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Cheze S, Quittet P, Adoue D, Viallard J, Sève P, Bonnotte B, Laribi K, Tardy S, Henique H, Graveleau J, Hacini M, Santagostino A, Aroichane M, Leclerc-Teffahi S, Niarra R, Guillemin S, Malatesta A, Michel M. Étude observationnelle prospective sur les Patients attEints de Purpura Thrombopénique Idiopathique (PTI) traités par des agonisTEs des R-TPO (ARTPO) : Eltrombopag et Romiplostim (Étude PEPITE). Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.046] [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: 12/12/2022]
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Hankard A, Ingen-Housz-Oro S, El Karoui K, Paule R, Lioger B, Brihaye B, Battistella M, Jobard S, Magnant J, Diot E, Bigot A, Ferreira-Maldent N, Deriaz S, Cook AR, Henique H, Maillot F, Aouba A, Audemard-Verger A. IgA vasculitis with underlying monoclonal IgA gammopathy: innovative therapeutic approach targeting plasma cells. A case series. Clin Rheumatol 2022; 41:3119-3123. [PMID: 35713822 DOI: 10.1007/s10067-022-06181-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE There is currently no evidence of the possible benefit of plasma cell-targeting therapies (PCTT) in immunoglobulin A (IgA) monoclonal gammopathy (MG) associated with IgA vasculitis (IgAV). We report the outcome of different PCTT regimens in a cohort of MG-IgAV. METHODS We used a French network to retrospectively describe the outcome of MG-IgAV patients treated with PCTT. RESULTS Five patients were included (mean age 65 years). All patients had severe baseline presentation including extensive necrotic purpura (n = 5), gastrointestinal involvement (n = 2), peripheral neuropathies (n = 2), and glomerulonephritis (n = 1). Two patients had IgA indolent multiple myeloma and three had IgA "MG of undetermined significance." Monotypic IgA deposition in the skin vessels wall was highlighted using an immunofluorescence assay. Cases of vasculitis in three patients (n = 3) were refractory to multiple line therapies, including cyclophosphamide (n = 3) or rituximab. Finally, PCTT including bortezomib plus cyclophosphamide and dexamethasone, bortezomib plus melphalan and prednisone, or bortezomib plus lenalidomide and dexamethasone were proposed, allowing complete remission in 4/5 patients without major adverse drug events. CONCLUSION This study suggests that the MG-IgAV phenotype might be distinctive of usual IgAV (severe and refractory to conventional immunosuppressive regimens) and supports the benefit of PCTT. This study sheds new light on the overall biology of IgAV, strengthening the pathogenic role of the monoclonal IgA component in IgAV.
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Affiliation(s)
| | | | | | - Romain Paule
- Department of Internal Medicine, Hôpital Foch, Suresne, France
| | - Bertrand Lioger
- Department of Internal Medicine, Hôpital de Blois, Blois, France
| | - Benoit Brihaye
- Department of Internal Medicine, CH Saint Quentin, Saint Quentin, France
| | | | - Stéphanie Jobard
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Julie Magnant
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Elisabeth Diot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Adrien Bigot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | - Sophie Deriaz
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Ann-Rose Cook
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Hélène Henique
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Francois Maillot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France.,University of Tours, Tours, France
| | - Achille Aouba
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France. .,University of Tours, Tours, France.
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Cheze S, Quittet P, Adoue D, Viallard J, Sève P, Bonnotte B, Laribi K, Tardy S, Henique H, Hamidou M, Hacini M, Santagostino A, Leclerc-Teffahi S, Filipovics A, Brini F, Munier J, Malastesta A, Michel M. Étude observationnelle prospective sur les patients atteints de Purpura Thrombopénique Immunologique (PTI) traités par des agonisTEs des R-TPO (ARTPO): Eltrombopag (EPAG) et Romiplostim (ROMI) (Etude PEPITE). Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.270] [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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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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Maillot F, Veyrat-Durebex C, Debeissat C, Blasco H, Patin F, Henique H, Emond P, Antar C, Herault O. Diminution de l’expression des gènes antioxydants dans les leucocytes des patients adultes atteints de phénylcétonurie. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.331] [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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Bigot A, Diot E, Pautrat M, Monjanel H, Garot D, Henique H, Gyan E, Maillot F. Chocs septiques à répétition : pensez à la mastocytose ! Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.217] [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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