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Lahuna C, Defendi F, Bouillet L, Boccon-Gibod I, Leblond V, Launay D, Cathébras P, Brihaye B, Armengol G, Aubineau M, Gondran G, Ly K, Gayet S, Desblache J, Martin L, Arsène M, Olivier F, Delphine G. Angiœdèmes bradykiniques par déficit acquis en C1-inhibiteur, associés aux gammapathies monoclonales de signification indéterminée : caractéristiques d’une cohorte nationale française. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.031] [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: 12/12/2022]
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Hankard A, Ingen-Housz-Oro S, El Karoui K, Paule R, Lioger B, Brihaye B, Battistella M, Jobard S, Magnant J, Diot E, Bigot A, Ferreira-Maldent N, Deriaz S, Cook AR, Henique H, Maillot F, Aouba A, Audemard-Verger A. IgA vasculitis with underlying monoclonal IgA gammopathy: innovative therapeutic approach targeting plasma cells. A case series. Clin Rheumatol 2022; 41:3119-3123. [PMID: 35713822 DOI: 10.1007/s10067-022-06181-4] [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] [Received: 12/08/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE There is currently no evidence of the possible benefit of plasma cell-targeting therapies (PCTT) in immunoglobulin A (IgA) monoclonal gammopathy (MG) associated with IgA vasculitis (IgAV). We report the outcome of different PCTT regimens in a cohort of MG-IgAV. METHODS We used a French network to retrospectively describe the outcome of MG-IgAV patients treated with PCTT. RESULTS Five patients were included (mean age 65 years). All patients had severe baseline presentation including extensive necrotic purpura (n = 5), gastrointestinal involvement (n = 2), peripheral neuropathies (n = 2), and glomerulonephritis (n = 1). Two patients had IgA indolent multiple myeloma and three had IgA "MG of undetermined significance." Monotypic IgA deposition in the skin vessels wall was highlighted using an immunofluorescence assay. Cases of vasculitis in three patients (n = 3) were refractory to multiple line therapies, including cyclophosphamide (n = 3) or rituximab. Finally, PCTT including bortezomib plus cyclophosphamide and dexamethasone, bortezomib plus melphalan and prednisone, or bortezomib plus lenalidomide and dexamethasone were proposed, allowing complete remission in 4/5 patients without major adverse drug events. CONCLUSION This study suggests that the MG-IgAV phenotype might be distinctive of usual IgAV (severe and refractory to conventional immunosuppressive regimens) and supports the benefit of PCTT. This study sheds new light on the overall biology of IgAV, strengthening the pathogenic role of the monoclonal IgA component in IgAV.
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Affiliation(s)
| | | | | | - Romain Paule
- Department of Internal Medicine, Hôpital Foch, Suresne, France
| | - Bertrand Lioger
- Department of Internal Medicine, Hôpital de Blois, Blois, France
| | - Benoit Brihaye
- Department of Internal Medicine, CH Saint Quentin, Saint Quentin, France
| | | | - Stéphanie Jobard
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Julie Magnant
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Elisabeth Diot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Adrien Bigot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | - Sophie Deriaz
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Ann-Rose Cook
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Hélène Henique
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Francois Maillot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France.,University of Tours, Tours, France
| | - Achille Aouba
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France. .,University of Tours, Tours, France.
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Allenbach Y, Mercy G, Deux J, Foissac F, Schoindre Y, Léonard L, Maisonobe T, Seilhean D, Charuel J, Ghillani-Dalbin P, Guy G, Lucidarme O, Cornec D, Abdoul H, Brihaye B, Bienvenu B, Benveniste O. Performances de l’IRM musculaire pour le diagnostic des myopathies auto-immunes : étude prospective multicentrique (DARWIM). Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.205] [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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Ducatez N, Chancel M, Douadi Y, Dayen C, Suguenot R, Lecuyer E, Brihaye B, Bentayeb H. Primary meningococcal arthritis in a COVID-19 18-year-old man: a case report and review of the literature. BMC Infect Dis 2021; 21:499. [PMID: 34051739 PMCID: PMC8164068 DOI: 10.1186/s12879-021-06211-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/19/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is associated with various complications. PMA (primary meningococcal arthritis) is a rare meningococcus-associated disease causing arthritis of the knee usually, without any signs of invasive meningococcal disease. No case of PMA in a COVID-19 (coronavirus disease, 2019) patient has yet been described. PMA mainly strikes young adults. PMA is not associated with any immunocompromising condition. It has a better outcome than usual septic arthritis CASE PRESENTATION: Herein, we report an 18-year-old man diagnosed with COVID-19, later admitted with persistent fever, right knee arthralgia and maculopapular rash. Due to family history, psoriasis and Henoch-Schönlein purpura were hypothesized and ruled out. Finally, synovial fluid culture confirmed Neisseria meningitidis serogroup B arthritis without any other symptoms of invasive meningococcal disease. Healing was achieved quickly with surgery and antibiotics. We concluded in a PMA. CONCLUSION We describe here the first primary meningococcal arthritis in a COVID-19 patient and we hope to shine a light on this rare but serious complication.
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Affiliation(s)
- Norman Ducatez
- Pneumology and Infectious Diseases department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France.
| | - Marine Chancel
- Internal Medicine department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
| | - Youcef Douadi
- Pneumology and Infectious Diseases department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
| | - Charles Dayen
- Pneumology and Infectious Diseases department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
| | - Rémi Suguenot
- Pneumology and Infectious Diseases department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
| | - Emmanuelle Lecuyer
- Pneumology and Infectious Diseases department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
| | - Benoit Brihaye
- Internal Medicine department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
| | - Houcine Bentayeb
- Pneumology and Infectious Diseases department, Saint-Quentin hospital, 1 avenue Michel de l'hospital, 02100, Saint-Quentin, France
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Martis N, Viau P, Zenone T, Andry F, Grados A, Ebbo M, Castela E, Brihaye B, Denis E, Liguori S, Audemard A, Schoindre Y, Morin AS, Terrier B, Marcq L, Mounier N, Lidove O, Chaborel JP, Quinsat D. Clinical value of a [18F]-FDG PET-CT muscle-to-muscle SUV ratio for the diagnosis of active dermatomyositis. Eur Radiol 2019; 29:6708-6716. [PMID: 31250167 DOI: 10.1007/s00330-019-06302-9] [Citation(s) in RCA: 8] [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: 03/05/2019] [Revised: 05/11/2019] [Accepted: 06/04/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To study a muscle-to-muscle standardised uptake value (SUV) ratio with FDG-PET/CT (FDG-PET) as a marker for the detection of disease activity in dermatomyositis (DM). METHODS Patients with DM (n = 24) who met the European Neuro-Muscular Centre diagnostic criteria were retrospectively identified over a 3-year period through a national survey. Muscle biopsy was performed in all patients. Maximum SUV was measured in proximal muscles (SUVPROX) that had the highest radiotracer uptake on visual grading as well as in the musculus longissimus thoracis (SUVMLT), whereas mean SUV was measured for the liver (SUVLIV). Muscle-to-liver SUV ratios for either muscle group were compared and a SUVPROX/SUVMLT ratio was calculated. SUVPROX/SUVMLT of DM patients were compared with age- and sex-matched control subjects (n = 24) with melanoma who had received FDG-PET scans. RESULTS DM patients presented with proximal and symmetrical muscle uptake. Differences in SUVPROX/SUVLIV and SUVMLT/SUVLIV ratios in DM subjects were significant (p < 0.001). SUVPROX/SUVMLT ratios in DM and their controls also differed significantly (p = 0.0012). The SUVPROX/SUVMLT ratio threshold between DM subjects and controls was 1.73 with a sensitivity of 50% (CI95%, 29.1 to 70.9%) and specificity at 83.3% (CI95%, 62.6 to 95.3%). When amyopathic DM patients were removed from the analysis, specificity was increased to 95% (CI95%, 75.1 to 99.9%) with a likelihood ratio of 10 and an AUC of 83.4% (CI95%, 71.4 to 95.4%). CONCLUSION A muscle-to-muscle SUVPROX/SUVMLT ratio with a cut-off value of 1.73 in FDG-PET imaging might serve as a non-invasive marker to determine disease activity in dermatomyositis. KEY POINTS • [18F]-FDG PET-scanner standardised uptake value (SUV) could reflect disease activity in dermatomyositis (DM). • A ratio of SUV in proximal muscles (SUVPROX) to SUV in musculus longissimus thoracis (SUVMLT) could be used to determine active DM. • Active disease is suspected for SUV PROX /SUV MLT ratios greater than 1.73.
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Affiliation(s)
- Nihal Martis
- Service de Médecine Interne, CHU de Nice, Université Côte d'Azur, Faculté de Médecine de Nice, Nice, France.
| | - Philippe Viau
- Service de Médecine Nucléaire, CHU de Nice, Université Côte d'Azur, Faculté de Médecine de Nice, Nice, France
| | - Thierry Zenone
- Service de Médecine Interne, CH de Valence, Valence, France
| | - Fanny Andry
- Service de Médecine Interne, CHU Michallon, Grenoble, France
| | - Aurélie Grados
- Service de Médecine Interne, Hôpital La Timone, AP-HM, Marseille, France
| | - Mikael Ebbo
- Service de Médecine Interne, Hôpital La Timone, AP-HM, Marseille, France
| | - Emeline Castela
- Service de Médecine Interne, CHU de Nice, Université Côte d'Azur, Faculté de Médecine de Nice, Nice, France
| | - Benoit Brihaye
- Service de Médecine Interne, CH Saint-Quentin, Saint-Quentin, France
| | - Eric Denis
- Service de Médecine Interne, CH d'Antibes-Juan-les-Pins, Antibes, France
| | - Stéphane Liguori
- Service de Biologie Médicale, CH d'Antibes-Juan-les-Pins, Antibes, France
| | | | - Yoland Schoindre
- Service de Médecine Interne, Hôpital de la Pitié Salpêtrière, AP-HP, Paris, France
| | - Anne-Sophie Morin
- Service de Médecine Interne, Hôpital Jean Verdier, AP-HP, Bondy, France
| | - Benjamin Terrier
- Service de Médecine Interne, Hôpital Cochin, AP-HP, Paris, France
| | - Laurent Marcq
- Service de Médecine Interne, CH d'Antibes-Juan-les-Pins, Antibes, France
| | - Nicolas Mounier
- Service d'Onco-Hématologie, CHU de Nice, Université Côte d'Azur, Faculté de Médecine de Nice, Nice, France
| | - Olivier Lidove
- Service de Médecine Interne, CH Croix St-Simon, Paris, France
| | | | - Denis Quinsat
- Service de Médecine Interne, CH d'Antibes-Juan-les-Pins, Antibes, France
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Boulu X, Lambour A, Metzelard M, Melboucy-Belkhir S, Khentache R, Brigant F, Brihaye B. Maladie auto-inflammatoire neutrophile avec anomalie caryotypique : le pire est à venir. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.290] [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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Grimaldi-Bensouda L, Rossignol M, Koné-Paut I, Krivitzky A, Lebrun-Frenay C, Clet J, Brassat D, Papeix C, Nicolino M, Benhamou PY, Fain O, Costedoat-Chalumeau N, Courcoux MF, Viallard JF, Godeau B, Papo T, Vermersch P, Bourgault-Villada I, Breart G, Abenhaim L, Abbas F, Abdelmoumni A, Hilliquin P, Requeda E, Adoue D, Brassat D, Agard C, Masseau A, Aladjidi N, Clet J, Fernandes H, Lemasson G, Perel Y, Raymond I, Richer O, Vital A, Allain-Launay E, Bru M, Nicolino M, Thomas C, Altman JJ, Amsallem D, Aras N, Boukari L, Dubrel M, Fain O, Letellier E, Lucidarme N, Mekinian A, Morin AS, Stirnemann J, Atlan C, Audry D, Augustin J, Bakir R, Bartolucci P, Chevalier X, Godeau B, Guillaud C, Khellaf M, Limal N, Lousteau V, Mahevas M, Méliksetyan G, Michel M, Roumier M, Bayart S, Bonnet F, Decaux O, Bekherraz A, Brihaye B, Dachez R, Daugas E, Hayem G, Meyer O, Papo T, Pasqualoni E, Sacre K, Travert F, Bellon H, Beltrand J, Lefrere F, Simon A, Benhamou PY, Benveniste O, Bolgert F, Costedoat-Chalumeau N, De Paz R, Demeret S, Fautrel B, Jacqueminet S, Louapre C, Maillart E, Morel N, Papeix C, Rigabert J, Bensaid P, Berger C, Berquin P, Le Moing AG, Berroir S, Besson G, Boutte C, Casez O, Bonnotte B, Audia S, Bossu-Estour C, Bourgarit A, Dupuy A, Keshmandt H, Bourre B, Brac A, Perrin A, Pondarré C, Villar-Fimbel S, Bruckert I, Cosson A, Magy-Bertrand N, Tisserand G, Camu W, Carlander B, Morales RJ, Cances C, Pasquet M, Castilla Lievre MA, Chabroux S, Charif M, Chatelus E, Sibilia J, Chevrant-Breton J, Clavel S, Bille-Turc F, Cohen J, Courcoux MF, Leverger G, Machet L, Cuisset JM, Cony-Makhoul P, Darsy P, Favre S, Giraud P, Leitenschenck L, Monteiro I, Morati C, DeSeze J, Dinulescu M, Dhaoui T, Dommange-Romero F, Drevard E, Dupuis C, Dumuis ML, Durand JM, Farad S, Lecomte P, Pierre P, Fouyssac F, Gaudin P, Gautier A, Gellen-Dautremer J, Jarrin I, Richette P, Georget E, Gras P, Moreau T, Giraud E, Hacini M, Mayer A, Guillaumat C, Guillaume S, Guitton C, Kone-Paut I, Marsaud C, Rossi L, Guyot MH, Hassler P, Heimfert C, Heinzlef O, Hillion B, Hocquelet C, Husson H, Ichai P, Jeziorski E, Deslandre CJ, Le Guern V, Kamenov K, Kerlan V, Lemoine P, Misery L, Pan-Petesch B, Krivitzky A, Labauge P, Rodier M, Lacade C, Razafimahefa B, Lachgar K, Larmarau MP, Leblanc T, Lebrun-Frenay C, Lefèbvre P, Lejoyeux P, Leske C, Ly K, Magy L, Mansuy S, Marechaud R, Martin Negrier ML, Sole G, Maupetit J, Mazingue F, Mochon S, Moktar B, Morcamp D, Morlet-Barla N, Nicolas G, Pautot V, Pellier I, Verret JL, Outteryck O, Vermersch P, Pallot-Prades B, Paquet JM, Puechal X, Sortais A, Pelletier J, Rico A, Pez D, Stankoff B, Quittet P, Rémy C, Roba E, Rosario H, Roudaut N, Sonnet E, Ruel M, Sebban S, Schaepelynck P, Simonin MJ, Vial C, Viallard JF, Ladedan I, Zenone T. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun 2017; 79:84-90. [DOI: 10.1016/j.jaut.2017.01.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/08/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
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Boulu X, Melboucy-Belkhir S, Brigant F, Khentache R, Paupière S, Brihaye B. Nécrose digitale : dissection spontanée de l’artère sous-clavière gauche ou néoplasie ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.321] [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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Regent A, Redeker S, Deroux A, Kieffer P, Ly K, Dougados M, Eric L, Larroche C, Guillevin L, Bouillet L, Espitia O, Costedoat-Chalumeau N, Soubrier M, Brihaye B, Liferman F, Lefebvre G, Puechal X, Mouthon L, Toussirot E. SAT0351 Tocilizumab in Giant Cell Arteritis: A Multicentre Open-Label Study OF34 Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4722] [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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Melboucy-Belkhir S, Dahmani S, Brigant F, Paupière S, Ferrand J, Khentache R, Brihaye B. Une ascite à éosinophiles. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.072] [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: 11/24/2022]
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Langlet C, Khentache R, Ferrand J, Paupière S, Brigant F, Brihaye B, Melboucy-Belkhir S. Fièvre, insuffisance rénale aiguë et gros reins : une infection à Hantavirus. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.053] [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: 11/29/2022]
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Lugosi M, Sacré K, Lidove O, Chauveheid MP, Brihaye B, Laissy JP, Chauchard M, Papo T. Fibrose(s) rétropéritonéale(s) : stratégie diagnostique, pathologies associées et suivi à long terme d’une cohorte française. Rev Med Interne 2013; 34:591-9. [DOI: 10.1016/j.revmed.2013.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 12/06/2012] [Accepted: 02/04/2013] [Indexed: 11/15/2022]
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Salle V, Schmidt J, Mazière JC, Smail A, Fuentes V, Dahmani R, Krim M, Brihaye B, Mazière C, Ducroix JP, Duhaut P. Anticorps dirigés contre l’annexine A2 et morbidité obstétricale. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.079] [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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Pasqualoni E, Aubart F, Brihaye B, Sacré K, Maisonobe T, Laissy JP, Lidove O, Papo T. Lambert–Eaton Myasthenic syndrome and follicular thymic hyperplasia in systemic lupus erythematosus. Lupus 2011; 20:745-8. [DOI: 10.1177/0961203310393769] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- E Pasqualoni
- Department of Internal Medicine, Bichat-Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - F Aubart
- Department of Neurophysiology, Pitié-Salpetrière Hospital, Paris, France
| | - B Brihaye
- Department of Internal Medicine, Bichat-Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - K Sacré
- Department of Internal Medicine, Bichat-Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - T Maisonobe
- Department of Neurophysiology, Pitié-Salpetrière Hospital, Paris, France
| | - J-P Laissy
- Department of Radiology, Bichat-Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - O Lidove
- Department of Internal Medicine, Bichat-Claude Bernard Hospital, Paris-Diderot University, Paris, France
| | - T Papo
- Department of Internal Medicine, Bichat-Claude Bernard Hospital, Paris-Diderot University, Paris, France
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Sacré K, Brihaye B, Hyafil F, Serfaty JM, Escoubet B, Zennaro MC, Lidove O, Laissy JP, Papo T. Asymptomatic myocardial ischemic disease in antiphospholipid syndrome: a controlled cardiac magnetic resonance imaging study. ACTA ACUST UNITED AC 2010; 62:2093-100. [PMID: 20506512 DOI: 10.1002/art.27488] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Antiphospholipid syndrome (APS) may cause coronary thrombosis. This study was undertaken to determine the prevalence of silent myocardial disease in patients with APS, using late gadolinium enhancement (LGE) of cardiac magnetic resonance imaging (CMRI). METHODS Twenty-seven consecutive patients with APS and 81 control subjects without known cardiovascular disease underwent CMRI. The prevalence of occult myocardial ischemic disease, as revealed by LGE, was compared between patients with APS and controls, and factors associated with myocardial disease were identified in patients with APS. RESULTS Myocardial ischemic disease, as characterized by LGE on CMRI, was present in 8 (29.6%) of 27 patients with APS, and imaging with LGE showed a typical pattern of myocardial infarction (MI) in 3 patients (11.1%). The myocardial scarring revealed on CMRI was not detected by electrocardiography or echocardiography. Although both patients with APS and control subjects shared a low risk of cardiovascular events, as calculated with the Framingham risk equation (mean +/- SD 5.1 +/- 8.2% and 6.5 +/- 7.6%, respectively, for the absolute risk within the next 10 years; P = 0.932), the prevalence of myocardial ischemia was more than 7 times higher in patients with APS (P = 0.0006 versus controls). No association was found between myocardial disease in patients with APS and classic coronary risk factors. The presence of myocardial scarring tended to be more closely associated with specific features of APS, such as duration of the disease, presence of livedo, and positivity for anti-beta(2)-glycoprotein I antibodies. CONCLUSION The finding of a significant and unexpectedly high prevalence of occult myocardial scarring in patients with APS indicates the usefulness of CMRI with LGE for the identification of silent myocardial disease in such patients.
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Affiliation(s)
- Karim Sacré
- Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, and Paris 7 University, Paris, France
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Costedoat-Chalumeau N, Galicier L, Francès C, Aumaitre O, Lioté F, Le Guern V, Limal N, Smail A, Ninet J, Perard L, Le Huong Thi D, Asli B, Grandpeix C, Sailler L, Ackermann F, Papo T, Brihaye B, Fain O, Stirnemann J, Jallouli M, Leroux G, Hulot JS, Lechat P, Musset L, Piette JC, Amoura Z. Étude des facteurs associés à une concentration basse d’hydroxychloroquine chez 523 patients inclus dans l’étude Plaquénil Lupus Systémique (PLUS, étude française multicentrique). Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.410] [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: 11/30/2022]
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Costedoat-Chalumeaum N, Galicier L, Aumaitre O, Francès C, Le Guern V, Lioté F, Smail A, Limal N, Perard L, Desmurs-Clavel H, Le Thi Huong D, Asli B, Grandpeix C, Pourrat J, Ackermann F, Papo T, Brihaye B, Fain O, Stirnemann J, Cohen J, Jallouli M, Hulot JS, Lechat P, Musset L, Piette JC, Amoura Z. Données épidémiologiques d’une cohorte française multicentrique de 569 patients lupiques. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.407] [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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Schmidt J, Duhaut P, Dessort L, Desblache J, Smail A, Salle V, Le Page L, Brihaye B, Ducroix JP. Hyperéosinophilies de l’adulte : quel spectre étiologique, et quel seuil pathologique ? Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.360] [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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Schmidt J, Duhaut P, Dessort L, Desblache J, Le Page L, Brihaye B, Salle V, Smail A, Ducroix JP. Hyperéosinophilies d’origine médicamenteuse : mythe ou réalité ? Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.419] [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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Costedoat-Chalumeau N, Jallouli M, Galicier L, Aumaître O, Francès C, Le Guern V, Liote F, Smail A, Limal N, Pérard L, Desmurs-Clavel H, Le Thi Huong D, Asli B, Grandpeix C, Pourrat J, Ackermann F, Papo T, Brihaye B, Fain O, Stirnemann J, Cohen J, Tanguy ML, Hulot JS, Lechat P, Musset L, Piette JC, Amoura Z. Description des patients lupiques inclus dans l’étude PLUS (Plaquénil Lupus Systémique, étude française multicentrique) en fonction de leur origine ethnique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.406] [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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Brihaye B, Lidove O, Sacré K, Laissy JP, Escoubet B, Valla D, Papo T. Diffuse periarterial involvement in systemic fibrosclerosis with Riedel's thyroiditis, sclerosing cholangitis, and retroperitoneal fibrosis. Scand J Rheumatol 2009; 37:490-2. [DOI: 10.1080/03009740802241725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Leroux G, Costedoat-Chalumeau N, Brihaye B, Cohen-Bittan J, Amoura Z, Haroche J, Limal N, Bletry O, Piette JC. Rituximab dans la polychondrite atrophiante : à propos de neuf cas. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.03.116] [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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Brihaye B, Aouba A, Pagnoux C, Vignaux O, Le Hello C, Guillevin L. Rituximab reversed cardiac involvement of Wegener's granulomatosis: magnetic resonance imaging assessment. Presse Med 2008; 37:412-5. [DOI: 10.1016/j.lpm.2007.08.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 08/17/2007] [Accepted: 08/29/2007] [Indexed: 10/22/2022] Open
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Sacré K, Brihaye B, Lidove O, Papo T, Pocidalo MA, Cuisset L, Dodé C. Dramatic improvement following interleukin 1beta blockade in tumor necrosis factor receptor-1-associated syndrome (TRAPS) resistant to anti-TNF-alpha therapy. J Rheumatol 2008; 35:357-358. [PMID: 18260167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Brihaye B, Aouba A, Pagnoux C, Cohen P, Lacassin F, Guillevin L. Adjunction of rituximab to steroids and immunosuppressants for refractory/relapsing Wegener's granulomatosis: a study on 8 patients. Clin Exp Rheumatol 2007; 25:S23-7. [PMID: 17428359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Rituximab, an anti-CD20 biotherapy, has been effective against refractory and/or relapsing Wegener's granulomatosis (WG). But the frequency of and time to responses to rituximab, and its effects on various clinical WG manifestations remain to be thoroughly evaluated. METHODS Retrospective study of 8 patients with refractory/relapsing WG. In addition to their ongoing therapy, 7 patients received rituximab (375 mg/m2 weekly for 4 weeks) and another received 2 rituximab infusions (1 g on days 1 and 15). Disease activity was assessed using BVAS 2003 before and 6 months after the first rituximab infusion. RESULTS The median BVAS before rituximab was 14.3 (range 4-30). At 6 months, 5/8 patients had BVAS=0; 3/8 were in complete remission; 3/8 in partial remission (lung nodules persisted in 2 patients, scored 0 in BVAS); 2/8 did not respond. One patient relapsed 1 year after stopping rituximab and responded successfully to a second cycle. Dissociated responses of constitutional and 'vasculitis' symptoms, as opposed to granulomatous manifestations, were observed: the former regressed within days or weeks, while the latter regressed more slowly, over several months. Tolerance was good for 7 patients but 1 developed an urticarial rash during the last 3 infusions. Corticosteroids could be tapered in all patients. CONCLUSION Rituximab, when prescribed in conjunction with corticosteroids and immunosuppressants to treat refractory/relapsing WG, was able to improve clinical outcome. But the dissociation of response times in patients with predominantly granulomatous manifestations, as opposed to vasculitis symptoms, merits further study before an optimal rituximab regimen can be defined.
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Affiliation(s)
- B Brihaye
- French Vasculitis Study Group, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris 5-René-Descartes, Paris, France
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