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Camou F, Lagadec A, Coutinho A, Berger MG, Cador-Rousseau B, Gaches F, Belmatoug N. Patient reported outcomes of patients with Gaucher disease type 1 treated with eliglustat in real-world settings: The ELIPRO study. Mol Genet Metab 2023; 140:107667. [PMID: 37597334 DOI: 10.1016/j.ymgme.2023.107667] [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: 04/18/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION Gaucher disease type 1 (GD1) is a rare genetic lysosomal storage disorder. Eliglustat is a first-line oral therapy for adult patients with GD1. The aim of the ELIPRO (ELIglustat Patient Reported Outcomes) study was to assess real-world outcomes of eliglustat treatment for over 1 year in patients with GD1, with a focus on patient-reported outcomes (PROs), including treatment adherence. METHODS This was a non-interventional, prospective, multicentric study. Patients were stratified according to their previous time on eliglustat: >6 months (Group1) and ≤ 6 months (Group2). The primary endpoint was adherence to eliglustat, measured by the eight-items Morisky Medication Adherence Scale (MMAS-8; scale of 0-8) at 6 months in Group2. Secondary endpoints were quality of life (QoL) measured by patient input using the European Quality of Life five-dimensional three-level [EQ-5D-3L] questionnaire, fatigue and pain measured by numeric rating scale [NRS; on a scale of 0-10], the evaluation of patient satisfaction level regarding eliglustat treatment measured by Likert scale [scale of 0-7] and treatment adherence at 12 months in both groups. The study also evaluated the safety and effectiveness of eliglustat in the adult GD1 population. RESULTS Sixty patients with GD1 (approximatively 52% male, mean age: 46.6 ± 13.9 years) were analyzed: 29 in Group1 and 31 in Group2. GD1 was mostly of mild severity (90%) and 95% of patients had extensive CYP2D6 metabolizer phenotype. Fifty-seven patients had previously received treatment for GD1 (91% enzyme replacement therapy) and 15% were splenectomized. Groups1 and 2 were not necessarily matching for all characteristics. At 6 months, 58% of Group2 patients showed medium adherence (6 < MMAS-8 < 7.75) while 21% showed high adherence (MMAS-8: 8) (mean MMAS-8: 6.7 ± 1.0); similar results were obtained in Group1 (50% showed high compliance, 35% showed medium compliance; mean MMAS-8: 6.8 ± 1.4). The mean MMAS-8 for Group1 and Group2 were 7.1 ± 1.2 (vs 7.0 ± 1.0 at baseline) and 6.5 ± 1.0, respectively, at 12 months. At 12 months, the mean NRS scores in Group1 and Group2 were 72.0 ± 18.5 and 77.3 ± 13.7 for QoL (vs. 71.7 ± 18.4 and 80.2 ± 12.4, respectively at baseline), 4.8 ± 2.6 and 3.6 ± 2.7 for fatigue (vs. 4.6 ± 2.7 and 3.6 ± 2.6, respectively at baseline) and 3.3 ± 2.7 and 2.3 ± 2.3 for pain (vs. 3.3 ± 2.7 and 2.0 ± 2.4, respectively at baseline). GD1 assessments (biological, clinical and imaging parameters) remained stable during 12 months in both groups. At the end of the study, majority (97.4%) of patients were satisfied with their treatment with eliglustat (satisfaction score over 5 out of 7). Sixty-six percent of patients (n = 41) experienced mostly mild adverse events (AE) (including four study withdrawals), of whom 27.4% (n = 17) of patients experienced eliglustat-related AEs. Treatment adherence remained stable during 12 months in both groups. CONCLUSIONS Eliglustat treatment compliance was good and sustained, along with overall health state, fatigue and pain levels, which was consistent with overall patients' clinical status. Eliglustat was well tolerated, and had a good safety profile, aligned with a good patient satisfaction. Our study should encourage greater use of PROs for evaluation of impact of the GD treatment on patient's symptoms and well-being.
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Affiliation(s)
| | | | - Angela Coutinho
- Vaincre les Maladies Lysosomales Patient Association, Massy, France
| | - Marc G Berger
- CHU Clermont-Ferrand, Hematology department, and EA 7453 CHELTER, University Clermont Auvergne, Clermont-Ferrand, France
| | | | | | - Nadia Belmatoug
- Referral Center for Lysosomal Diseases, Paris Cité University, APHP-Nord, France
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Mekinian A, Biard L, Lorenzo D, Novikov PI, Salvarani C, Espitia O, Sciascia S, Michaud M, Lambert M, Hernández-Rodríguez J, Schleinitz N, Awisat A, Puechal X, Aouba A, Munoz Pons H, Smitienko I, Gaultier JB, Edwige LM, Benhamou Y, Perlat A, Jego P, Goulenok T, Sacre K, Lioger B, Hassold N, Broner J, Dufrost V, Sené T, Seguier J, Maurier F, Berthier S, Belot A, Frikha F, Denis G, Audemard-Verger A, Koné-Paut I, Humbert S, Woaye-Hune P, Tomelleri A, Baldissera EM, Kuwana M, Logullo A, Mukuchyan V, Dellal A, Gaches F, Zeminsky P, Galli E, Alvarado M, Boiardi L, Francesco M, Vautier M, Corrado C, Moiseev S, Vieira M, Cacoub P, Fain O, Saadoun D. Intravenous versus subcutaneous tocilizumab in Takayasu arteritis: multicentre retrospective study. RMD Open 2023; 9:e002830. [PMID: 37321669 DOI: 10.1136/rmdopen-2022-002830] [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: 10/30/2022] [Accepted: 02/02/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVES In this large multicentre study, we compared the effectiveness and safety of tocilizumab intravenous versus subcutaneous (SC) in 109 Takayasu arteritis (TAK) patients. METHODS We conducted a retrospective multicentre study in referral centres from France, Italy, Spain, Armenia, Israel, Japan, Tunisia and Russia regarding biological-targeted therapies in TAK, since January 2017 to September 2019. RESULTS A total of 109 TAK patients received at least 3 months tocilizumab therapy and were included in this study. Among them, 91 and 18 patients received intravenous and SC tocilizumab, respectively. A complete response (NIH <2 with less than 7.5 mg/day of prednisone) at 6 months was evidenced in 69% of TAK patients, of whom 57 (70%) and 11 (69%) patients were on intravenous and SC tocilizumab, respectively (p=0.95). The factors associated with complete response to tocilizumab at 6 months in multivariate analysis, only age <30 years (OR 2.85, 95% CI 1.14 to 7.12; p=0.027) and time between TAK diagnosis and tocilizumab initiation (OR 1.18, 95% CI 1.02 to 1.36; p=0.034). During the median follow-up of 30.1 months (0.4; 105.8) and 10.8 (0.1; 46.4) (p<0.0001) in patients who received tocilizumab in intravenous and SC forms, respectively, the risk of relapse was significantly higher in TAK patients on SC tocilizumab (HR=2.55, 95% CI 1.08 to 6.02; p=0.033). The overall cumulative incidence of relapse at 12 months in TAK patients was at 13.7% (95% CI 7.6% to 21.5%), with 10.3% (95% CI 4.8% to 18.4%) for those on intravenous tocilizumab vs 30.9% (95% CI 10.5% to 54.2%) for patients receiving SC tocilizumab. Adverse events occurred in 14 (15%) patients on intravenous route and in 2 (11%) on SC tocilizumab. CONCLUSION In this study, we confirm that tocilizumab is effective in TAK, with complete remission being achieving by 70% of disease-modifying antirheumatic drugs-refractory TAK patients at 6 months.
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Affiliation(s)
- Arsène Mekinian
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, Service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France, French Armenian research center, Erevan, Armenia
| | - Lucie Biard
- Université de Paris, AP-HP, Hôpital Saint Louis, Service de Biostatistique et Information Médicale (DMU PRISME), INSERM U1153 Team ECSTRRA, Paris, France
| | - Dagna Lorenzo
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Pavel I Novikov
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Carlo Salvarani
- Azienda USL-IRCCS; Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Olivier Espitia
- Department of internal and vascular medicine, Nantes Université, CHU Nantes, F-44000 Nantes, France
| | - Savino Sciascia
- Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, Nephrology and Dialysis, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Martin Michaud
- Médecine Interne, Hôpital Joseph Ducuing, Toulouse, France
| | - Marc Lambert
- Univ. Lille, CHU Lille, Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), INSERM, UMR 1167, RID-AGE, Lille, France
| | - José Hernández-Rodríguez
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Abid Awisat
- Rheumatology Unit, Bnei Zion Hospital, Haifa, Israel
| | - Xavier Puechal
- Université Paris Descartes, Paris, France ; AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, 27 rue du Faubourg Saint-Jacques, Paris, France
| | - Achille Aouba
- Département de médecine interne, CHU Caen, Caen, France
| | - Helene Munoz Pons
- Département de médecine interne, CHU Saint Etienne, Saint-Etienne, France
| | - Ilya Smitienko
- Rheumatology Department, Medical Center K-31, Moscow, Russian Federation
| | - Jean Baptiste Gaultier
- Service de Médecine Interne, Hôpital Nord, Centre Hospitalier universitaire de St Etienne, Saint Etienne, France
| | - Le Mouel Edwige
- Internal Medicine and Clinical Immunology Department, CHU Rennes, Universitaire de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Ygal Benhamou
- Service de médecine interne, Université Rouen, CHU de Rouen, Rouen, France
| | - Antoinette Perlat
- Internal Medicine and Clinical Immunology Department, CHU Rennes, Universitaire de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Patrick Jego
- Internal Medicine and Clinical Immunology Department, CHU Rennes, Universitaire de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Tiphaine Goulenok
- Département de Médecine Interne, Hôpital Bichat, Université de Paris, Assistance Publique Hôpitaux de Paris, INSERM U1149, Paris, France
| | - Karim Sacre
- Département de Médecine Interne, Hôpital Bichat, Université de Paris, Assistance Publique Hôpitaux de Paris, INSERM U1149, Paris, France
| | | | - Nolan Hassold
- Service de Rhumatologie pédiatrique et centre de référence des maladies autoinflammatoires et de l'amylose inflammatoire, CEREMAIA, hôpital de Bicêtre, APHP, France, université de Paris Sud-Saclay, Paris, France
| | | | - Virginie Dufrost
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, University of Lorraine, Inserm UMR_S 1116, CHRU de Nancy, Nancy, France
| | - Thomas Sené
- Service de médecine interne, Rothschild, Paris, France
| | - Julie Seguier
- Département de médecine interne, CHU de La Timone, Marseille, France
| | - Francois Maurier
- Service de Médecine Interne et Immunologie Clinique Groupe Hospitalier UNEOS, Vantoux, France
| | - Sabine Berthier
- Service de médecine interne et immunologie clinique, Université Dijon, Hôpital Dijon, Dijon, France
| | - Alexandre Belot
- Service de pédiatrie et immunologie clinique, Université Lyon, Hôpital Lyon, Lyon, France
| | - Faten Frikha
- Service de Médecine interne CHU Hédi Chaker, Route El Ain 3029 Sfax -Faculté de Médecine de Sfax, Sfax, Tunisia
| | - Guillaume Denis
- Service de médecine et d'hématologie, Hopital Rochefort, Rochefort, France
| | - Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, University of Tours, Tours, France
| | - Isabelle Koné-Paut
- Service de Rhumatologie pédiatrique et centre de référence des maladies autoinflammatoires et de l'amylose inflammatoire, CEREMAIA, hôpital de Bicêtre, APHP, France, université de Paris Sud-Saclay, Paris, France
| | - Sebastien Humbert
- Service de médecine interne et immunologie clinique, Hôpital Besancon, Besancon, France
| | | | - Alessandro Tomelleri
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Marina Baldissera
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | - Alberto Logullo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Ospedale Piemonte, Messina, Italy
| | - Vahan Mukuchyan
- Department of Internal Medicine and Rheumatology, Nairi hospital, Erevan, Armenia
| | - Azeddine Dellal
- Service de rhumatologie, Hôpital Montfermeil, GHI Le Raincy Montfermeil, Montfermeil, France
| | - Francis Gaches
- Médecine Interne, Hôpital Joseph Ducuing, Toulouse, France
| | - Pierre Zeminsky
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, University of Lorraine, Inserm UMR_S 1116, CHRU de Nancy, Nancy, France
| | - Elena Galli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Moya Alvarado
- Azienda USL-IRCCS; Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Boiardi
- Azienda USL-IRCCS; Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Muratore Francesco
- Azienda USL-IRCCS; Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia and Università di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Mathieu Vautier
- Université de Paris, AP-HP, Hôpital Saint Louis, Service de Biostatistique et Information Médicale (DMU PRISME), INSERM U1153 Team ECSTRRA, Paris, France
| | - Campochiaro Corrado
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Sergey Moiseev
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Matheus Vieira
- AP-HP, Hôpital Pitié Salpetrière, Department of Internal Medicine and Clinical Immunology France, Centre national de référence maladies Autoimmunes Systémiques rares, Centre national de référence maladies Autoinflammatoires et Amylose, and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France
| | - Patrice Cacoub
- AP-HP, Hôpital Pitié Salpetrière, Department of Internal Medicine and Clinical Immunology France, Centre national de référence maladies Autoimmunes Systémiques rares, Centre national de référence maladies Autoinflammatoires et Amylose, and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France
| | - Olivier Fain
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, Service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), F-75012, Paris, France, French Armenian research center, Erevan, Armenia
| | - David Saadoun
- AP-HP, Hôpital Pitié Salpetrière, Department of Internal Medicine and Clinical Immunology France, Centre national de référence maladies Autoimmunes Systémiques rares, Centre national de référence maladies Autoinflammatoires et Amylose, and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Sorbonne Universités, Paris, France
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Zuelgaray E, Chevret S, Jachiet M, Cacoub P, Kahn JE, Groh M, Granel B, Scafi M, Geffray L, Chasset F, Gatfosse M, Mekinian A, Lioger B, Mahr A, Gaches F, Michaud M, Ludot I, Cordoliani F, de Masson A, Cassius C, Retornaz F, Audemard-Verger A, Lartigau-Roussin C, Roriz M, Chaigne B, Pallure V, Marie I, Castel B, Loustau V, Chiche L, Gavand PE, Cathebras P, Barete S, Frances C, Brenaut E, Allenbach Y, Benveniste O, Noel N, Urbanski G, Hinschberger O, Bessis D, Bagot M, Bouaziz JD, Sène D. Trunk involvement and peau d'orange aspect are poor prognostic factors in eosinophilic fasciitis (Shulman disease): A multicenter retrospective study of 119 patients. J Am Acad Dermatol 2023; 88:160-163. [PMID: 33188872 DOI: 10.1016/j.jaad.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Elina Zuelgaray
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Sylvie Chevret
- Service de Biostatistique et Information Médicale, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Marie Jachiet
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Patrice Cacoub
- Département de Médecine Interne et d'Immunologie clinique, Sorbonne-Université, Hôpital de la Pitié-Salpêtrière, APHP, Paris, France
| | - Jean-Emmanuel Kahn
- Centre National de Référence des Syndromes Hyperéosinophiliques, Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | - Matthieu Groh
- Centre National de Référence des Syndromes Hyperéosinophiliques, Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | - Brigitte Granel
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Nord, Marseille, France
| | - Manon Scafi
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Nord, Marseille, France
| | - Loïk Geffray
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitaliser de Lisieux, Lisieux, France
| | - François Chasset
- Service de Dermatologie, Université de Paris, Hôpital Tenon, Paris, France
| | - Marc Gatfosse
- Service de Médecine Interne et d'Immunologie clinique, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Arsène Mekinian
- Service de Médecine Interne et d'Immunologie clinique, Sorbonne Université, Hôpital Saint-Antoine, Paris, France
| | - Bertrand Lioger
- Unité de Médecine Interne et Maladies systémiques, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Alfred Mahr
- Unité de Médecine Interne et Maladies systémiques, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Francis Gaches
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Joseph Ducuing, Toulouse, France
| | - Martin Michaud
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Joseph Ducuing, Toulouse, France
| | - Isabelle Ludot
- Service de Rhumatologie, Clinique Pasteur, Toulouse, France
| | - Florence Cordoliani
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Adèle de Masson
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Charles Cassius
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Frédérique Retornaz
- Unité de soins et de recherche en médecine interne et de maladies infectieuses, Hôpital Européen, Marseille, France
| | - Alexandra Audemard-Verger
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalo-Universitaire Côte de Nacre, Caen, France
| | - Céline Lartigau-Roussin
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalier Ouest Réunion, Saint Paul, France
| | - Mélanie Roriz
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Bichat, Paris, France
| | - Benjamin Chaigne
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Cochin, Paris, France
| | - Valérie Pallure
- Service de Dermatologie, Centre Hospitalier de Perpignan, Perpignan, France
| | - Isabelle Marie
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - Brice Castel
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalier de Lourdes, Lourdes, France
| | - Valentine Loustau
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalier Alpes Léman, Contamine-sur-Avre, France
| | - Laurent Chiche
- Unité de soins et de recherche en médecine interne et de maladies infectieuses, Hôpital Européen, Marseille, France
| | - Pierre-Edouard Gavand
- Service de Médecine Interne et d'Immunologie clinique, Clinique Rhena, Strasbourg, France
| | - Pascal Cathebras
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalo-Universitaire de Saint Etienne, Hôpital Nord, Saint-Etienne, France
| | - Stéphane Barete
- Service de Dermatologie, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Camille Frances
- Service de Dermatologie, Université de Paris, Hôpital Tenon, Paris, France
| | - Emilie Brenaut
- Service de Dermatologie, Centre Hospitalo-Universitaire Morvan, Brest, France
| | - Yves Allenbach
- Département de Médecine Interne et d'Immunologie clinique, Sorbonne-Université, Hôpital de la Pitié-Salpêtrière, APHP, Paris, France
| | - Olivier Benveniste
- Département de Médecine Interne et d'Immunologie clinique, Sorbonne-Université, Hôpital de la Pitié-Salpêtrière, APHP, Paris, France
| | - Nicolas Noel
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Bicêtre, Kremlin-Bicêtre, France
| | - Geoffrey Urbanski
- Service de Médecine Interne et d'Immunologie clinique, Centre Hospitalo-Universitaire d'Angers, Angers, France
| | - Olivier Hinschberger
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Emile Muller, Mulhouse, France
| | - Didier Bessis
- Service de Dermatologie, Hôpital Saint Eloi, Montpellier, France
| | - Martine Bagot
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France
| | - Jean-David Bouaziz
- Service de Dermatologie, Université de Paris, Hôpital Saint-Louis, Paris, France.
| | - Damien Sène
- Service de Médecine Interne et d'Immunologie clinique, Hôpital Lariboisière, Paris, France
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Chaves SDA, Puissant B, Porel T, Bories E, Adoue D, Alric L, Astudillo L, Huart A, Lairez O, Michaud M, Ribes D, Prévot G, Sailler L, Gaches F, Pugnet G. Clinical impact and prognosis of cryoglobulinemia and cryofibrinogenemia in systemic sclerosis. Autoimmun Rev 2022; 21:103133. [PMID: 35752439 DOI: 10.1016/j.autrev.2022.103133] [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: 05/14/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION An association of systemic sclerosis (SSc) with cryoglobulin and/or cryofibrinogenemia has been described. However, clinical, biological, morphological and prognostic implications are unknown. The objective of this study was to describe the phenotype and evaluate the prognosis of cryoglobulinemia and/or cryofibrinogenemia in the progression of SSc. MATERIALS AND METHODS Patients were included from the Systemic Scleroderma Toulouse Cohort (SSTC), between June 1, 2005 and May 31, 2018, and underwent a measurement of a cryoglobulin and/or cryofibrinogen in immunology laboratory at the Toulouse University Hospital Center. Patients with and without cryoglobulinemia >50 mg/l and patients with and without cryofibrinogenemia were compared to identified the impact of cryoprcipitate on the phenotype. Mortality based on cryoprecipitate was explored. RESULTS 166 patients were included in the study. 43.3% and 46.6% had a cryoglobulinemia >50 mg/l and cryofibrinogenemia, respectively. Cryoglobulin >50 mg was not associated with microvascular damage. Cryoglobulin does not influence the phenotype. 5-and 10-years survival were 97.6% and 88.8% respectively in patients with cryoglobulinemia >50 mg/l versus 91.9% and 78.4% in patients without cryoglobulin>50 mg/l. 10-years survival was better for patients with cryoglobulinemia >50 mg/l (log-rank 0.0363). Cryofibrinogenemia was not associated with neoplasia, any clinical (in particular ischemic damage), biological or morphological features. Cryofibrinogenemia had no influence on the mortality of these patients. CONCLUSION Cryoglobulinemia and cryofibrinogenemia are frequent in SSc. The presence of cryoprecipitate (cryoglobulin or cryofibrinogen) not influence the phenotype and has not associated with a poor survival.
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Affiliation(s)
| | - Bénédicte Puissant
- Centre Hospitalier Universitaire, Laboratoire d'Immunologie, Toulouse, France
| | - Tiphaine Porel
- Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France
| | - Eva Bories
- Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France
| | - Daniel Adoue
- Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France
| | - Laurent Alric
- Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France
| | | | - Antoine Huart
- Centre Hospitalier Universitaire, Néphrologie, Toulouse, France
| | - Olivier Lairez
- Centre Hospitalier Universitaire, Cardiologie, Toulouse, France
| | - Martin Michaud
- Clinique Ambroise-Paré, Medecine Interne, Toulouse, France
| | - David Ribes
- Centre Hospitalier Universitaire, Néphrologie, Toulouse, France
| | - Grégoire Prévot
- Centre Hospitalier Universitaire, Pneumologie, Toulouse, France
| | - Laurent Sailler
- Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France
| | - Francis Gaches
- Hopital Joseph Ducuing, Medecine Interne, Toulouse, France
| | - Gregory Pugnet
- Centre Hospitalier Universitaire, Medecine Interne, Toulouse, France; Centre Hospitalier Universitaire, Laboratoire d'Immunologie, Toulouse, France; Clinique Saint-Exupery, Medecine Interne, Toulouse, France; Centre Hospitalier Universitaire, Néphrologie, Toulouse, France; Centre Hospitalier Universitaire, Cardiologie, Toulouse, France; Clinique Ambroise-Paré, Medecine Interne, Toulouse, France; Centre Hospitalier Universitaire, Pneumologie, Toulouse, France; Hopital Joseph Ducuing, Medecine Interne, Toulouse, France; Centre D'investigation Clinique (CIC), 1436 PEPSS Team, Toulouse, France
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Bories E, De Almeida S, Porel T, Alric L, Astudillo L, Gaches F, Michaud M, Catros F, Prevot G, Sailler L, Adoue D, Lairez O, Pugnet G. Épidémiologie descriptive de l’atteinte cardiaque sévère dans la sclérodermie systémique : étude rétrospective bicentrique sur 459 patients. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.261] [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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De Almeida Chaves S, Benedicte P, Porel T, Bories E, Adoue D, Astudillo L, Alric L, Huart A, Michaud M, Ribes D, Prevot G, Sailler L, Gaches F, Pugnet G. AB0651 Clinical Impact and Prognosis of cryoglobulinemia and cryofibrinogenemia in Systemic Sclerosis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSystemic sclerosis (SSc) is reported to be a secondary cause of cryoglobulinemia as well as cryofibrinogenemia. However, prevalence, clinical implication and associated pronostic of cryoprecipitates in SSc are unknown.ObjectivesTo describe the prevalence, the phenotype and evaluate the prognosis of cryoglobulinemia and/or cryofibrinogenemia associated with systemic sclerosis.MethodsWe included all adult (≥18 years) consecutive SSc patients from the Systemic Scleroderma Toulouse Cohort (SSTC) [1] for whom a cryoglobulin and/or cryofibrinogen measurement was carried out at the immunology laboratory of the Toulouse University Hospital between June 1, 2005 and May 31, 2018 and at least one follow-up visit. We compared SSc-patients characteristics’ with and without cryoglobulinemia > 50 mg/l and with and without cryofibrinogenemia. Survival analysis based on presence of cryoglobulin cryofibrinogen was performed using the Kaplan-Meier method. Univariable and multivariable Cox proportional hazards models (ascending step-by-step method) were used to determine baseline variables associated with cryoglobulin or cryofibrinogen presence.Results166 patients were included in the study. 74.6% of patients were women, with a average age at diagnosis of 51.2 years-old. 24% were diffuse cutaneous subtypes and 71.6% limited cutaneous subtypes. Anti-centromere and anti-Scl70 were respectively positive in 44.5% and 21.6% of cases. All these patients were assessed for cryoglobulin detection and 75 cryofibrinogen detection in serum. 43.3% had a cryoglobulinemia >50 mg/l. 46.6% had cryofibrinogenemia. Patients with cryoglobulinemia >50 mg had more cardiac diastolic involvement (22.8% vs. 5.1% p=0.0395). In the multivariate analysis, diastolic involvement (HR=6.23; p=0.0331) was an independent predictor of cryoglobulin >50 mg/l. Survival at 10 years was better for patients with cryoglobulinemia >50 mg/l (log-rank 0.0363) (Figure 1). Survival at 5 and 10 years was 97.6% and 88.8% respectively in patients with cryoglobulinemia >50 mg/l versus 91.9% and 78.4% in patients with cryoglobulinemia <50 mg/l. In cox regression model adjusted for gender, age and type of systemic sclerosis, cryoglobulin >50 mg/l was negatively associated with mortality (HR: 0.09; p=0.03). The presence of cryofibrinogenemia was not associated with any clinical, biological or morphological features. In the multivariate analysis, no variable was predictive of the presence of cryofibrinogenemia in patients with SSc. The presence of cryofibrinogenemia had no influence on the mortality of these patients.ConclusionIn SSc patients, the presence of cryoglobulin >50 mg/l is an independent predictive factor of cardiac diastolic involvement and is associated with a better survival. However, cryofibrinogenemia does not influence clinical phenotype or impact mortality in SSc patients.References[1]De Almeida Chaves S, Porel T, Mounié M, Alric L, Astudillo L et al. Sine scleroderma, limited cutaneous, and diffused cutaneous systemic sclerosis survival and predictors of mortality. Arthritis Res Ther. 2021 Dec 7;23(1):295. doi: 10.1186/s13075-021-02672-y.Disclosure of InterestsNone declared
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De Almeida Chaves S, Puissant B, Porel T, Bories E, Adoue D, Astudillo L, Alric L, Huart A, Michaud M, Ribes D, Prevot G, Sailler L, Gaches F, Pugnet G. Impact clinique et pronostique d’une cryoglobulinémie et d’une cryofibrinogénémie au cours de la sclérodermie systémique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.254] [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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Bories E, DE Almeida Chaves S, Porel T, Alric L, Astudillo L, Gaches F, Michaud M, Catros F, Prevot G, Sailler L, Adoue D, Lairez O, Pugnet G. POS0884 DESCRIPTIVE EPIDEMIOLOGY OF SEVERE CARDIAC INVOLVEMENT IN SYSTEMIC SCLEROSIS: A BICENTRIC RETROSPECTIVE STUDY ON 459 PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe prevalence of cardiac involvement in systemic sclerosis (SSc) varies in the literature between 3% and 44% and represents a leading cause of mortality in this disease. The incidence of severe cardiac involvement and the factors associated with the occurrence of severe cardiac involvement are not known in the literature.ObjectivesThe objective of this study was to evaluate the incidence, prognosis and factors associated with the occurrence of severe cardiac involvement during SSc course.MethodsWe conducted a retrospective, bi-centric study from January 1, 1966 to December 31, 2018. The patients included had a diagnosis of SS according to the ACR/EULAR 2013 criteria. The primary endpoint was the occurrence of severe cardiac involvement. Cardiac involvement was defined by the presence of at least one of the following elements: death of cardiovascular origin, left ventricular ejection fraction less than or equal to 50%, abnormality of at least 3 measurement parameters of diastolic function, global longitudinal strain less than or equal to 18 in absolute value, ventricular tachycardia, ventricular extrasystoles requiring intervention or elevated troponin. Patients with associated myositis and whose only criterion for cardiac involvement was elevated troponin were not included in the group with cardiac involvement. Severe cardiac involvement was defined by the occurrence of hospitalization for cardiovascular reasons or by death of cardiovascular origin. Univariable and multivariable Cox proportional hazards models were used to determine variables associated with severe cardiac involvement occurrence. Survival analysis was performed using the Kaplan-Meier method with comparisons performed using the log rank test.ResultsFour hundred and fifty-nine patients with SSc were included and were followed for a median of 7.1 years [3.1; 13.3]. The median age of our population was 54 years old. There were 81% of women, 77% of patients had limited cutaneous SSc, 15% diffuse cutaneous SSc and 8% SSc sine scleroderma. Of the 459 patients, 105 (23%) had cardiac involvement and 56 (12%) severe cardiac involvement. The incidence of severe cardiac involvement was 2.42 per 100 patient years. Ninety-six hospitalizations were recorded, including 40 (42%) for acute heart failure, 19 (20%) for arrhythmia, 5 (5%) for acute pericarditis, 6 (6%) for acute myocarditis and 14 (15 %) for coronary artery disease (acute coronary syndrome, myocardial infarction or coronary revascularization). The independent factors associated with severe cardiac involvement in SSc were age over 54 years at SSc-diagnosis (OR = 3.21 95% CI [1.73; 5.95], p < 0.001), the presence of myositis (OR = 5.01 95% CI [1.89; 13.28], p = 0.001), pericardial involvement (OR = 3.79 95% CI [2.05; 7.03]; p < 0.001) or scleroderma renal crisis (OR = 4.72 95% CI [2.05; 10.92], p < 0.001). The survival rate of patients with severe cardiac involvement was 70% at 5 years and 53% at 10 years. Patients with severe cardiac involvement had a mortality risk three times greater than patients without severe cardiac involvement, HR = 3.1 (95% CI [1.7; 5.7], p<0.0001) (Figure 1). Pericardial involvement was an independent risk factor for mortality, HR = 2.0 (95% CI [1.02; 4.0], p=0.04).Figure 1.Survival of patients with severe cardiac involvement of systemic scleroderma. HR: Hazard ratio; 95% CI: 95% Confidence interval; Nb at risk: Number at riskConclusionWe need to focus our clinical attention on diagnosing and manage cardiac involvement in SSc, as severe cardiac involvement is not uncommon and is responsible for a poor prognosis.Disclosure of InterestsNone declared
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De Almeida Chaves S, Porel T, Mounié M, Alric L, Astudillo L, Huart A, Lairez O, Michaud M, Prévot G, Ribes D, Sailler L, Gaches F, Adoue D, Pugnet G. Sine scleroderma, limited cutaneous, and diffused cutaneous systemic sclerosis survival and predictors of mortality. Arthritis Res Ther 2021; 23:295. [PMID: 34876194 PMCID: PMC8650544 DOI: 10.1186/s13075-021-02672-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/08/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Systemic sclerosis (SSc) is associated with a variability of mortality rates in the literature. OBJECTIVE To determine the mortality and its predictors in a long-term follow-up of a bi-centric cohort of SSc patients. METHODS A retrospective observational study by systematically analyzing the medical records of patients diagnosed with SSc in Toulouse University Hospital and Ducuing Hospital. Standardized Mortality Ratio (SMR), mortality at 1, 3, 5, 10, and 15 years of disease and causes of death were described. Predictors of mortality using Cox regression were assessed. RESULTS Three hundred seventy-five patients were included: 63 with diffuse cutaneous SSc, 279 with limited cutaneous SSc, and 33 with sine scleroderma. The SMR ratio was 1.88 (95% CI 1.46-1.97). The overall survival rates were 97.6% at 1 year, 93.4% at 3 years, 87.1% at 5 years, 77.9% at 10 years, and 61.3% at 15 years. Sixty-nine deaths were recorded. 46.4% were SSc related deaths secondary to interstitial lung disease (ILD) (34.4%), pulmonary hypertension (31.2%), and digestive tract involvement (18.8%). 53.6% were non-related to SSc: cardiovascular disorders (37.8%) and various infections (35.1%) largely distanced those from cancer (13.5%). Four significant independent predictive factors were identified: carbon monoxide diffusing capacity (DLCO) < 70% (HR=3.01; p=0.0053), C-reactive protein (CRP) >5 mg/l (HR=2.13; p=0.0174), cardiac involvement (HR=2.86; p=0.0012), and the fact of being male (HR=3.25; p=0.0004). CONCLUSION Long-term data confirmed high mortality of SSc. Male sex, DLCO <70%, cardiac involvement, and CRP> 5mg/l were identified as independent predictors of mortality.
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Affiliation(s)
| | - Tiphaine Porel
- Department of Internal Medicine, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Mickael Mounié
- INSERM UMR1027, 37 Allées Jules Guesdes, Toulouse, Midi-Pyrénées, France
| | - Laurent Alric
- Department of Internal Medicine, CHU Toulouse, Toulouse, Midi-Pyrénées, France
- Universite Toulouse III Paul Sabatier Toulouse, Occitanie, France
| | - Léonardo Astudillo
- Department of Internal Medicine, Saint Exupéry Nephrology Clinic, Toulouse, Midi-Pyrénées, France
| | - Antoine Huart
- Department of Nephrology, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Olivier Lairez
- Universite Toulouse III Paul Sabatier Toulouse, Occitanie, France
- Department of Cardiology, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Martin Michaud
- Department of Internal Medicine, Hospital Joseph Ducuing, Toulouse, France
| | - Grégoire Prévot
- Department of Pneumology, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - David Ribes
- Department of Nephrology, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Laurent Sailler
- Department of Internal Medicine, CHU Toulouse, Toulouse, Midi-Pyrénées, France
- Universite Toulouse III Paul Sabatier Toulouse, Occitanie, France
| | - Francis Gaches
- Department of Internal Medicine, Hospital Joseph Ducuing, Toulouse, France
| | - Daniel Adoue
- Department of Internal Medicine, CHU Toulouse, Toulouse, Midi-Pyrénées, France
- Universite Toulouse III Paul Sabatier Toulouse, Occitanie, France
| | - Gregory Pugnet
- Department of Internal Medicine, CHU Toulouse, Toulouse, Midi-Pyrénées, France
- Universite Toulouse III Paul Sabatier Toulouse, Occitanie, France
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Mekinian A, Biard L, Dagna L, Novikov P, Salvarani C, Espita O, Sciscia S, Michaud M, Lambert M, Hernández-Rodríguez J, Schleinitz N, Awisat A, Puéchal X, Aouba A, Pons HM, Smitienko I, Gaultier JB, Edwige LM, Benhamou Y, Perlat A, Jego P, Goulenok T, Sacre K, Lioger B, Nolan H, Broner J, Dufrost V, Sene T, Seguier J, Maurier F, Berthier S, Belot A, Frikha F, Denis G, Audemard-Verger A, Pault IK, Humbert S, Woaye-Hune P, Tomelleri A, Baldissera E, Kuwana M, Logullo A, Gaches F, Zeminsky P, Galli E, Alvarado M, Luigi PB, Francesco M, Vautier M, Campochiaro C, Moiseev S, Cacoub P, Fain O, Saadoun D. Efficacy and safety of TNF-α antagonists and tocilizumab in Takayasu arteritis: Multicenter retrospective study of 209 patients. Rheumatology (Oxford) 2021; 61:1376-1384. [PMID: 34363461 DOI: 10.1093/rheumatology/keab635] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 03/16/2021] [Revised: 08/02/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To assess safety and efficacy of TNF-α antagonists and tocilizumab in patients with Takayasu arteritis (TAK). METHODS AND RESULTS Two-hundred nine patients with TAK [median age of 29 years [7-62], and 186 (89%) females] were included. They received either TNF-α antagonists [n = 132 (63%) with 172 lines; infliximab (n = 109), adalimumab (n = 45), golimumab (n = 8), certolizumab (n = 6) and etanercept (n = 5)], or tocilizumab [n = 77 (37%) with 121 lines; intravenous and subcutaneous in 95 and 26 cases, respectively]. A complete response at 6 months was evidenced in 101/152 (66%) on TNF-α antagonists and 75/107 (70%) on tocilizumab, respectively. Age ≥ 30 years [OR = 2.09 [1.09; 3.99]] was associated with complete response, whereas vascular signs [0.26 [0.1; 0.65]], baseline prednisone ≥ 20 mg/day [0.51 [0.28; 0.93]] were negatively associated with the complete response to TNF-α antagonists or tocilizumab. During a median follow-up of 36 months, 103 relapses were noted. Supra-aortic branches and thoracic aorta involvements [HR 2.44 (1.06; 5.65) and 3.66 (1.18; 11.4), respectively], and systemic signs at baseline [HR 2.01 (1.30; 3.11)] were significantly associated with relapse. The cumulative incidence of treatment discontinuation and relapse were similar in TNFα antagonists and tocilizumab. Fifty-eight (20%) adverse effects occurred on biological-targeted therapies of whom 37 (21%) and 21 (17%), (p= 0.4) on TNF-α antagonists and tocilizumab, respectively. CONCLUSION This large multicentre study shows high efficacy of biological-targeted treatments in refractory TAK. Efficacy, relapse and drug retention rate were equivalent with TNF-α antagonists and tocilizumab.
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Affiliation(s)
- Arsène Mekinian
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Paris, F-75012, France
| | - Lucie Biard
- Université de Paris, AP-HP, Hôpital Saint Louis, Service de Biostatistique et Information Médicale (DMU PRISME), INSERM U1153 Team ECSTRRA, Paris, France
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Pavel Novikov
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Carlo Salvarani
- Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Italy.,Unit of Rheumatology, Università di Modena e Reggio Emilia, Italy
| | - Olivier Espita
- Service de Médecine Interne, CHU Hôtel-Dieu, Nantes, 44093, France
| | - Savino Sciscia
- Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, Nephrology and Dialysis, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Martin Michaud
- Médecine Interne, Hôpital Joseph Ducuing, Toulouse, 31076
| | - Marc Lambert
- Service de médecine interne, CHU Lille, Université Lille II, Lille, France
| | - José Hernández-Rodríguez
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS, University of Barcelona, Barcelona, Spain )
| | | | - Abid Awisat
- Rheumatology unit, Bnai Zion medical center, Haifa, Israel
| | - Xavier Puéchal
- Université Paris Descartes, Paris, France; AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, service de médecine interne, 27 rue du Faubourg Saint-Jacques, Paris, 75014, France
| | - Achille Aouba
- Département de médecine interne, CHU, Caen, Caen, France
| | - Helene Munoz Pons
- Département de médecine interne, CHU, Saint Etienne, Saint Etienne, France
| | - Ilya Smitienko
- Rheumatology department, Medical Center, Moscow, K-31, Russia
| | - Jean Baptiste Gaultier
- Service de Médecine Interne, Hôpital Nord, Centre Hospitalier universitaire de St Etienne, saint Etienne cedex 2, 42055, France
| | - Le Mouel Edwige
- Département de médecine interne, CHU de Rennes, Rennes, France
| | - Ygal Benhamou
- Service de médecine interne, Université Rouen, CHU de Rouen, Rouen, France
| | | | - Patrick Jego
- Département de médecine interne, CHU de Rennes, Rennes, France
| | - Tiphaine Goulenok
- Département de Médecine Interne, Hôpital Bichat, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, INSERM U1149, France
| | - Karim Sacre
- Département de Médecine Interne, Hôpital Bichat, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, INSERM U1149, France
| | | | - Hassold Nolan
- Service de Rhumatologie pédiatrique et centre de référence des maladies autoinflammatoires et de l'amylose inflammatoire, CEREMAIA, hôpital de Bicêtre, APHP, France, université de Paris Sud-Saclay
| | | | - Virginie Dufrost
- University of Lorraine, Inserm UMR_S 1116, CHRU de Nancy, Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, F-54000, France
| | - Thomas Sene
- Service de médecine interne, Rothschild, Paris, France
| | - Julie Seguier
- Département de médecine interne, CHU de La Timone, Marseille, France
| | - Francois Maurier
- Service de Médecine Interne et Immunologie Clinique Groupe Hospitalier UNEOS Metz-Vantoux, France
| | - Sabine Berthier
- Service de médecine interne et immunologie clinique, Université Dijon, Hôpital Dijon, Dijon, France
| | - Alexandre Belot
- Service de pédiatrie et immunologie clinique, Université Lyon, Hôpital Lyon, Lyon, France
| | - Faten Frikha
- Service de Médecine interne CHU Hédi Chaker, Route El Ain, Sfax -Faculté de Médecine de Sfax, 3029, Tunisie
| | - Guillaume Denis
- Service de médecine et d'hématologie, Hopital Rochefort, Rochefort, France
| | | | - Isabelle Kone Pault
- Service de Rhumatologie pédiatrique et centre de référence des maladies autoinflammatoires et de l'amylose inflammatoire, CEREMAIA, hôpital de Bicêtre, APHP, France, université de Paris Sud-Saclay
| | - Sebastien Humbert
- Service de médecine interne et immunologie clinique, Hôpital Besancon, Besancon, France
| | | | - Alessandro Tomelleri
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Baldissera
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | - Alberto Logullo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Ospedale Piemonte, Messina, Italy
| | - Francis Gaches
- Médecine Interne, Hôpital Joseph Ducuing, Toulouse, 31076
| | - Pierre Zeminsky
- University of Lorraine, Inserm UMR_S 1116, CHRU de Nancy, Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy, F-54000, France
| | - Elena Galli
- Unit of Rheumatology, Università di Modena e Reggio Emilia, Italy
| | - Moya Alvarado
- Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Italy
| | | | | | - Mathieu Vautier
- Université de Paris, AP-HP, Hôpital Saint Louis, Service de Biostatistique et Information Médicale (DMU PRISME), INSERM U1153 Team ECSTRRA, Paris, France
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Sergey Moiseev
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Patrice Cacoub
- Sorbonne Université, AP-HP, Hôpital Pitié Salpetrière, Department of Internal Medicine and Clinical Immunology France, Centre national de référence maladies Autoimmunes Systémiques rares, Centre national de référence maladies Autoinflammatoires et Amylose, and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Paris, F-75013, France
| | - Olivier Fain
- Sorbonne Université, AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU i3), Paris, F-75012, France
| | - David Saadoun
- Sorbonne Université, AP-HP, Hôpital Pitié Salpetrière, Department of Internal Medicine and Clinical Immunology France, Centre national de référence maladies Autoimmunes Systémiques rares, Centre national de référence maladies Autoinflammatoires et Amylose, and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Paris, F-75013, France
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Michaud M, Mauhin W, Belmatoug N, Garnotel R, Bedreddine N, Catros F, Ancellin S, Lidove O, Gaches F. When and How to Diagnose Fabry Disease in Clinical Pratice. Am J Med Sci 2020; 360:641-649. [PMID: 32723516 DOI: 10.1016/j.amjms.2020.07.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/30/2020] [Accepted: 07/09/2020] [Indexed: 01/27/2023]
Abstract
Fabry disease is a frequent lysosomal storage disorder secondary to the deficiency of alpha-galactosidase A enzyme. This X-linked genetic disease realizes progressive and systemic manifestations that affect both male and female. Fabry disease may present as "classical", as "late-onset" or "non-classical" forms. Symptoms and organ involvements of classical Fabry disease are acral pain crisis, cornea verticillata, hypertrophic cardiomyopathy, stroke and chronic kidney disease with proteinuria. Other common symptoms are often poorly recognized, such as gastrointestinal or ear involvements. In classical Fabry disease, symptoms first appear during childhood or during teenage years in males, but later in females. Patients with non-classical or late-onset Fabry disease have delayed manifestations or a single-organ involvement. Diagnosis is therefore difficult when classical organ involvements are missing, in paucisymptomatic patients or in late-onset forms. Recognition of Fabry disease is important because effective treatments are available. They have to be prescribed early. In male, diagnosis is made with alpha-galactosidase A enzyme activity dosage in leukocyte, that is very low or null in classical forms and under 30 percent in late-onset forms. Diagnosis is more challenging in females who may express normal residual enzyme activity. Other plasmatic biomarkers, such as lyso-globotriaosylceramide are interesting, especially in females. In this review, we aimed to summarize main clinical manifestations of Fabry disease to know when to evoke Fabry disease and propose a practical diagnosis algorithm to know how to diagnose.
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Affiliation(s)
- Martin Michaud
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France; Competence Center for Lysosomal Storage Diseases, Hopital Joseph Ducuing, Toulouse, France.
| | - Wladimir Mauhin
- Internal Medicine and Rheumatology Department, Diaconesses-Croix Saint Simon Hospital Group, Paris, France; Referral Center for Lysosomal Diseases, site Avron, Paris, France
| | - Nadia Belmatoug
- Department of Internal Medicine, University Hospital Paris Nord Val de Seine, Assistance Publique-Hôpitaux de Paris, Clichy, France; Referral Center for Lysosomal Diseases, University Hospital Paris Nord Val de Seine, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Roselyne Garnotel
- Biochemistry Laboratory, American Memorial Hospital Reims, Reims, France
| | - Naiya Bedreddine
- Association des patients de la maladie de Fabry, Marsannay La Cote, France
| | - Florian Catros
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France; Competence Center for Lysosomal Storage Diseases, Hopital Joseph Ducuing, Toulouse, France
| | - Sophie Ancellin
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France; Competence Center for Lysosomal Storage Diseases, Hopital Joseph Ducuing, Toulouse, France
| | - Olivier Lidove
- Internal Medicine and Rheumatology Department, Diaconesses-Croix Saint Simon Hospital Group, Paris, France; Referral Center for Lysosomal Diseases, site Avron, Paris, France
| | - Francis Gaches
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France; Competence Center for Lysosomal Storage Diseases, Hopital Joseph Ducuing, Toulouse, France
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Michaud M, Ranaivojaona S, Livideanu C, Mery C, Gaches F. Umbilical Vein Recanalization. Am J Med Sci 2020; 361:e41. [PMID: 32713510 DOI: 10.1016/j.amjms.2020.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/12/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Martin Michaud
- Department of Internal Medicine, Joseph Ducuing Hospital, Toulouse, France.
| | | | | | - Cécile Mery
- Department of Gastroenterology, Joseph Ducuing Hospital, Toulouse, France
| | - Francis Gaches
- Department of Internal Medicine, Joseph Ducuing Hospital, Toulouse, France
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Porel T, DE Almeida Chaves S, Adoue D, Astudillo L, Ribes D, Prévôt G, Gaches F, Michaud M, Alric L, Sailler L, Pugnet G. SAT0339 NERVOUS SYSTEM INVOLVEMENT IN SYSTEMIC SCLEROSIS: A COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Nervous system involvement is considered to be rare in systemic sclerosis (SSc). Its prevalence is highly variable in SSc cohort studies and its prognosis is not well established.Objectives:To determine the frequency, clinical characteristics, associations, and outcomes of different types of peripheral nervous system (PNS) and central nervous system (CNS) disease in a cohort of systemic sclerosis patients.Methods:We have carried out a retrospective observational study by systematically analyzing the medical records of patients diagnosed with SSc in Toulouse University Hospital and Ducuing Hospital, south west France. We included patients who met the following inclusion criteria: being over 18 years of age on diagnosis, meeting the ACR /EULAR 2013 classification criteria, being diagnosed after 01/01/1966 and before 31/12/2018, at least 12 months of follow-up. Patients were followed until 31/12/2019. Nervous system involvement associated with SSc was included when there was involvement on or after diagnosis and after exclusion of all other causes. Only symptomatic clinical involvement was included. Ischemic or hemorrhagic strokes were excluded. We calculated the incidence of CNS and/or PNS disease during the follow-up period per 1,000 person-years. Kaplan-Meier curves were plotted to determine the cumulative incidence of nervous system disease. We evaluated associated factors of CNS and/or PNS disease using multivariable Cox regression.Results:Of 447 SSc patients, 79.8% were female, 68 (15%) were diffuse cutaneous SSc, 342 (77%) were limited cutaneous SSc and 37 (8%) were sine scleroderma SSc. The mean ± SD age at diagnosis was 52.9 ± 14.3 years.During the study period, 82 (18%) patients experienced a PNS disease, 29 (6%) a CNS disease. The incidence was 28 per 1,000 patient-years of any nervous system disease, with 22 per 1,000 patient-years and 6 per 1,000 patient-years of PNS disease and CNS disease, respectively. The most frequent were carpal tunnel syndrome (63%) and polyneuropathies (12%) for PNS disease, and headache (45%) and seizures (10%) for CNS disease.Three significant independent associated factors with PNS disease occurrence were identified using multivariable Cox regression: BMI>23.1kg/m2(HR = 1.06 [1.01-1.12]), joint involvement (HR = 2.7 [1.3-5.5]), and an alteration in the left ventricular ejection fraction (HR = 3.8 [1.4-10.3]).Four significant independent associated factors with CNS disease occurrence were identified: age > 54 years (HR = 2.5 [1.1-6.0]), positive anti-PmScl testing (HR = 6.4 [1.5-28.2]), Caucasian origin (HR = 0.2 [0.1-0.5]) and hemoglobin < 12g/dl (HR = 0.2 [0.04-0.8]).Nervous system disease occurrence did not appear to have a negative impact on the survival of SSc patients (log-rank p=0.56).Conclusion:This study shows that specific nervous system disease in SSc is not uncommon and does not appear to increase mortality, but it could have an impact on functional prognosis and needs to be monitored.Disclosure of Interest:None declared
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Michaud M, Bidouze L, Ancellin S, Catros F, Gaches F. Annual screening of comorbidities for people living with HIV in a single day hospitalization: A one-year experience. Eur J Intern Med 2020; 76:104-106. [PMID: 32046941 DOI: 10.1016/j.ejim.2020.02.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Martin Michaud
- Internal Medicine Department, Joseph Ducuing Hospital, Toulouse, France.
| | - Lucie Bidouze
- Internal Medicine Department, Joseph Ducuing Hospital, Toulouse, France
| | - Sophie Ancellin
- Internal Medicine Department, Joseph Ducuing Hospital, Toulouse, France
| | - Florian Catros
- Internal Medicine Department, Joseph Ducuing Hospital, Toulouse, France
| | - Francis Gaches
- Internal Medicine Department, Joseph Ducuing Hospital, Toulouse, France
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Michaud M, Catros F, Gaches F. Usefulness of serum amyloid a protein dosage for monitoring patients receiving tocilizumab. Eur J Intern Med 2020; 74:115-116. [PMID: 31926783 DOI: 10.1016/j.ejim.2019.12.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/17/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Martin Michaud
- Department of Internal Medicine, Joseph Ducuing Hospital, 15 rue Varsovie, Toulouse 31076, France.
| | - Florian Catros
- Department of Internal Medicine, Joseph Ducuing Hospital, 15 rue Varsovie, Toulouse 31076, France
| | - Francis Gaches
- Department of Internal Medicine, Joseph Ducuing Hospital, 15 rue Varsovie, Toulouse 31076, France
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Michaud M, Belmatoug N, Catros F, Ancellin S, Touati G, Levade T, Gaches F. Mucopolysaccharidoses : quand y penser ? Rev Med Interne 2020; 41:180-188. [DOI: 10.1016/j.revmed.2019.11.010] [Citation(s) in RCA: 7] [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: 05/19/2019] [Revised: 11/08/2019] [Accepted: 11/25/2019] [Indexed: 12/17/2022]
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Michaud M, Lemeu M, Balardy L, Catros F, Gaches F. Effets de la corticothérapie systémique sur la composition corporelle : revue systématique de la littérature. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.179] [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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Guille M, Michaud M, Hitzel A, Lairez O, Catros F, Ancellin S, Pugnet G, Debard A, Prevot G, Gaches F. Intérêt du TEP-TDM au 18F-FDG dans le bilan étiologique des péricardites. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Michaud M, Ancellin S, Catros F, Livideanu C, Mathe Bonnet V, Mouchet F, Gaches F. Artérite de Takayasu révélée par une surdité bilatérale. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.244] [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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Michaud M, Ancellin S, Catros F, Gaches F, Le Grusse J. Traitement de l’IRIS tuberculeux par anti-TNF : une première paradoxale ? Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Comont T, Brun N, Germain J, Dingremont C, Castel B, Arista S, Madaule S, Montané De La Roque P, Prudhomme L, Sailler L, Balardy L, Alric L, Gaches F, Lapeyre-Mestre M, Beyne-Rauzy O, Adoue D, Moulis G. Rentabilité diagnostique du myélogramme systématique chez les patients de plus de 60 ans au diagnostic de purpura thrombopénique immunologique pour rechercher une cause secondaire. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.022] [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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Michaud M, Bidouze L, Ancellin S, Catros F, Davis J, Gaches F. Comments on "Vaccination in the Adult Patient Infected with HIV". Am J Med 2019; 132:e667. [PMID: 31492439 DOI: 10.1016/j.amjmed.2019.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Martin Michaud
- Department of Medicine, Hôpital Joseph Ducuing, Toulouse, France.
| | - Lucie Bidouze
- Department of Medicine, Hôpital Joseph Ducuing, Toulouse, France
| | - Sophie Ancellin
- Department of Medicine, Hôpital Joseph Ducuing, Toulouse, France
| | - Florian Catros
- Department of Medicine, Hôpital Joseph Ducuing, Toulouse, France
| | - Joshua Davis
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Francis Gaches
- Department of Medicine, Hôpital Joseph Ducuing, Toulouse, France
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Michaud M, Catros F, Ancellin S, Gaches F. Treatment of systemic lupus erythematosus: don't forget hydroxychloroquine. Ann Rheum Dis 2019; 79:e133. [PMID: 31167763 DOI: 10.1136/annrheumdis-2019-215799] [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] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Martin Michaud
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France
| | - Florian Catros
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France
| | - Sophie Ancellin
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France
| | - Francis Gaches
- Department of Internal Medicine, Hopital Joseph Ducuing, Toulouse, France
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Michaud M, Sené T, Lidove O, Chazerain P, Urbanski G, Chiche L, Bienvenu B, Alric L, Sailler L, Caudrelier L, Giraud J, Gaches F. Efficacité et Tolérance du Tocilizumab en utilisation hors AMM en médecine interne : étude rétrospective multicentrique. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Faviez G, Catros F, Gaches F, Ancellin S, Ferro M, Michaud M. Péricardite aiguë à Bocavirus : 1re description. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.057] [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: 10/14/2022]
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Bidouze L, Gaches F, Catros F, Ancellin S, Cella A, Garipuy D, Ferro M, Obadia M, Fourcade C, Bicart See A, Bonnet E, Michaud M. Intérêt du bilan annuel pour le dépistage des complications chez les personnes vivant avec le VIH. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.337] [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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Bidouze L, Gaches F, Catros F, Ancellin S, Obadia M, Bicart See A, Fourcade C, Bonnet E, Cella A, Garipuy D, Ferro M, Michaud M. Intérêt du bilan annuel pour le dépistage des complications chez les personnes vivant avec le VIH. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.060] [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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Paricaud K, Pugnet G, Astudillo L, Moulis G, Arlet P, Alric L, Thiercelin-Legrand M, Adoue D, Balardy L, Constantin A, Gaches F, Sailler L. Évolution à 5 ans au cours de l’artérite cellule géante : des indications pour guider la prescription de tocilizumab ? Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Landon-Cardinal O, Monseau G, Schoindre Y, Rigolet A, Champtiaux N, Hervier B, Masseau A, Hachulla E, Papo T, Terrier B, Meyer A, Maurier F, Gaches F, Salort-Campana E, Audia S, Bouvier A, Stenzel W, Benveniste O, Bienvenu B, Allenbach Y. Anti-Mi2 dermatomyositis revisited: pure DM phenotype with muscle fiber necrosis and high risk of malignancy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Babinet M, Catros F, Koch R, Gaches F. Thrombopénie majeure après transfusion de concentrés érythrocytaires dans un contexte d’anémie par carence martiale. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.199] [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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Bories E, Michaud M, Paolino L, Catros F, Cella A, Barres BH, Tournier E, Guerin M, Delas A, Gaches F. Cholécystite alithiasique et artérite temporale révélant une granulomatose éosinophilique avec polyangéite. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Michaud M, Gaches F. Hydroxychloroquine in Systemic Lupus Erythematosus: Comment on the Article by Muangchan et al. Arthritis Care Res (Hoboken) 2016; 68:1052-3. [DOI: 10.1002/acr.22780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/07/2015] [Accepted: 10/27/2015] [Indexed: 11/11/2022]
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Legendre L, Payré B, Comont T, Gaches F, Lamant L, Gaulier JM, Livideanu C, Bagheri H, Delisle MB, Paul C, Livideanu CB. « La peau est bleue comme une orange » : dermatopathomimie au carbone. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.448] [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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Michaud M, Moulis G, Puissant B, Balardy L, Huart A, Gaches F, Cougoul P, Arlet P, Blancher A, Pourrat J, Sailler L. Cryofibrinogenemia: a marker of severity of cryoglobulinemic vasculitis. Am J Med 2015; 128:916-21. [PMID: 25827358 DOI: 10.1016/j.amjmed.2015.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 08/04/2014] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cryofibrinogenemia is frequently associated with cryoglobulinemia. The aim of this study was to determine the characteristics associated with the presence of cryofibrinogenemia in patients with cryoglobulinemic vasculitis. METHODS This was a single-center retrospective study that included patients with cryoglobulinemic vasculitis who were tested for cryofibrinogen at a tertiary referral center between January 1, 2011 and December 31, 2012. Twenty-nine patients fulfilled the CryoVas (cryoglobulinemic vasculitis) Survey criteria for cryoglobulinemic vasculitis. Eighteen patients had a detectable cryofibrinogen (CF-positive) and 11 had no detectable cryofibrinogen (CF-negative). Median cryoglobulin levels were 89 ± 129 mg/L in the CF-positive group and 68 ± 82 mg/L in the CF-negative group (P = .32). Median cryofibrinogen level was 70 ± 174 mg/L. Clinical manifestations were similar in both groups. Cancers and hematological disorders were more frequent among CF-positive patients (39% vs 0%, P = .026). Levels of alpha-1 and alpha-2 globulinemia were higher in the CF-positive group. Cryofibrinogenemia ≥ 100 mg/L was associated with cryoglobulinemic vasculitis (odds ratio [OR] 2.86; 95% confidence interval [CI], 1.06-7.73) in cryoglobulinemic patients. Presence of cryofibrinogenemia was associated with use of corticosteroids, immunosuppressants, or plasmapheresis in cryoglobulinemic vasculitis patients (OR 22.7; 95% CI, 2.02-256.44). CONCLUSIONS Our results strongly suggest that presence of cryofibrinogenemia is associated with a more severe phenotype among patients with cryoglobulinemic vasculitis.
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Affiliation(s)
- Martin Michaud
- Department of Internal Medicine and Gerontology, Toulouse University Hospital, Toulouse, France; Institute National de la Recherche Medicale (INSERM) U858, Toulouse, France; Toulouse University, Toulouse, France.
| | - Guillaume Moulis
- Toulouse University, Toulouse, France; Department of Internal Medicine, Toulouse University Hospital, France; INSERM UMR1027, Toulouse, France
| | - Bénédicte Puissant
- Toulouse University, Toulouse, France; Immunology Laboratory, Toulouse University Hospital, France
| | - Laurent Balardy
- Department of Internal Medicine and Gerontology, Toulouse University Hospital, Toulouse, France
| | - Antoine Huart
- Department of Nephrology, Toulouse University Hospital, France
| | - Francis Gaches
- Department of Internal Medicine, Joseph Ducuing Hospital, Toulouse, France
| | - Pierre Cougoul
- Department of Internal Medicine, Cancer University Institute of Toulouse-Oncopole, Toulouse, France
| | - Philippe Arlet
- Toulouse University, Toulouse, France; Department of Internal Medicine, Toulouse University Hospital, France
| | - Antoine Blancher
- Toulouse University, Toulouse, France; Immunology Laboratory, Toulouse University Hospital, France
| | - Jacques Pourrat
- Toulouse University, Toulouse, France; Department of Nephrology, Toulouse University Hospital, France
| | - Laurent Sailler
- Toulouse University, Toulouse, France; Department of Internal Medicine, Toulouse University Hospital, France; INSERM UMR1027, Toulouse, France
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Michaud M, Levade T, Gaches F. Maladie de Fabry : caractéristiques des patients adultes suivis en médecine interne à Toulouse. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.081] [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: 10/23/2022]
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Lidove O, Noel E, Hachulla E, Gaches F, Douillard C, Darne B, Ly K, Lavigne C, Masseau A, Leguy V, Ziza J. Caractéristiques des douleurs au cours de la maladie de Fabry. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.089] [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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Kaminsky P, Barbey F, Jaussaud R, Dussol B, Gaches F, Leguy-Seguin V, Hachulla E, Zenone T, Lavigne C, Douillard C, Lidove O. Cohérence intrafamiliale des symptômes cliniques dans la maladie de Fabry. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.024] [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: 11/28/2022]
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Decaux O, Carreiro M, Fleck E, Gaches F, Hamidou M, Maigné G, Ruggieri I, Delain JC, Crave JC. Incidence des événements indésirables après réintroduction sur le marché d’une immunoglobuline intraveineuse : analyse intermédiaire de l’étude GAMMATRACK. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.084] [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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Michaud M, Moulis G, Gaches F, Pourrat J, Huart A, Cougoul P, Puissant B, Blancher A, Arlet P, Sailler L. Cryofibrinogénémie isolée : étude rétrospective monocentrique au CHU de Toulouse sur 2ans. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.116] [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: 12/01/2022]
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Michaud M, Moulis G, Pourrat J, Gaches F, Puissant B, Blancher A, Cougoul P, Huart A, Arlet P, Sailler L. Cryoglobulinémie avec ou sans cryofibrinogénémie : des phénotypes différents ? Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.117] [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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Michaud M, Moulis G, Pourrat J, Gaches F, Puissant B, Blancher A, Cougoul P, Huart A, Arlet P, Sailler L. Vascularite cryoglobulinémique avec ou sans cryofibrinogénémie associée : des phénotypes différents. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.118] [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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Kaminsky P, Lidove O, Jaussaud R, Gaches F, Leguy-Seguin V, Hachulla E, Lavigne C, Zenone T, Douillard C, Barbey F. Leçons à retenir de l’étude séméiologique des patients dépistés lors d’une enquête familiale dans la Maladie de Fabry. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.087] [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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Kaminsky P, Barbey F, Jaussaud R, Gaches F, Leguy-Seguin V, Hachulla E, Zenone T, Lavigne C, Douillard C, Lidove O. Diagnostic de la maladie de Fabry : leçons d’une analyse sémiologique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.085] [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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Bennani I, Moulis G, Tournier E, Gaches F. Une panniculite peut en cacher une autre. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.170] [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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Michaud M, Moulis G, Inchauspe A, Broussaud S, Garipuy D, Fontaine S, Ferro MJ, Couteau C, Tack I, Vallet M, Gaches F. Myopathie et évaluation du débit de filtration glomérulaire : situation piège. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.197] [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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Gaches F. Thyroïdite de Riedel et rhumatisme inflammatoire : rémission sous anti-TNF après huit ans d’échec des autres thérapeutiques. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gaches F, Noel E, Kaminsky P, Monlun E, Gaborieau V, Lorcerie B. Prise en charge de la maladie de Fabry en France (enquête TOPS). Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.03.077] [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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Abstract
We report the case of a 36-year old woman with a history of long-term fever associated with a biologic inflammatory syndrome that was not corrected by several courses of corticosteroid treatment. The only remarkable result during previous investigations was the presence of a positive Epstein-Barr virus (EBV) serology. Clinical examination revealed an heterogenous thyroid with a nodule on the right lobe. Serum thyrotropin (TSH) concentration was normal. The levels of antiperoxidase antibodies and thyrocalcitonin were normal. Ultrasound examination of the neck showed a 3-cm hypoechogenous nodule in the right lobe of the thyroid. A total thyroidectomy was performed. Histopathologic findings led to the diagnosis of Riedel's thyroiditis. We observed a dramatic improvement after surgery with absence of fever and normalization of inflammatory parameters. The role of EBV infection in the process of this unusual form of Riedel's thyroiditis is discussed.
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Affiliation(s)
- S Fontaine
- Department of Endocrinology, CHU Rangueil, Toulouse, France
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Audemard D, Galipienzo V, Marck E, Girard B, Romieu-Louvety A, Gaches F, Dupeyron G. [Silent sinus syndrome: a rare case of enophthalmia]. J Fr Ophtalmol 2002; 25:266-9. [PMID: 11941252] [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: 02/24/2023]
Abstract
INTRODUCTION The causes of spontaneous enophthalmos, without trauma, surgical factors, or systemic illness, which can be found are rare. A particular entity called silent sinus syndrome in the Anglo-Saxon literature, which concerns the long-term effect of hypoventilation of the maxillary sinus responsible for an attraction of the sinus walls, resulting in sagging of the orbital floor, itself responsible for the enophthalmos. CASE REPORT We report the case about a 29-year-old woman, presenting a left-side spontaneous enophthalmos, with sinus-type pains for 2 months. The clinical examination revealed a horizontal diplopia when looking leftwards. Computed tomography showed a maxillary homolateral sinusitis with characteristic attraction of the sinus walls. The draining of the sinus collection by inferior endoscopic enlargement of the maxillary ostium led to pain resolution. The enophthalmos and diplopia were stabilized. CONCLUSION After eradicating the orbital causes of enophthalmos, the sinus causes were sought more precisely, the pauci-symptomatic causes such as the silent sinus syndrome. The recognition of this syndrome stopped the progression of enophthalmos by making the maxillary sinus permeable again. A surgical reconstruction of the orbital floor can be proposed in order to correct the motility of the eyes and esthetic considerations.
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Affiliation(s)
- D Audemard
- CHU Nîmes, Hôpital G. Doumergue, 5, rue Hoche, 30029 Nîmes, France
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