sample. VZV responsiveness was defined according to IFN-γ release from VZV-stimulated PBMC. Upon VZV stimulation, we found that allo-HSCT recipients at a median time of 6 [5-8] months post-transplant had lower IFN-γ release (median [IQR], 0.34 [0.12–8.56] vs. 409.5 [143.9–910.2] pg/ml, P <.0001) and fewer proliferating T cells (0.05 [0.01–0.57] % vs. 8.74 [3.12–15.05] %, P <.0001) than HI. A subset of allo-HSCT recipients (VZV-responders, n = 15/57, 26%) distinguished themselves from VZV-non-responders (n = 42/57, 74%; missing data, n = 3) by higher IFN-γ release (80.45 [54.3–312.8] vs. 0.22 [0.12–0.42] pg/ml, P <.0001) and T-cell proliferation (2.22 [1.18–7.56] % vs. 0.002 [0.001–0.11] %, P <.0001), suggesting recovery of VZV-specific CMI. Interestingly, VZV responders had a significant fold increase in ifn-γ gene expression, whereas ifn-γ mRNA was not detected in whole blood of VZV-non-responders (P <.0001). This study is the first to suggest that measurement of ifn-γ gene expression in 24-h-stimulated whole blood could be an accurate test of VZV-specific CMI. The routine use of this immune functional assay to guide antiviral prophylaxis at an individual level remains to be evaluated.
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Affiliation(s)
- Mathilde Boccard
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Anne Conrad
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - William Mouton
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
| | - Florent Valour
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Chantal Roure-Sobas
- Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Emilie Frobert
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Barbara Rohmer
- Service d’Hépatologie Gastro-Entérologie et Nutrition Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Vincent Alcazer
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département d’Hématologie clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Hélène Labussière-Wallet
- Département d’Hématologie clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Hervé Ghesquières
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département d’Hématologie clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Fabienne Venet
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
- Laboratoire d’Immunologie, Hospices Civils de Lyon, Lyon, France
- EA7426 UCBL1-HCL-bioMérieux Pathophysiology of Injury-induced Immunosuppression, Lyon, France
| | - Karen Brengel-Pesce
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
| | - Sophie Trouillet-Assant
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Laboratoire de Recherche Commun (LCR), Hospices Civils de Lyon/BioMérieux, Pierre-Bénite, France
| | - Florence Ader
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
- Département des Maladies infectieuses et tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- *Correspondence: Florence Ader,
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7
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Boillot O, Chopinet S, Gregoire E, Milot L, Petit P, Rohmer B, Roquelaure B, Dariel A, Panait N, Hardwigsen J, Dumortier J. Partial splenectomy in children undergoing liver transplantation or venous shunt for severe hypersplenism: A case control comparative study. Clin Res Hepatol Gastroenterol 2022; 46:101929. [PMID: 35462062 DOI: 10.1016/j.clinre.2022.101929] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Hypersplenism is a consequence of portal hypertension and splenomegaly secondary to cirrhosis or portal cavernoma in children. In order to avoid persistent hypersplenism and splenomegaly after liver transplantation (LT) or venous shunt (VS), partial splenectomy (PS) may represent a relevant therapeutic option. The aim of this retrospective study was to evaluate the results of PS performed in children presenting hypersplenism. METHODS The following end-points were evaluated: (1) reversion of hypersplenism and its durability over time, (2) postoperative outcome, (3) courses of spleen size and volume and (4) comparison to a control group in which PS was not performed. RESULTS Between 1996 and 2020, 16 children underwent PS associated with LT (8 cases) for cirrhosis or VS (8 cases) for portal cavernoma. From Day 0 to 1 month, mean platelet and white blood cell counts (WBC) dramatically improved from 48 ± 19 at day 0 to 176 ± 70 × 109/L (P < 0.0001) and from 2469 ± 853 to 7198 ± 3982/L (P = 0.001) respectively. PS allowed significant reduction of splenic length and volume from 176 ± 33 to 112 ± 24 cm (P < 0.0001) and from 1228 ± 464 to 450 ± 297 cm3 (P = 0.0003) respectively. After a mean follow-up of 92.6 ± 84.7 months (range: 4.1-210.7), 14 patients are alive with normal platelet and WBC counts and persistent spleen size reduction. Compared to control group, PS was associated with a significant platelet count rise from baseline to one year. CONCLUSIONS PS appears to be effective for treatment of hypersplenism and splenomegaly in combination with LT or VS without compromising outcome.
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Affiliation(s)
- Olivier Boillot
- Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; University Claude Bernard Lyon 1, France; Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, la Timone Hospital, Marseille, France.
| | - Sophie Chopinet
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, la Timone Hospital, Marseille, France
| | - Emilie Gregoire
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, la Timone Hospital, Marseille, France
| | - Laurent Milot
- Department of Radiology, Edouard Herriot Hospital, Hospices Civils de Lyon, France
| | - Philippe Petit
- Department of Pediatric Radiology, la Timone Hospital, Assistance Publique - Hôpitaux de Marseille, France
| | - Barbara Rohmer
- Department of Pediatry, Femme Mère Enfant Hospital, Hospices Civils de Lyon, France
| | - Bertrand Roquelaure
- Department of Pediatry, la Timone Hospital, Assistance Publique - Hôpitaux de Marseille, France
| | - Anne Dariel
- Department of Pediatric Surgery, la Timone Hospital, Assistance Publique - Hôpitaux de Marseille, France
| | - Nicoleta Panait
- Department of Pediatric Surgery, la Timone Hospital, Assistance Publique - Hôpitaux de Marseille, France
| | - Jean Hardwigsen
- Aix-Marseille University, Assistance Publique des Hôpitaux de Marseille, Department of General Surgery and Liver Transplantation, la Timone Hospital, Marseille, France
| | - Jérôme Dumortier
- Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; University Claude Bernard Lyon 1, France
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8
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de Sainte Marie B, Ebbo M, Grados A, Rebours V, Reumaux H, Briantais A, Urbina D, Cury J, Morel N, Lhote F, Rohmer B, Lazaro E, Agbo-Kpati KP, Deroux A, Domont F, Delacroix I, Lavigne C, Perlat A, Kahn JE, Godeau B, Hamidou M, Launay D, Bader-Meunier B, Schleinitz N. A descriptive study of IgG4-related disease in children and young adults. Clin Exp Rheumatol 2022; 21:103035. [PMID: 34995766 DOI: 10.1016/j.autrev.2022.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/02/2022] [Indexed: 11/02/2022]
Affiliation(s)
- B de Sainte Marie
- Department of Internal Medicine, Timone Hospital, AP-HM, Aix-Marseille Université, 13005 Marseille, France.
| | - M Ebbo
- Department of Internal Medicine, Timone Hospital, AP-HM, Aix-Marseille Université, 13005 Marseille, France.
| | - A Grados
- Department of Internal Medicine, CH de Niort, 79000 Niort, France
| | - V Rebours
- Pancreatology Unit, Inserm, UMR 1149, Beaujon Hospital, 100, boulevard Gal-Leclerc, 92110 Clichy, France.
| | - H Reumaux
- Department of Pediatric Rheumatology and Emergency, Jeanne de Flandre Hospital, Lille, France.
| | - A Briantais
- Department of Internal Medicine, Timone Hospital, AP-HM, Aix-Marseille Université, 13005 Marseille, France
| | - D Urbina
- Pediatric Department, Children's, Nord Hospital, Chemin des Bourrelys, 13915 Marseille Cedex 20, France.
| | - J Cury
- Paris-Saclay University, CNRS, INRIA, Laboratory in Informatique Research, UMR 8623, Orsay, France.
| | - N Morel
- Pierre et Marie Curie-Paris 6 University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, SNFMI, 75651 Paris Cedex 13, France.
| | - F Lhote
- Department of Internal Medicine, Saint-Denis Hospital, Saint-Denis, France.
| | - B Rohmer
- Pediatric Gastro-Enterology Department, Femme Mère Enfant Hospital, Groupement Hospitalier Est, 59, Boulevard Pinel, 69677 BRON Cedex, France.
| | - E Lazaro
- CHU Bordeaux, FHU ACRONIM, Place Amélie Raba Léon, 33076 Bordeaux, France.
| | - K P Agbo-Kpati
- Pediatric Department, Marne-La-Vallée Hospital, 2-4, cours de La-Gondoire, 77600 Jossigny, France.
| | - A Deroux
- Department of Internal Medicine, CHU de Grenoble, Grenoble, France.
| | - F Domont
- Department of Internal Medicine and Clinical Immunology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
| | - I Delacroix
- Internal Medicine Department, Centre Hospitalier Intercommunal de Créteil, Creteil, France.
| | - C Lavigne
- Department of Internal Medicine and Vascular Diseases, CCMR, CHU Angers, Université Angers, 49000 Angers, France.
| | - A Perlat
- Department of Internal Medicine, Sud Hospital, CHU de Rennes, Rennes, France.
| | - J E Kahn
- Department of Internal Medicine Ambroise-Paré Hospital, Boulogne-Billancourt, Versailles Saint-Quentin-en-Yvelines University, France.
| | - B Godeau
- Department of Internal Medicine, Reference Center for Autoimmune Cytopenia, Henri Mondor University Hospital, Creteil, France.
| | - M Hamidou
- Department of Internal Medicine, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| | - D Launay
- Department of Internal Medicine, CHU Lille, Lille, France.
| | - B Bader-Meunier
- Immunology-Hematology Department, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - N Schleinitz
- Department of Internal Medicine, Timone Hospital, AP-HM, Aix-Marseille Université, 13005 Marseille, France.
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9
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De Sainte Marie B, Bader-Meunier B, Rebours V, Hamidou M, Lazaro E, Rohmer B, Morel N, Deroux A, Agbo-Kpati K, Urbina D, Lhote F, Ebbo M, Schleinitz N. La maladie associée aux IgG4 à début pédiatrique ou « juvénile » existe-t-elle ? A propos d’une série descriptive de 25 cas. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.053] [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: 10/22/2022]
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10
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Noailly Charny PA, Rohmer B, Collardeau-Frachon S, Gillet Y, Dupont D, Wallon M, Lachaux A, Rabodonirina M. Invasive Hepatobiliary Trichosporon asahii Infection in a Child With Autoimmune Cholangitis. J Pediatric Infect Dis Soc 2019; 8:574-577. [PMID: 31107957 DOI: 10.1093/jpids/piz030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 04/19/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Pierre-Amaël Noailly Charny
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France.,Service des urgences pédiatriques, Hôpital Femme Mère Enfant, Groupement Hospitalier Est
| | - Barbara Rohmer
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France.,Service d'Hépato Gastro Entérologie Pédiatrique, Hôpital Femme Mère Enfant, Groupement Hospitalier Est
| | - Sophie Collardeau-Frachon
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France.,Institut de Pathologie, Groupement Hospitalier Est
| | - Yves Gillet
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France.,Service des urgences pédiatriques, Hôpital Femme Mère Enfant, Groupement Hospitalier Est
| | - Damien Dupont
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France
| | - Martine Wallon
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France
| | - Alain Lachaux
- Universite Claude Bernard Lyon 1, Hospices Civils de Lyon, France.,Service d'Hépato Gastro Entérologie Pédiatrique, Hôpital Femme Mère Enfant, Groupement Hospitalier Est
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11
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Fayard J, Collardeau S, Bertrand Y, Cordier MP, Malcus C, Dubois R, Mure PY, de Saint Basile G, Louazon T, Rohmer B, Lachaux A, Duclaux R, Peretti N. TTC7A mutation must be considered in patients with repeated intestinal atresia associated with early inflammatory bowel disease: Two new case reports and a literature review. Arch Pediatr 2018; 25:S0929-693X(18)30112-X. [PMID: 29921470 DOI: 10.1016/j.arcped.2018.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/12/2018] [Accepted: 05/20/2018] [Indexed: 12/11/2022]
Abstract
TTC7A mutations cause multiple neonatal intestinal atresias with early inflammatory bowel disease and severe combined immunodeficiency. There are no treatment protocols for this rare disease. Two new cases are described for which radical early treatment measures - total enterectomy, home parenteral nutrition, immunoglobulin therapy and intravenous antibiotic prophylaxis - have allowed both patients to develop optimally.
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Affiliation(s)
- J Fayard
- Department of Pediatric Hepatology Gastroenterology and Nutrition, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - S Collardeau
- Anathomopathology department, Hospices Civils de Lyon, 69677 Bron, France
| | - Y Bertrand
- Hospices Civils de Lyon, IHOP, 69677 Bron, France
| | - M-P Cordier
- Department of genetic, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - C Malcus
- Immunology laboratory, Hospices Civils de Lyon, HEH, 69677 Bron, France
| | - R Dubois
- Department of Pediatric Surgery, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - P-Y Mure
- Department of Pediatric Surgery, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - G de Saint Basile
- Inserm, unité U1163 Paris, centre d'études des déficits immunitaires, université Paris Descartes-Sorbonne Paris Cité, Paris, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - T Louazon
- Department of Pediatric Hepatology Gastroenterology and Nutrition, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - B Rohmer
- Department of Pediatric Hepatology Gastroenterology and Nutrition, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - A Lachaux
- Department of Pediatric Hepatology Gastroenterology and Nutrition, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France; Inserm U1060, laboratoire CarMeN, université Claude-Bernard Lyon 1, 69008 Lyon, France
| | - R Duclaux
- Department of Pediatric Hepatology Gastroenterology and Nutrition, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France
| | - N Peretti
- Department of Pediatric Hepatology Gastroenterology and Nutrition, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant de Lyon, 69677 Bron, France; Inserm U1060, laboratoire CarMeN, université Claude-Bernard Lyon 1, 69008 Lyon, France.
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12
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Rohmer B, Valla FV, Baleydier F, Launay V, Dommange-Romero F, Pondarré C. Newly diagnosed immune thrombocytopenic purpura in childhood: successful implementation of a limited intervention strategy in the setting of pediatric emergency care. J Pediatr 2015; 166:480-2. [PMID: 25454932 DOI: 10.1016/j.jpeds.2014.10.001] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 08/21/2014] [Accepted: 10/01/2014] [Indexed: 01/19/2023]
Abstract
Immune thrombocytopenic purpura is a bleeding disorder for which management remains mainly guided by platelet counts. Pediatric hematologists and emergency physicians collaborated to set up a limited intervention strategy, focusing on clinical bleeding severity irrespective of platelet counts, starting in the emergency room. We report how this strategy was safely applied for 106 consecutive children admitted for newly diagnosed immune thrombocytopenic purpura.
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Affiliation(s)
| | - Frédéric V Valla
- Hospices Civils de Lyon, Lyon, France; Department of Pediatric Emergency and Critical Care, Hôpital-Femme-Mère-Enfant
| | - Frédéric Baleydier
- Hospices Civils de Lyon, Lyon, France; Institut d'hématologie et d'oncologie pédiatrique (Department of Pediatric Hematology and Oncology); Lyon I University, Lyon, France
| | - Valérie Launay
- Hospices Civils de Lyon, Lyon, France; Department of Pediatric Emergency and Critical Care, Hôpital-Femme-Mère-Enfant
| | - Florence Dommange-Romero
- Hospices Civils de Lyon, Lyon, France; Institut d'hématologie et d'oncologie pédiatrique (Department of Pediatric Hematology and Oncology)
| | - Corinne Pondarré
- Hospices Civils de Lyon, Lyon, France; Institut d'hématologie et d'oncologie pédiatrique (Department of Pediatric Hematology and Oncology); Lyon I University, Lyon, France; Referral Center for Thalassemia, Paris, France.
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