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Von Tokarski F, Fillon A, Maisons V, Thoreau B, Bayer G, Gatault P, Longuet H, Sautenet B, Buchler M, Vigneau C, Fakhouri F, Halimi JM. Thrombotic microangiopathies after kidney transplantation in modern era: nosology based on chronology. BMC Nephrol 2023; 24:278. [PMID: 37730583 PMCID: PMC10512637 DOI: 10.1186/s12882-023-03326-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Thrombotic microangiopathies (TMAs) are rare but can be severe in kidney transplant. recipients (KTR). METHODS We analysed the epidemiology of adjudicated TMA in consecutive KTR during the. 2009-2021 period. RESULTS TMA was found in 77/1644 (4.7%) KTR. Early TMA (n = 24/77 (31.2%); 1.5% of all KTR) occurred during the first two weeks ((median, IQR) 3 [1-8] days). Triggers included acute antibody-mediated rejection (ABMR, n = 4) and bacterial infections (n = 6). Graft survival (GS) was 100% and recurrence rate (RR) was 8%. Unexpected TMA (n = 31/77 (40.2%); 1.5/1000 patient-years) occurred anytime during follow-up (3.0 (0.5-6.2) years). Triggers included infections (EBV/CMV: n = 10; bacterial: n = 6) and chronic active ABMR (n = 5). GS was 81% and RR was 16%. Graft-failure associated TMA (n = 22/77 (28.6%); 2.2% of graft losses) occurred after 8.8 (4.9-15.5) years). Triggers included acute (n = 4) or chronic active (n = 14) ABMR, infections (viral: n = 6; bacterial: n = 5) and cancer (n = 6). 15 patients underwent transplantectomy. RR was 27%. Atypical (n = 6) and typical (n = 2) haemolytic and uremic syndrome, and isolated CNI toxicity (n = 4) were rare. Two-third of biopsies presented TMA features. CONCLUSIONS TMA are mostly due to ABMR and infections; causes of TMA are frequently combined. Management often is heterogenous. Our nosology based on TMA timing identifies situations with distinct incidence, causes and prognosis.
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Affiliation(s)
- Florent Von Tokarski
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
| | - Alexandre Fillon
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
| | - Valentin Maisons
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
| | - Benjamin Thoreau
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
| | - Guillaume Bayer
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
| | - Philippe Gatault
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
- EA4245, François-Rabelais University, Tours, France
| | - Hélène Longuet
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
| | - Bénédicte Sautenet
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
- Inserm U1246, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Matthias Buchler
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France
- EA4245, François-Rabelais University, Tours, France
| | - Cécile Vigneau
- Service de Néphrologie, CHU Pontchaillou, 35033, Rennes, France
- Université Rennes 1, Inserm IRSET, UMR 1085, 35033, Rennes, France
| | - Fadi Fakhouri
- Department of medicine, Service of Nephrology, CHUV and Université de Lausanne, Lausanne, Switzerland
| | - Jean-Michel Halimi
- Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, Hôpital Bretonneau Et Hôpital Clôcheville, CHU Tours, 2 Bd Tonnellé, 37044, Tours, Tours Cedex, France.
- EA4245, François-Rabelais University, Tours, France.
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2
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Samman B, Yadav J, Bayer G, Foerster EG, Chen L, Rocha JDB, Girardin SE, Philpott DJ. A178 ELUCIDATING THE ROLE OF THE LEUCINE-RICH REPEAT KINASE 2 G2019S MUTATION IN CROHN’S DISEASE PATHOGENESIS USING A CITROBACTER RODENTIUM INFECTIOUS COLITIS MODEL. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991366 DOI: 10.1093/jcag/gwac036.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Associations have been found linking certain LRRK2 kinase domain gain-of-function variants, such as G2019S, to the development of Crohn’s disease and Parkinson’s disease, yet their exact roles in pathogenesis remains elusive. LRRK2 is most robustly expressed in circulating and tissue-resident immune cells, such as neutrophils, lymphocytes, and macrophages. Myeloid cells deficient in LRRK2 exhibit defective antimicrobial responses, such as reduced production of reactive oxygen species in response to microbial stimuli and reduced bactericidal activity in response to infection. As an enteric colitis-inducing extracellular pathogen, Citrobacter rodentium can help us better understand the consequences of LRRK2 kinase hyperactivity on intestinal inflammation by correlating pathogen burden with key host response parameters over the course of infection. Purpose To investigate the effects of the Crohn’s and Parkinson’s disease-associated Lrrk2 G2019S hyper-kinase mutation on pathogen burden and colonic inflammation in the context of C. rodentium-induced infectious colitis. Method Wild-type and Lrrk2 G2019S mutant mice (7-8 weeks old) were fasted for 4 hours then infected with 1 x 108 CFU of C. rodentium in a 3% NaHCO3 solution by oral gavage. Body weight, faecal pathogen burden, and faecal lipocalin-2 (Lcn2) concentrations were measured at 2, 4, 7, 9, 10, 12, and 14 days post-infection (DPI). Systemic pathogen burden (as measured in the mesenteric lymph nodes and spleen), colon length, colonic inflammatory gene expression, and histopathological scoring were assessed at 7, 10, and 14 DPI. Result(s) While G2019S mice exhibited marginally higher C. rodentium loads at certain timepoints, no significant differences were found in overall pathogen burden or pathogen clearance rates between genotypes over the first 14 days of infection. Faecal pathogen load peaked at 7-9 DPI in both WT and G2019S mice, which correlated with detectable levels of C. rodentium in the mesenteric lymph nodes and spleens of some mice at 7 DPI. Lcn2 secretion and the expression of inflammatory and antimicrobial genes of interest were induced robustly over the course of infection. They peaked and ebbed at timepoints correlating well with pathogen burden; however, no significant differences were observed between WT and G2019S mutant mice at the various timepoints assessed. Conclusion(s) Mice expressing the G2019S Lrrk2 mutation exhibit neither defective pathogen control nor deleterious hyperinflammation – compared to WT mice – when infected with C. rodentium. Further research will aim to investigate the role of this Lrrk2 variant in additional models of intestinal inflammation. Please acknowledge all funding agencies by checking the applicable boxes below CCC, CIHR Disclosure of Interest None Declared
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Affiliation(s)
- B Samman
- Laboratory Medicine and Pathobiology
| | - J Yadav
- Immunology, University of Toronto
| | - G Bayer
- Immunology, University of Toronto
| | | | - L Chen
- Laboratory Medicine and Pathobiology,Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Canada
| | | | - S E Girardin
- Laboratory Medicine and Pathobiology,Immunology, University of Toronto
| | - D J Philpott
- Laboratory Medicine and Pathobiology,Immunology, University of Toronto
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Galli R, Ângelo ES, Bayer G, Klepa TC, Politta A, Gomes KM, Luz EFM, Gasparine AVCDS. LINFOMA AGRESSIVO COM LISE TUMORAL SEM MASSA BULKY, LINFOCITOSE OU LINFONODOMEGALIA. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.209] [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: 11/11/2022] Open
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Halimi JM, Thoreau B, von Tokarski F, Bauvois A, Gueguen J, Goin N, Barbet C, Cloarec S, Mérieau E, Lachot S, Garot D, Lemaignen A, Gyan E, Perrotin F, Pouplard C, Maillot F, Gatault P, Sautenet B, Rusch E, Frémeaux-Bacchi V, Vigneau C, Bayer G, Fakhouri F. What is the impact of blood pressure on neurological symptoms and the risk of ESKD in primary and secondary thrombotic microangiopathies based on clinical presentation: a retrospective study. BMC Nephrol 2022; 23:39. [PMID: 35057750 PMCID: PMC8781095 DOI: 10.1186/s12882-022-02672-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 01/05/2022] [Indexed: 12/26/2022] Open
Abstract
Abstract
Background
The impact of blood pressure on neurological symptoms and risk of end-stage kidney disease (ESKD) is unknown in primary and secondary thrombotic microangiopathies (TMAs).
Methods
We measured baseline systolic (SBP) and diastolic (DBP) BP in consecutive 563 patients with adjudicated primary and secondary TMAs, and assessed its association with the risk of ESKD.
Results
Normal BP, grade 1, 2 and 3 hypertension were present in 243 (43.1%), 132 (23.4%), 101 (17.9%) and 88 (15.6%), respectively.
Significant BP differences were noted in relation to the cause of TMA: highest BP values were found in patients with atypical hemolytic-uremic syndrome (aHUS), pregnancy, transplantation and auto-immune-related TMAs. Normal BP or grade 1 hypertension was found in 17/18 (94.4%) patients with thrombotic thrombocytopenic patients (only 1/18 (5.6%) had a SBP value>150 mmHg). In contrast, BP values could not differentiate isolated “essential” malignant hypertension (MH) from MH associated with aHUS (isolated MH (n=15): BP (median (IQR)): 220 (182-249)/132 (101-150) mmHg; MH with aHUS (n=5): BP: 223 (196-245)/131 (111-144) mmHg).
The risk of vigilance disturbances (6.9%, 15.0%, 25.0%, respectively), epileptic seizures (1.5%, 4.0%, 12.5%, respectively) and posterior reversible encephalopathy syndrome (0.76%, 2.97%, 6.82%, respectively) increased with increasing baseline BP values from grade 1 to grade 3 hypertension.
ESKD occurred in 35/563 (6.2%) patients (1.23%, 2.27%, 11.9% and 19.3% of patients with normal BP, grade 1, 2 and 3 hypertension, respectively). As compared to patients with normal BP (<120/139 mmHg), grade 1, grade 2 and grade 3 hypertension were associated with a greater risk of ESKD in univariate (OR: 1.91 [0.83-4.40], 13.2 [3.56-48.9] and 34.8 [9.31-130], respectively) and multivariate (OR: 0.89 [0.30-2.69], 7.00 [1.57-31.3] and 19.7 [4.53-85.2], respectively) analyses. The association between BP and the risk of ESRD was unchanged after adjustment on eculizumab use (OR: 3.46 [1.41-8.49], 17.7 [4.44-70.0] and 70.6 [8.61-579], respectively). Patients with MH, regardless of its cause, had a greater risk of ESKD (OR: 26.4 [10.0-69.8] vs other patients).
Conclusions
Baseline BP differs in primary and secondary TMAs. High BP reduces the neurological tolerance of TMAs and is a powerful independent risk factor of ESKD, even after adjustment on TMA’s cause.
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Thoreau B, von Tokarski F, Bauvois A, Bayer G, Barbet C, Cloarec S, Mérieau E, Lachot S, Garot D, Bernard L, Gyan E, Perrotin F, Pouplard C, Maillot F, Gatault P, Sautenet B, Rusch E, Frémeaux-Bacchi V, Vigneau C, Fakhouri F, Halimi JM. Infection in Patients with Suspected Thrombotic Microangiopathy Based on Clinical Presentation. Clin J Am Soc Nephrol 2021; 16:1355-1364. [PMID: 34497111 PMCID: PMC8729578 DOI: 10.2215/cjn.17511120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/08/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES In contrast to shigatoxin-associated Escherichia coli (STEC) causing hemolytic uremic syndrome, STEC-unrelated infections associated with thrombotic microangiopathy are less characterized. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Our retrospective study in a four-hospital institution of 530 consecutive patients with adjudicated thrombotic microangiopathies during the 2009-2016 period studied STEC-unrelated infections' epidemiology and major outcomes (death, acute dialysis, and major cardiovascular events). RESULTS STEC-unrelated infection was present in 145 of 530 (27%) patients, thrombotic microangiopathies without infection were present in 350 of 530 (66%) patients, and STEC causing hemolytic and uremic syndrome was present in 35 of 530 (7%) patients. They (versus thrombotic microangiopathy without infection) were associated with age >60 years (36% versus 18%), men (53% versus 27%), altered consciousness (32% versus 11%), mean BP <65 mm Hg (21% versus 4%), lower hemoglobin and platelet count, and AKI (72% versus 49%). They were associated with more than one pathogen in 36 of 145 (25%) patients (either isolated [14%] or combined [86%] to other causes of thrombotic microangiopathy); however, no significant clinical or biologic differences were noted between the two groups. They were more frequently due to bacteria (enterobacteria [41%], Staphylococcus aureus [11%], and Streptococcus pneumonia [3%]) than viruses (Epstein-Barr [20%], cytomegalovirus [18%], influenza [3%], hepatitis C [1%], HIV [1%], and rotavirus [1%]). STEC-unrelated infections were independent risk factors for in-hospital death (odds ratio, 2.22; 95% confidence interval, 1.18 to 4.29), major cardiovascular event (odds ratio, 3.43; 95% confidence interval, 1.82 to 6.69), and acute dialysis (odds ratio, 3.48; 95% confidence interval, 1.78 to 7.03). Bacteria (versus other pathogens), and among bacteria, enterobacteria, presence of more than one bacteria, and E. coli without shigatoxin were risk factors for acute dialysis. CONCLUSIONS Infections are frequent thrombotic microangiopathy triggers or causes, and they are mostly unrelated to STEC. Infections convey a higher risk of death and major complications. The most frequent pathogens were enterobacteria, S. aureus, Epstein-Barr virus, and cytomegalovirus. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_09_07_CJN17511120.mp3.
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Affiliation(s)
- Benjamin Thoreau
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Florent von Tokarski
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Adeline Bauvois
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Guillaume Bayer
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Christelle Barbet
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Sylvie Cloarec
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Elodie Mérieau
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France
| | - Sébastien Lachot
- Service d'Hématologie Biologique, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Denis Garot
- Service de Médecine Intensive Réanimation, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Louis Bernard
- Service de Maladies Infectieuses, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Emmanuel Gyan
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, CHU Tours, Equipe de recherche Labellisée, Centre National pour le Recherche Scientifique 7001, Université de Tours, Tours, France
| | - Franck Perrotin
- Service de Gynécologie Obstétrique B. Maternité Olympe de Gouges, Hôpital Bretonneau, CHU Tours, Tours, France.,Institut National de la Santé et de la Recherche Médicale U1253 Imaging and Brain (iBrain), Université de Tours, Tours, France
| | - Claire Pouplard
- Service d'Hématologie-Hémostase, Hôpital Trousseau, CHU Tours, Tours, France.,EA7501, François-Rabelais University, Tours, France
| | - François Maillot
- Service de Médecine interne, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Philippe Gatault
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France.,EA4245, François-Rabelais University, Tours, France
| | - Bénédicte Sautenet
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France.,Institut National de la Santé et de la Recherche Médicale U1246 the methodS in Patient-centered outcomes and HEalth ResEarch, Université de Tours, Université de Nantes, Tours, France
| | - Emmanuel Rusch
- Laboratoire de Santé Publique, Hôpital Bretonneau, CHU Tours, Tours, France
| | | | - Cécile Vigneau
- CHU Pontchaillou, Service de Néphrologie, Rennes, France.,Université Rennes 1, Institut National de la Santé et de la Recherche Médicale Institut de Recherche en Santé, environnement et Travail, Unité Mixte de Recherche 1085, Rennes, France
| | - Fadi Fakhouri
- Service of Nephrology, Department of Medicine, Centre Hospitalier Universitaire Vaudois and Université de Lausanne, Lausanne, Switzerland
| | - Jean-Michel Halimi
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Néphrologie Pédiatrique, Hôpital Bretonneau et Hôpital Clocheville, Centre Hospitalier Universitaire (CHU) Tours, Tours, France et French Clinical Research Network Infrastructure-Cardiovascular and Renal Clinical Trialists, Tours, France .,EA4245, François-Rabelais University, Tours, France
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6
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Galland J, Thoreau B, Delrue M, Neuwirth M, Stepanian A, Chauvin A, Dellal A, Nallet O, Roriz M, Devaux M, London J, Martin-Lecamp G, Froissart A, Arab N, Ferron B, Groff MH, Queyrel V, Lorut C, Regard L, Berthoux E, Bayer G, Comarmond C, Lioger B, Mekinian A, Szwebel TA, Sené T, Amador-Boreiro B, Mangin O, Sellier PO, Mouly S, Kevorkian JP, Siguret V, Vodovar D, Sene D. White blood count, D-dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID-19 patients: The French multicenter CLOTVID retrospective study. Eur J Haematol 2021; 107:190-201. [PMID: 34288162 PMCID: PMC8239942 DOI: 10.1111/ejh.13638] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022]
Abstract
Background A high prevalence of pulmonary embolism (PE) has been described during COVID‐19. Our aim was to identify predictive factors of PE in non‐ICU hospitalized COVID‐19 patients. Methods Data and outcomes were collected upon admission during a French multicenter retrospective study, including patients hospitalized for COVID‐19, with a CT pulmonary angiography (CTPA) performed in the emergency department for suspected PE. Predictive factors significantly associated with PE were identified through a multivariate regression model. Results A total of 88 patients (median [IQR] age of 68 years [60‐78]) were analyzed. Based on CTPA, 47 (53.4%) patients were diagnosed with PE, and 41 were not. D‐dimer ≥3000 ng/mL (OR 8.2 [95% CI] 1.3‐74.2, sensitivity (Se) 0.84, specificity (Sp) 0.78, P = .03), white blood count (WBC) ≥12.0 G/L (29.5 [2.3‐1221.2], Se 0.47, Sp 0.92, P = .02), and ferritin ≥480 µg/L (17.0 [1.7‐553.3], Se 0.96, Sp 0.44, P = .03) were independently associated with the PE diagnosis. The presence of the double criterion D‐dimer ≥3000 ng/mL and WBC ≥12.0 G/L was greatly associated with PE (OR 21.4 [4.0‐397.9], P = .004). Conclusion The white blood count, the D‐dimer and ferritin levels could be used as an indication for CTPA to confirm PE on admission in non‐ICU COVID‐19 patients.
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Affiliation(s)
- Joris Galland
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,University of Paris, Paris, France
| | - Benjamin Thoreau
- University of Paris, Paris, France.,Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, AP-HP, Université de Paris, Paris, France.,INSERM U1016, CNRS UMR 8104, Cochin Institute, Paris, France
| | - Maxime Delrue
- Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.,EA 3518, Paris University, Paris, France
| | - Marie Neuwirth
- Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.,INSERM UMRS U1140, Paris University, Paris, France
| | - Alain Stepanian
- Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.,EA 3518, Paris University, Paris, France
| | - Anthony Chauvin
- University of Paris, Paris, France.,Emergency Department, Lariboisière Hospital, AP-HP, University of Paris, Paris, France
| | - Azeddine Dellal
- Department of Rheumatology and Internal Medicine, Le Raincy-Montfermeil Hospital, Montfermeil, France
| | - Olivier Nallet
- Department of Cardiology, Le Raincy-Montfermeil Hospital, Montfermeil, France
| | - Melanie Roriz
- Department of Internal Medicine, Hospital Center of Agen, Agen, France
| | - Mathilde Devaux
- Department of Internal Medicine, Hospital Center of Poissy-Saint Germain, Saint Germain en Laye, France
| | - Jonathan London
- Department of Internal Medicine, Diaconesses Croix Saint-Simon Hospital, Paris, France
| | | | - Antoine Froissart
- Department of Internal Medicine, Intermunicipal Hospital Center of Créteil, Créteil, France
| | - Nouara Arab
- Department of Internal Medicine, Intermunicipal Hospital Center of Créteil, Créteil, France
| | - Bertrand Ferron
- Department of Internal Medicine, Hospital Center of Sens, Sens, France
| | - Marie-Helene Groff
- Department of Internal Medicine, Hospital Center of Nord-Mayenne, Mayenne, France
| | - Viviane Queyrel
- Department of Internal Medicine, University Hospital of Nice, Nice, France
| | - Christine Lorut
- Department of Pneumology, Cochin Hospital, AP-HP, Université de Paris, Paris, France
| | - Lucile Regard
- Department of Pneumology, Cochin Hospital, AP-HP, Université de Paris, Paris, France
| | - Emilie Berthoux
- Department of Internal Medicine, Saint Luc-Saint Joseph Hospital, Lyon, France
| | - Guillaume Bayer
- Department of Internal Medicine, Claude Galien Hospital, Quincy sous Senart, France
| | - Chloe Comarmond
- Department of Internal Medicine, Pitié-Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France.,Sorbonne University, Paris, France
| | - Bertrand Lioger
- Department of Internal Medicine, Simone Veil Hospital, Blois, France
| | - Arsène Mekinian
- Sorbonne University, Paris, France.,Department of Internal Medicine, Saint Antoine Hospital, APHP, Paris, France
| | - Tali-Anne Szwebel
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, AP-HP, Université de Paris, Paris, France
| | - Thomas Sené
- Department of Internal Medicine, Fondation Rothschild, Paris, France
| | - Blanca Amador-Boreiro
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,University of Paris, Paris, France
| | - Olivier Mangin
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,University of Paris, Paris, France
| | | | - Stephane Mouly
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,University of Paris, Paris, France
| | | | - Virginie Siguret
- University of Paris, Paris, France.,Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.,INSERM UMRS U1140, Paris University, Paris, France
| | | | - Dominique Vodovar
- University of Paris, Paris, France.,Centre Anti-Poison, Fernand Widal Hospital, AP-HP, University of Paris, Paris, France.,INSERM UMRS 1144, Paris, France
| | - Damien Sene
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,University of Paris, Paris, France
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7
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Thoreau B, Galland J, Delrue M, Neuwirth M, Stepanian A, Chauvin A, Dellal A, Nallet O, Roriz M, Devaux M, London J, Martin-Lecamp G, Froissart A, Arab N, Ferron B, Groff MH, Queyrel V, Lorut C, Regard L, Berthoux E, Bayer G, Comarmond C, Lioger B, Mekinian A, Szwebel TA, Sené T, Amador-Borrero B, Mangin O, Sellier PO, Siguret V, Mouly S, Kevorkian JP, Vodovar D, Sene D. D-Dimer Level and Neutrophils Count as Predictive and Prognostic Factors of Pulmonary Embolism in Severe Non-ICU COVID-19 Patients. Viruses 2021; 13:v13050758. [PMID: 33926038 PMCID: PMC8146364 DOI: 10.3390/v13050758] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 01/08/2023] Open
Abstract
The incidence of pulmonary embolism (PE) is high during severe Coronavirus Disease 2019 (COVID-19). We aimed to identify predictive and prognostic factors of PE in non-ICU hospitalized COVID-19 patients. In the retrospective multicenter observational CLOTVID cohort, we enrolled patients with confirmed RT-PCR COVID-19 who were hospitalized in a medicine ward and also underwent a CT pulmonary angiography for a PE suspicion. Baseline data, laboratory biomarkers, treatments, and outcomes were collected. Predictive and prognostics factors of PE were identified by using logistic multivariate and by Cox regression models, respectively. A total of 174 patients were enrolled, among whom 86 (median [IQR] age of 66 years [55–77]) had post-admission PE suspicion, with 30/86 (34.9%) PE being confirmed. PE occurrence was independently associated with the lack of long-term anticoagulation or thromboprophylaxis (OR [95%CI], 72.3 [3.6–4384.8]) D-dimers ≥ 2000 ng/mL (26.3 [4.1–537.8]) and neutrophils ≥ 7.0 G/L (5.8 [1.4–29.5]). The presence of these two biomarkers was associated with a higher risk of PE (p = 0.0002) and death or ICU transfer (HR [95%CI], 12.9 [2.5–67.8], p < 0.01). In hospitalized non-ICU severe COVID-19 patients with clinical PE suspicion, the lack of anticoagulation, D-dimers ≥ 2000 ng/mL, neutrophils ≥ 7.0 G/L, and these two biomarkers combined might be useful predictive markers of PE and prognosis, respectively.
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Affiliation(s)
- Benjamin Thoreau
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, AP-HP, University of Paris, CEDEX 14, 75679 Paris, France;
- INSERM U1016, Cochin Institute, Paris, University of Paris, CNRS UMR 8104, 75014 Paris, France
- Correspondence: ; Tel.: +33-1-58-41-14-36; Fax: +33-1-58-41-14-50
| | - Joris Galland
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP) Université de Paris, 75010 Paris, France; (J.G.); (B.A.-B.); (O.M.); (S.M.); (D.S.)
| | - Maxime Delrue
- Haemostasis Laboratory, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; (M.D.); (M.N.); (A.S.); (V.S.)
| | - Marie Neuwirth
- Haemostasis Laboratory, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; (M.D.); (M.N.); (A.S.); (V.S.)
| | - Alain Stepanian
- Haemostasis Laboratory, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; (M.D.); (M.N.); (A.S.); (V.S.)
| | - Anthony Chauvin
- Emergency Department, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France;
| | - Azeddine Dellal
- Department of Rheumatology and Internal Medicine, Le Raincy-Montfermeil Hospital, 93370 Montfermeil, France;
| | - Olivier Nallet
- Department of Cardiology, Le Raincy-Montfermeil Hospital, 93370 Montfermeil, France;
| | - Melanie Roriz
- Department of Internal Medicine, Hospital Center of Agen, 47923 Agen, France;
| | - Mathilde Devaux
- Department of Internal Medicine, Hospital Center of Poissy-Saint Germain, 78300 Saint Germain en Laye, France;
| | - Jonathan London
- Department of Internal Medicine, Diaconesses Croix Saint-Simon Hospital, 75012 Paris, France;
| | | | - Antoine Froissart
- Department of Internal Medicine, Intermunicipal Hospital Center of Créteil, 94000 Créteil, France; (A.F.); (N.A.)
| | - Nouara Arab
- Department of Internal Medicine, Intermunicipal Hospital Center of Créteil, 94000 Créteil, France; (A.F.); (N.A.)
| | - Bertrand Ferron
- Department of Internal Medicine, Hospital Center of Sens, 89100 Sens, France;
| | - Marie-Helene Groff
- Department of Internal Medicine, Hospital Center of Nord-Mayenne, 53100 Mayenne, France;
| | - Viviane Queyrel
- Department of Rheumatology, University Hospital of Nice, 06000 Nice, France;
| | - Christine Lorut
- Department of Pneumology, Cochin Hospital, AP-HP, Université de Paris, 75014 Paris, France; (C.L.); (L.R.)
| | - Lucile Regard
- Department of Pneumology, Cochin Hospital, AP-HP, Université de Paris, 75014 Paris, France; (C.L.); (L.R.)
| | - Emilie Berthoux
- Department of Internal Medicine, Saint Luc-Saint Joseph Hospital, 69007 Lyon, France;
| | - Guillaume Bayer
- Department of Internal Medicine, Claude Galien Hospital, 91480 Quincy sous Senart, France;
| | - Chloe Comarmond
- Department of Internal Medicine, Pitié-Salpétrière Hospital, AP-HP, Sorbonne University, 75013 Paris, France;
| | - Bertrand Lioger
- Department of Internal Medicine, Simone Veil Hospital, 41000 Blois, France;
| | - Arsène Mekinian
- Department of Internal Medicine, Saint Antoine Hospital, APHP, 75012 Paris, France;
| | - Tali-Anne Szwebel
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, AP-HP, University of Paris, CEDEX 14, 75679 Paris, France;
| | - Thomas Sené
- Department of Internal Medicine, Fondation Rothschild, 75019 Paris, France;
| | - Blanca Amador-Borrero
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP) Université de Paris, 75010 Paris, France; (J.G.); (B.A.-B.); (O.M.); (S.M.); (D.S.)
| | - Olivier Mangin
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP) Université de Paris, 75010 Paris, France; (J.G.); (B.A.-B.); (O.M.); (S.M.); (D.S.)
| | - Pierre O. Sellier
- Department of Infectious Disease, Lariboisière Hospital, APHP, 75010 Paris, France;
| | - Virginie Siguret
- Haemostasis Laboratory, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; (M.D.); (M.N.); (A.S.); (V.S.)
| | - Stéphane Mouly
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP) Université de Paris, 75010 Paris, France; (J.G.); (B.A.-B.); (O.M.); (S.M.); (D.S.)
| | | | | | - Dominique Vodovar
- Centre Anti-Poison, Fernand Widal Hospital, AP-HP, University of Paris, 75010 Paris, France;
- INSERM UMRS 1144, 75006 Paris, France
| | - Damien Sene
- Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, (AP-HP) Université de Paris, 75010 Paris, France; (J.G.); (B.A.-B.); (O.M.); (S.M.); (D.S.)
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Le Marec J, Henique H, Rubenstein E, Bigot A, Puyade M, Urbanski G, Lozac’h P, Allain JS, Bayer G, Fain O, Lioger B. Absence of impact of hypovitaminosis C on the bleeding phenotype of primary immune thrombocytopenia: a French prospective multicenter study. Platelets 2020; 31:1101-1103. [DOI: 10.1080/09537104.2020.1732326] [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] [Indexed: 10/24/2022]
Affiliation(s)
- Julien Le Marec
- Department of Internal Medicine, CHRU de Tours, Tours, France
| | - Hélène Henique
- Department of Internal Medicine, CHRU de Tours, Tours, France
| | - Emma Rubenstein
- Department of Internal Medicine and Systemic Diseases, Saint-Louis Hospital, Paris VII University, Paris, France
| | - Adrien Bigot
- Department of Internal Medicine, CHRU de Tours, Tours, France
| | - Mathieu Puyade
- Department of Internal Medicine, CHU de Poitiers, Poitiers, France
| | | | - Pierre Lozac’h
- Department of Internal Medicine, CHU d’Angers, Angers, France
| | - Jean-Sébastien Allain
- Department of Internal Medicine and Clinical Immunology, CHU de Rennes, Rennes, France
- Pôle CVM, Centre hospitalier de Saint Malo, France
| | - Guillaume Bayer
- Department of Internal Medicine, Claude Galien Private Hospital, Quincy-sous-Sénart, France
| | - Olivier Fain
- Department of Internal Medicine, Saint-Antoine Hospital, AP-HP, DHUi2B, Sorbonne University, Paris, France
| | - Bertrand Lioger
- Department of Internal Medicine and Systemic Diseases, Saint-Louis Hospital, Paris VII University, Paris, France
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9
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Thoreau B, Bayer G, Barbet C, Cloarec S, Meriau E, Lachot S, Garot D, Bernard L, Gyan E, Perrotin F, Pouplard C, Maillot F, Gatault P, Sautenet B, Rusch E, Buchler M, Fremeaux-Bacchi V, Vigneau C, Fakhouri F, Halimi J. Microangiopathies thrombotiques (MAT) associées aux infections : particularités et pronostic. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.046] [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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10
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Von Tokarski F, Bayer G, Bauvois A, Thoreau B, Barbet C, Buchler M, Vigneau C, Fakhouri F, Halimi J. Microangiopathie thrombotique après transplantation rénale : une étude rétrospective monocentrique. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.324] [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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11
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Bayer G, Agier MS, Lioger B, Lepelley M, Zenut M, Lanoue MC, Maillot F, Jonville-Bera AP. Rituximab-induced serum sickness is more frequent in autoimmune diseases as compared to hematological malignancies: A French nationwide study. Eur J Intern Med 2019; 67:59-64. [PMID: 31279430 DOI: 10.1016/j.ejim.2019.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 05/13/2019] [Accepted: 06/14/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Rituximab induced serum sickness (RISS) is a rare delayed hypersensitivity reaction. The aim of this study was to describe the epidemiological and clinical characteristics of the RISS cases reported in France. METHOD Serum sickness cases involving rituximab were identified from the French PharmacoVigilance Database from 1998 to 2016. RESULTS We analyzed 37 cases of RISS. Rituximab was prescribed for an autoimmune disease in 78% of cases. Serum sickness occurred mainly after the first injection (54%) with a median time to onset of 12 days. The most frequent manifestations were rheumatologic symptoms (92%), fever (87%), and skin lesions (78%). The incidence was significantly higher when rituximab was used for autoimmune diseases than for a hematological malignancies. Taking into account the existence of a Systemic Lupus Erythematosus (SLE) as the indication of rituximab or as a comorbidity, the incidence of RISS in patients with SLE was even higher. DISCUSSION We report on the largest series of RISS studied to date and confirm that this reaction preferentially occurs in patients with autoimmune disease, especially SLE. This may be due to B-cell lysis, leading to the release of intracellular antigens into the serum and subsequent antigen-antibody complex formation, especially in patients with elevated autoantibody production. This could also explain why RISS often occurred after a single injection. CONCLUSION Patients generally recovered from RISS rapidly without obvious benefit from corticosteroid therapy. The risk of recurrence should prompt clinicians to question the use of rituximab after an episode of RISS.
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Affiliation(s)
- Guillaume Bayer
- CHRU de Tours, Service de médecine interne, Tours, France; Université François Rabelais, Tours, France.
| | - Marie-Sara Agier
- CHRU de Tours, Centre Régional de pharmacovigilance Centre Val de Loire, Tours, France
| | | | - Marion Lepelley
- CHRU de Grenoble, Centre Régional de pharmacovigilance, Grenoble, France
| | - Marie Zenut
- CHRU de Clermont-Ferrand, Centre Régional de pharmacovigilance, Clermont-Ferrand, France
| | | | - François Maillot
- CHRU de Tours, Service de médecine interne, Tours, France; Université François Rabelais, Tours, France
| | - Annie-Pierre Jonville-Bera
- CHRU de Tours, Centre Régional de pharmacovigilance Centre Val de Loire, Tours, France; Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
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12
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Kiesewetter B, Lamm W, Dolak W, Lukas J, Mayerhoefer M, Weber M, Kornauth C, Schiefer A, Bayer G, Simonitsch-Klupp I, Raderer M. TRANSFORMED MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMAS: A SINGLE INSTITUTION RETROSPECTIVE STUDY INCLUDING PCR-BASED CLONALITY ANALYSIS. Hematol Oncol 2019. [DOI: 10.1002/hon.73_2630] [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] [Indexed: 11/09/2022]
Affiliation(s)
- B. Kiesewetter
- Department of Medicine I; Clinical Division of Oncology, Medical University of Vienna; Vienna Austria
| | - W. Lamm
- Department of Medicine I; Clinical Division of Oncology, Medical University of Vienna; Vienna Austria
| | - W. Dolak
- Department of Medicine III; Clinical Division of Gastroenterology and Hepatology, Medical University of Vienna; Vienna Austria
| | - J. Lukas
- Department of Ophthalmology and Optometry; Medical University of Vienna; Vienna Austria
| | - M.E. Mayerhoefer
- Department of Biomedical Imaging and Image-guided Therapy; Division of Nuclear Medicine, Medical University of Vienna; Vienna Austria
| | - M. Weber
- Department of Biomedical Imaging and Image-guided Therapy; Division of Nuclear Medicine, Medical University of Vienna; Vienna Austria
| | - C. Kornauth
- Department of Pathology; Medical University of Vienna; Vienna Austria
| | - A.I. Schiefer
- Department of Pathology; Medical University of Vienna; Vienna Austria
| | - G. Bayer
- Department of Pathology; Medical University of Vienna; Vienna Austria
| | | | - M. Raderer
- Department of Medicine I; Clinical Division of Oncology, Medical University of Vienna; Vienna Austria
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13
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Demyanets S, Kaider A, Thalhammer R, Bayer G, Krauth M, Agis H, Schwarzinger I. Choice of proper approach for the assessment of plasma cells in the bone marrow of patients with monoclonal gammapathies. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.910] [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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14
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Bayer G, von Tokarski F, Thoreau B, Bauvois A, Barbet C, Cloarec S, Mérieau E, Lachot S, Garot D, Bernard L, Gyan E, Perrotin F, Pouplard C, Maillot F, Gatault P, Sautenet B, Rusch E, Buchler M, Vigneau C, Fakhouri F, Halimi JM. Etiology and Outcomes of Thrombotic Microangiopathies. Clin J Am Soc Nephrol 2019; 14:557-566. [PMID: 30862697 PMCID: PMC6450353 DOI: 10.2215/cjn.11470918] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [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: 09/23/2018] [Accepted: 02/04/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Thrombotic microangiopathies constitute a diagnostic and therapeutic challenge. Secondary thrombotic microangiopathies are less characterized than primary thrombotic microangiopathies (thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome). The relative frequencies and outcomes of secondary and primary thrombotic microangiopathies are unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a retrospective study in a four-hospital institution in 564 consecutive patients with adjudicated thrombotic microangiopathies during the 2009-2016 period. We estimated the incidence of primary and secondary thrombotic microangiopathies, thrombotic microangiopathy causes, and major outcomes during hospitalization (death, dialysis, major cardiovascular events [acute coronary syndrome and/or acute heart failure], and neurologic complications [stroke, cognitive impairment, or epilepsy]). RESULTS We identified primary thrombotic microangiopathies in 33 of 564 patients (6%; thrombotic thrombocytopenic purpura: 18 of 564 [3%]; atypical hemolytic and uremic syndrome: 18 of 564 [3%]). Secondary thrombotic microangiopathies were found in 531 of 564 patients (94%). A cause was identified in 500 of 564 (94%): pregnancy (35%; 11 of 1000 pregnancies), malignancies (19%), infections (33%), drugs (26%), transplantations (17%), autoimmune diseases (9%), shiga toxin due to Escherichia coli (6%), and malignant hypertension (4%). In the 31 of 531 patients (6%) with other secondary thrombotic microangiopathies, 23% of patients had sickle cell disease, 10% had glucose-6-phosphate dehydrogenase deficiency, and 44% had folate deficiency. Multiple causes of thrombotic microangiopathies were more frequent in secondary than primary thrombotic microangiopathies (57% versus 19%; P<0.001), and they were mostly infections, drugs, transplantation, and malignancies. Significant differences in clinical and biologic differences were observed among thrombotic microangiopathy causes. During the hospitalization, 84 of 564 patients (15%) were treated with dialysis, 64 of 564 patients (11%) experienced major cardiovascular events, and 25 of 564 patients (4%) had neurologic complications; 58 of 564 patients (10%) died, but the rates of complications and death varied widely by the cause of thrombotic microangiopathies. CONCLUSIONS Secondary thrombotic microangiopathies represent the majority of thrombotic microangiopathies. Multiple thrombotic microangiopathies causes are present in one half of secondary thrombotic microangiopathies. The risks of dialysis, neurologic and cardiac complications, and death vary by the cause of thrombotic microangiopathies.
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Affiliation(s)
- Guillaume Bayer
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | - Florent von Tokarski
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | - Benjamin Thoreau
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | - Adeline Bauvois
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | - Christelle Barbet
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | - Sylvie Cloarec
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | - Elodie Mérieau
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville
| | | | - Denis Garot
- Service de Médecine Intensive Réanimation, Hôpital Bretonneau
| | - Louis Bernard
- Service de Maladies Infectieuses, Hôpital Bretonneau
| | - Emmanuel Gyan
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Bretonneau.,Équipe de Recherche Labellisée Centre National de la Recherche Scientifique 7001, Université de Tours, Tours, France
| | | | - Claire Pouplard
- Laboratoire d'Hématologie-Hémostase, Hôpital Trousseau.,Équipe d'accueil7501 and
| | | | - Philippe Gatault
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville.,Équipe d'accueil4245, François Rabelais University, Tours, France
| | - Bénédicte Sautenet
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville.,Institut National de la Santé et de la Recherche Médicale U1246, Hôpital Bretonneau, and
| | - Emmanuel Rusch
- Laboratoire de Santé Publique, Hôpital Bretonneau, Centre Hospitalier Universitaire Tours, Tours, France
| | - Matthias Buchler
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville.,Équipe d'accueil4245, François Rabelais University, Tours, France
| | - Cécile Vigneau
- Centre Hospitalier Universitaire Pontchaillou, Service de Néphrologie, Rennes, France.,Université Rennes 1, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1085, Rennes, France; and
| | - Fadi Fakhouri
- Centre de recherche en Transplantation et immunologie, Unité Mixte de Recherche 1064, Institut National de la Santé et de la Recherche Médicale, Université de Nantes et département de Néphrologie et Immunologie, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Jean-Michel Halimi
- Service de Néphrologie-hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et hôpital Clocheville, .,Équipe d'accueil4245, François Rabelais University, Tours, France
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15
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Willibald M, Bayer G, Stahlhut V, Poschmann G, Stühler K, Seeger H, Niederacher D, Fehm T, Neubauer H, Meier-Stiegen F. Upon Progestin Stimulation Progesterone Receptor Membrane Component-1 is Phosphorylated in Breast Cancer Cells and Binds to Estrogen Receptor α-Coregulators PHB1 and PHB2. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1606151] [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] [Indexed: 10/18/2022] Open
Affiliation(s)
- M Willibald
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
| | - G Bayer
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
| | - V Stahlhut
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
| | - G Poschmann
- Molecular Proteomics Laboratory, BMFZ, Heinrich Heine University Düsseldorf, Düsseldorf
| | - K Stühler
- Molecular Proteomics Laboratory, BMFZ, Heinrich Heine University Düsseldorf, Düsseldorf
| | - H Seeger
- Department of Women's Health, University Hospital and Faculty of Medicine of the Eberhard Karls University Tuebingen, Tuebingen
| | - D Niederacher
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
| | - T Fehm
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
| | - H Neubauer
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
| | - F Meier-Stiegen
- Department of Obstetrics and Gynecology, University Hospital and Medical Faculty of the Heinrich-Heine University Duesseldorf, Duesseldorf
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16
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Bayer G, Bauvois A, Mankikian J, Tardieu M, Maillot F, Salame E, Woimant F, Poujois A, Viana M, Legras A. [Ecchymosis as the presenting manifestation of Wilson disease: A case report]. Rev Med Interne 2016; 38:416-419. [PMID: 27639912 DOI: 10.1016/j.revmed.2016.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 07/21/2016] [Accepted: 08/09/2016] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The presence of a psychiatric disorder during the course of an organic disease is a common cause of delayed diagnosis. CASE REPORT We report a 16-year-old girl who was admitted with thrombocytopenia and had a two-year history of neuropsychiatric disorder which was attributed to a difficult family situation. Neurological examination showed a frontal lobe disorder and extrapyramidal manifestations. The thrombocytopenia was attributed to liver cirrhosis. These neurological and hepatic injuries were consistent with a metabolic disease, most likely Wilson disease. This was supported by the presence of a corneal Kayser-Fleischer ring and a decreased ceruloplasmin concentration. An urgent liver transplantation was required due to worsening neurological symptoms. CONCLUSION Wilson disease is a rare genetic disease caused by copper toxicity. It is characterized by combined hepatic and neurologic damage to varying degrees and can develop at any age. Urgent treatment is required, but the diagnosis may be delayed by prevailing psychiatric symptoms.
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Affiliation(s)
- G Bayer
- Réanimation polyvalente, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Médecine interne, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
| | - A Bauvois
- Réanimation polyvalente, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Médecine interne, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - J Mankikian
- Réanimation polyvalente, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - M Tardieu
- Médecine pédiatrique, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France
| | - F Maillot
- Médecine interne, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; UFR de médecine, université François-Rabelais, Tours, France
| | - E Salame
- UFR de médecine, université François-Rabelais, Tours, France; Chirurgie digestive, oncologique et endocrinienne, transplantation hépatique, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France
| | - F Woimant
- Centre national de référence de la maladie de Wilson, CHU Lariboisière, AP-HP, Paris, France
| | - A Poujois
- Centre national de référence de la maladie de Wilson, CHU Lariboisière, AP-HP, Paris, France
| | - M Viana
- Ophtalmologie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - A Legras
- Réanimation polyvalente, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
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Affiliation(s)
- G Bayer
- Service de Médecine Interne, CHRU Bretonneau, Tours, France
| | - E Diot
- Service de Médecine Interne, CHRU Bretonneau, Tours, France
| | - B Erra
- Service de Médecine Nucléaire, CHRU Bretonneau, Tours, France
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Ponholzer A, Stopfer J, Bayer G, Susani M, Steinbacher F, Herbst F, Schramek P, Madersbacher S, Maresch J. Is penile atherosclerosis the link between erectile dysfunction and cardiovascular risk? An autopsy study. Int J Impot Res 2012; 24:137-40. [DOI: 10.1038/ijir.2012.3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Juraszek A, Bayer G, Dziodzio T, Holfeld J, Dumfarth J, Gottardi R, Ehrlich M, Grimm M, Czerny M. Histopathologic evaluation of the intraoperative specimens of the entire aorta. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247026] [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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Chalubinski KM, Bayer G, Nather A. Sono- und Histomorphologie des invasiven Plazentawachstums. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818100] [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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Bayer G. Moving ahead after a tragedy. Critical-incident services are offering tools to rebuild. Behav Healthc Tomorrow 2000; 9:34-5. [PMID: 11143101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Broessner C, Klingler CH, Bayer G, Pycha A, Kuber W. A 3,500-gram leiomyoma of the bladder: case report on a 3-year follow-up after surgical enucleation. Urol Int 2000; 61:175-7. [PMID: 9933840 DOI: 10.1159/000030317] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report on a unique-sized large leiomyoma of the bladder wall in a male patient. After open surgical intervention all symptoms resolved spontaneously and no relapse occurred within a 3-year follow-up period. In conclusion, for symptomatic leiomyoma of the bladder surgical intervention should be considered as an early treatment option since it is associated with low morbidity, a high cure rate for this type of tumor and an immediate relief of urological symptoms.
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Affiliation(s)
- C Broessner
- Department of Urology, General Hospital Oberwart, Austria
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Weninger W, Rendl M, Mildner M, Mayer C, Ban J, Geusau A, Bayer G, Tanew A, Majdic O, Tschachler E. Keratinocytes express the CD146 (Muc18/S-endo) antigen in tissue culture and during inflammatory skin diseases. J Invest Dermatol 2000; 115:219-24. [PMID: 10951239 DOI: 10.1046/j.1523-1747.2000.00039.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The CD146 (or MUC18/MEL-CAM) antigen is a cell adhesion molecule of the immunoglobulin superfamily. Besides in melanoma, expression of CD146 antigen has been demonstrated in breast epithelia and hair follicles. We studied its expression by human keratinocytes in culture as well as in neoplastic and inflammatory skin diseases. Staining of primary cultured keratinocytes revealed expression of CD146 on the cell membrane, preferentially on cell-cell contact sites. Western blot analysis of keratinocytes detected a band of approximately 113 kDa, corresponding to the CD146 protein. In contrast to primary keratinocytes, neither CD146 protein nor mRNA expression was found in the keratinocyte-derived cell lines A431 and HaCaT. Treatment of keratinocytes with the proinflammatory cytokines interleukin-1 and interleukin-6, tumor necrosis factor-alpha, and interferon-gamma, resulted in no change of CD146 expression and incubation with phorbol 12-myristate 13-acetate led to a reduction of CD146 on keratinocytes. By contrast, when culturing keratinocytes in medium devoid of growth supplements, a distinct upregulation was observed as compared with culture in fully supplemented medium. In normal human epidermis expression of the CD146 antigen was not detectable. It was strongly upregulated, however, on suprabasal keratinocytes in psoriasis, in lichen planus, in the epidermis overlying skin neoplasms, and in viral warts. In squamous cell carcinomas and basal cell carcinomas only a minority of tumor cells expressed CD146. Our findings suggest that the CD146 antigen represents an activation marker of keratinocytes and may be involved in cutaneous inflammatory tissue reaction.
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Affiliation(s)
- W Weninger
- Division of Immunology, Allergy, and Infectious Diseases, Division of Special and Environmental Dermatology, Department of Dermatology, Institute of Immunology, University of Vienna Medical School, Vienna, Austria
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Abstract
OBJECTIVES To compare, in a retrospective study, pathological specimens of prostate cancer detected in additional areas of a 12-core biopsy with tumours detected using traditional sextant biopsy. PATIENTS AND METHODS The study included 27 patients who had undergone radical prostatectomy (RP) for prostate cancer. Prostatectomy specimens of cancers detected using standard sextant biopsies were compared with those detected using six additional core biopsies. The RP specimens were analysed for cancer volume, Gleason score, tumour grade (Mostofi) and pathological stage. RESULTS Of the 27 patients, six (29%) had cancer detected in the extra six biopsy cores which would have otherwise have been undetected using sextant biopsy. Only two insignificant cancers were detected. The mean Gleason score was 6.1 for cancer detected by the sextant or 12-core method (P = 0.907); the mean grade (Mostofi) was 2.1 and 2. 33, respectively (P = 0.29). The final tumour stage in the 21 patients undergoing sextant biopsy was pT2 in 13 and pT3 in eight, compared with six pT2 tumours in the six patients diagnosed using extra biopsies. The mean (median, range) tumour volume was 5.7 (3.5, 0.312-23.75) mL for cancers detected on sextant biopsy and 1.99 (1. 85, 0.4-3.6) mL in the six cancers detected using extra cores (P = 0. 0138). CONCLUSION The detection of prostate cancer was increased using extra biopsy cores. There was a significant difference in tumour volume but not in Gleason score, Mostofi grade or final pathological tumour stage between tumours diagnosed using 12 cores and those detected on sextant biopsy.
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Affiliation(s)
- C Brössner
- Departments of Urology and Pathology, Oberwart Hospital and Department of Urology, University of Vienna, Austria.
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Bayer G, Schaldach M. Entwicklung eines Medikamentendepots auf Neurostimulationselektroden zur kontrollierten Freisetzung von Dexamethason. BIOMED ENG-BIOMED TE 2000. [DOI: 10.1515/bmte.2000.45.s1.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hufnagl P, Bayer G, Oberbamscheidt P, Wehrstedt K, Guski H, Hauptmann S, Dietel M. Comparison of different telepathology solutions for primary frozen section diagnostic. Anal Cell Pathol 2000; 21:161-7. [PMID: 11339563 PMCID: PMC4618815 DOI: 10.1155/2000/123057] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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] [Indexed: 11/18/2022] Open
Abstract
In a retrospective study on a set of 125 cases we compared the following three telepathology solutions for primary frozen section diagnosis: ATM-TP (connection via ATM), TPS 1.0 (connection via LAN) and TELEMIC (connection via Internet), which represent different concepts of telepathological procedures. A set of 125 routine frozen sections (breast) was selected from the Charité cases of the year 1999. Four experienced pathologists diagnosed retrospectively all of these cases using the ATM-TP and TPS systems and 53 of them with the TELEMIC system. Using the ATM-TP we recorded no false positive (0%), 4 false negative (3.2%) and 4 deferred (3.2%) cases. Using the TPS we recorded no false positive (0%), 4 false negative (3.2%) and 4 deferred (3.2%) cases. Using the TELEMIC we recorded in 53 cases no false positive (0%), no false negative (0%) and 16 deferred (30.2%) cases. The average time of 2.2 minutes per case using ATM-TP is also short enough for routine frozen section diagnostic. This is also true for the TPS system with 7.2 minutes per case.
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Affiliation(s)
- P Hufnagl
- Institute of Pathology, Charité, Medical Faculty of the Humboldt University Berlin, Germany
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Brössner C, Madersbacher S, Bayer G, Pycha A, Klingler HC, Maier U. Comparative study of two different TRUS-guided sextant biopsy techniques in detecting prostate cancer in one biopsy session. Eur Urol 2000; 37:65-71. [PMID: 10671788 DOI: 10.1159/000020102] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to compare a transrectal ultrasound (TRUS)-guided sextant biopsy technique, which puts more emphasis on the apical region of the prostate where most prostate carcinomas (PCs) develop, with the standard sextant biopsy technique. METHODS A total of 280 patients with suspected PC were included in this analysis. Twelve biopsy cores were obtained from all patients. Six biopsy cores were taken within a lateral parasagittal plane from each lobe at the apex, middle and basis, with an angle of approximately 45 degrees (technique A), and 6 further biopsy cores were taken from the left to the right lateral margin always penetrating the prostate in the apex with the same angle (socalled fan-shaped technique, technique B). Technique A predominantly samples in the sagittal and technique B samples more in the transversal plane with emphasis on the apical region where most PCs develop. The sensitivity in detecting PCs for both techniques was calculated and correlated to the serum prostate-specific antigen (PSA) levels. RESULTS A total of 72 PCs (25.7%) were diagnosed. We subsequently performed subgroup analysis depending on the serum PSA levels: in patients with a PSA of </=10 ng/ml (n = 27) technique A has a PC sensitivity of 88.8% (p = 0.037) and technique B 96.2% (p = 0.326) as compared to our reference standard of 100% by sampling 12 biopsy cores in the same prostate. The number of positive biopsy cores using technique B was superior in 12 cases as compared to 3 cases with technique A (p = 0.04). In 12 patients the number of positive biopsy cores was identically. In patients with a PSA of >10 ng/ml (n = 45) technique A has a PC sensitivity of 93.3% (p = 0.083) and technique B 88.8% (p = 0.023) as compared to our reference standard. The number of positive core biopsies using technique A was superior in 14 cases as compared to 12 with technique B (p = 0.154). In 19 patients the number of positive biopsies was identical. CONCLUSION Our data suggest that in patients with PSA of </=10 ng/ml technique B bring significant benefit with regard to the number of positive core biopsies, as well as an enhanced PC detection rate which is near the 12-core biopsy. Due to the fact that technique B samples more in the apical region where most cancers develop, it should be performed in suspected early stage cancers of the prostate (PSA</=10 ng/ml).
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Affiliation(s)
- C Brössner
- Urology, Oberwart Hospital, Oberwart, Austria
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Almer G, Hainfellner JA, Brücke T, Jellinger K, Kleinert R, Bayer G, Windl O, Kretzschmar HA, Hill A, Sidle K, Collinge J, Budka H. Fatal familial insomnia: a new Austrian family. Brain 1999; 122 ( Pt 1):5-16. [PMID: 10050890 DOI: 10.1093/brain/122.1.5] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We present clinical, pathological and molecular features of the first Austrian family with fatal familial insomnia. Detailed clinical data are available in five patients and autopsy in four patients. Age at onset of disease ranged between 20 and 60 years, and disease duration between 8 and 20 months. Severe loss of weight was an early symptom in all five patients. Four patients developed insomnia and/or autonomic dysfunction, and all five patients developed motor abnormalities. Analysis of the prion protein (PrP) gene revealed the codon 178 point mutation and methionine homozygosity at position 129. In all brains, neuropathology showed widespread cortical astrogliosis, widespread brainstem nuclei and tract degeneration, and olivary 'pseudohypertrophy' with vacuolated neurons, in addition to neuropathological features described previously, such as thalamic and olivary degeneration. Western blotting of one brain and immunocytochemistry in four brains revealed quantitative and regional dissociation between PrP(res)(the protease resistant form of PrP) deposition and histopathology. In the cerebellar cortex of one patient, PrP(res) deposits were prominent in the molecular layer and displayed a peculiar patchy and strip-like pattern with perpendicular orientation to the surface. In another patient, a single vacuolated neuron in the inferior olivary nuclei contained prominent intravacuolar granular PrP(res) deposits, resembling changes of brainstem neurons in bovine spongiform encephalopathy.
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Affiliation(s)
- G Almer
- Clinic of Neurology, University of Vienna, Austria
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Wagner SM, Bayer G, Fröhlich R, Lang V, Bolz A, Schaldach M. [Blood flow measurement for implantable devices. Experimental results]. BIOMED ENG-BIOMED TE 1998; 43 Suppl:134-5. [PMID: 9859293 DOI: 10.1515/bmte.1998.43.s1.134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- S M Wagner
- Zentralinstitut für Biomedizinische Technik, Friedrich-Alexander-Universität, Erlangen
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Bayer G, Fröhlich R, Zinner G, Behrend D, Schmitz KP, Schaldach M. [Development of a surface coating for spinal cord stimulation]. BIOMED ENG-BIOMED TE 1998; 43 Suppl:556-7. [PMID: 9859489 DOI: 10.1515/bmte.1998.43.s1.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- G Bayer
- Zentralinstitut für Biomedizinische Technik der Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
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Rzany A, Bayer G, Bolz A, Schaldach M. [Atomic force study of solid body-induced blood coagulation in relation to electronic surface properties]. BIOMED ENG-BIOMED TE 1998; 42 Suppl:43-4. [PMID: 9517039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- A Rzany
- Zentralinstitut für Biomedizinische Technik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
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Rzany A, Bayer G, Bolz A, Schaldach M. AFM-Untersuchung der festkörperinduzierten Blutgerinnung in Abhängigkeit von den elektronischen Oberflächeneigenschaften. BIOMED ENG-BIOMED TE 1997. [DOI: 10.1515/bmte.1997.42.s2.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bayer G, Rzany A, Bolz A, Schaldach M, Hahn CY, Uttich T, Müller P. Rastersondenmikroskopische Untersuchung des Fibrinogens als zentralem Protein der festkörperinduzierten Blutgerinnung. BIOMED ENG-BIOMED TE 1996. [DOI: 10.1515/bmte.1996.41.s1.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bayer G. Natürliche und synthetische Rubine: Eigenschaften und Bestimmung by K. Schmetzer. Acta Crystallogr Sect B 1987. [DOI: 10.1107/s010876818709801x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Bayer G. Einfuehrung in die Kristallographie by W. Kleber. Acta Crystallogr Sect B 1984. [DOI: 10.1107/s0108768184002603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Bayer G. Einfuehrung in die Kristallographieby W. Kleber. Acta Crystallogr A 1984. [DOI: 10.1107/s0108767384000994] [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: 11/10/2022] Open
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Abstract
Twelve patients receiving heparin during hemodialysis had coagulation parameters monitored using the whole blood clotting time (WBCT), activated partial thromboplastin time (APTT), plasma heparin levels and activated whole blood clotting time (AWBCT). The AWBCT, performed with a battery-powered portable incubator/timer, correlated with both the corresponding WBCT and the plasma heparin levels. However, the correlation between the AWBCT and the APTT was quite poor. This assay is simply performed, inexpensive, and reproducible. It is recommended as an excellent method for monitoring heparin therapy.
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Bayer G, Hoffmann W, Siesler H. Characterization of deformation phenomena in polymers by rapid-scanning Fourier transform infra-red (FT i.r.) spectroscopy and mechanical measurements: 1. Orientation of isotactic polypropylene during uniaxial deformation. POLYMER 1980. [DOI: 10.1016/0032-3861(80)90068-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [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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Bayer G. Synthetic gem and allied crystal manufacture. VonD. Mac Innes. Noyes Data Corp., Park Ride/N. J. (USA)-London 1973. l. Aufl., IX, 221 S., 41, meist mehrteilige Abb. u. Tab., geb. $ 24.00. CHEM-ING-TECH 1974. [DOI: 10.1002/cite.330460825] [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: 11/06/2022]
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