1
|
Fadel J, Noyelle J, Maingon M, Homedan C, Dieu X, de la Barca JMC, Reynier P, Mallebranche C, Brasme JF, Mirebeau-Prunier D, Orvain C, Chabrun F. Rapid haemoglobin A and S quantification using Tosoh HLC-723G8 in variant mode for patients with sickle cell disease. Biomed Chromatogr 2024; 38:e5799. [PMID: 38041149 DOI: 10.1002/bmc.5799] [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: 10/12/2023] [Accepted: 11/13/2023] [Indexed: 12/03/2023]
Abstract
The management of life-threatening complications in patients with sickle cell disease (SCD) requires an accurate and reproducible quantification of haemoglobin A (HbA) and S (HbS) with a short turnaround time and 24-7 availability. We propose a novel method for quantifying HbA and HbS using the glycated haemoglobin (HbA1c) assay on a Tosoh HLC-723G8 (G8) analyser in variant mode. HbA and HbS results obtained using our method highly correlated with results obtained using a reference method (r > 0.99 for 124 samples of patients with SCD or sickle cell trait). Our method met laboratory requirements for linearity (coefficient of variation [CV] and bias <5%), between-run and within-run reproducibility (CV <10%) and carryover (<0.5%) over the range of HbS and HbA values expected in a therapeutic context. Using the G8 analyser in variant mode is viable for monitoring HbA and HbS concentrations in dire situations. This method is easy to use, quick (1.6 min per sample), and automatable and produces highly reproducible results without significant bias. Finally, it does not require modifications to the analytical pipeline recommended by the supplier, enabling a 24-7 availability without disrupting routine monitoring of HbA1c in the laboratory.
Collapse
Affiliation(s)
- Julien Fadel
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
| | - Juliette Noyelle
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
| | - Mathieu Maingon
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
| | - Chadi Homedan
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
| | - Xavier Dieu
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
- Mitolab, Mitovasc, Mixed Research Unit (UMR) Inserm U1083, CNRS 6015, University of Angers, Angers, France
| | - Juan Manuel Chao de la Barca
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
- Mitolab, Mitovasc, Mixed Research Unit (UMR) Inserm U1083, CNRS 6015, University of Angers, Angers, France
| | - Pascal Reynier
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
- Mitolab, Mitovasc, Mixed Research Unit (UMR) Inserm U1083, CNRS 6015, University of Angers, Angers, France
| | - Coralie Mallebranche
- Department of Paediatric Haematology, Oncology and Immunology, University Hospital of Angers, Angers, France
| | - Jean-François Brasme
- Department of Paediatric Haematology, Oncology and Immunology, University Hospital of Angers, Angers, France
| | - Delphine Mirebeau-Prunier
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
- Mitolab, Mitovasc, Mixed Research Unit (UMR) Inserm U1083, CNRS 6015, University of Angers, Angers, France
| | - Corentin Orvain
- Department of Clinical Haematology, University Hospital of Angers, Angers, France
| | - Floris Chabrun
- Laboratory of Biochemistry and Molecular Biology, University Hospital of Angers, Angers, France
- Mitolab, Mitovasc, Mixed Research Unit (UMR) Inserm U1083, CNRS 6015, University of Angers, Angers, France
| |
Collapse
|
2
|
Louvigné M, Rakotonjanahary J, Goumy L, Tavenard A, Brasme JF, Rialland F, Baruchel A, Auclerc MF, Despert V, Desgranges M, Jean S, Faye A, Meinzer U, Lorrot M, Job-Deslandre C, Bader-Meunier B, Gandemer V, Pellier I. Persistent osteoarticular pain in children: early clinical and laboratory findings suggestive of acute lymphoblastic leukemia (a multicenter case-control study of 147 patients). Pediatr Rheumatol Online J 2020; 18:1. [PMID: 31898528 PMCID: PMC6941319 DOI: 10.1186/s12969-019-0376-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/29/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The aim of this study was to identify early clinical and laboratory features that distinguish acute lymphoblastic leukemia (ALL) from juvenile idiopathic arthritis (JIA) in children presenting with persistent bone or joint pain for at least 1 month. METHODS We performed a multicenter case-control study and reviewed medical records of children who initially presented with bone or joint pain lasting for at least 1 month, all of whom were given a secondary diagnosis of JIA or ALL, in four French University Hospitals. Each patient with ALL was paired by age with two children with JIA. Logistic regression was used to compare clinical and laboratory data from the two groups. RESULTS Forty-nine children with ALL and 98 with JIA were included. The single most important feature distinguishing ALL from JIA was the presence of hepatomegaly, splenomegaly or lymphadenopathy; at least one of these manifestations was present in 37 cases with ALL, but only in 2 controls with JIA, for an odds ratio (OR) of 154 [95%CI: 30-793] (regression coefficient: 5.0). If the presence of these findings is missed or disregarded, multivariate analyses showed that non-articular bone pain and/or general symptoms (asthenia, anorexia or weight loss) (regression coefficient: 4.8, OR 124 [95%CI: 11.4-236]), neutrophils < 2 × 109/L (regression coefficient: 3.9, OR 50 [95%CI: 4.3-58]), and platelets < 300 × 109/L (regression coefficient: 2.6, OR 14 [95%CI: 2.3-83.9]) were associated with the presence of ALL (area under the ROC curve: 0.96 [95%CI: 0.93-0.99]). CONCLUSIONS Based on our findings we propose the following preliminary decision tree to be tested in prospective studies: in children presenting with at least 1 month of osteoarticular pain and no obvious ALL in peripheral smear, perform a bone marrow examination if hepatomegaly, splenomegaly or lymphadenopathy is present. If these manifestations are absent, perform a bone marrow examination if there is fever or elevated inflammatory markers associated with non-articular bone pain, general symptoms (asthenia, anorexia or weight loss), neutrophils < 2 × 109/L or platelets < 300 × 109/L.
Collapse
Affiliation(s)
- Mathilde Louvigné
- Unité d'Onco-Hémato-Immunologie pédiatrique, CHU Angers, 4 rue Larrey, 49933, Angers, France.
| | - Josué Rakotonjanahary
- 0000 0004 0472 0283grid.411147.6Unité d’Onco-Hémato-Immunologie pédiatrique, CHU Angers, 4 rue Larrey, 49933 Angers, France
| | - Laurence Goumy
- 0000 0004 0472 0283grid.411147.6Service de Pédiatrie générale, CHU Angers, Angers, France
| | - Aude Tavenard
- 0000 0001 2175 0984grid.411154.4Unité d’Onco-Hémato-Immunologie pédiatrique, CHU Rennes, Rennes, France
| | - Jean-François Brasme
- 0000 0004 0472 0283grid.411147.6Unité d’Onco-Hémato-Immunologie pédiatrique, CHU Angers, 4 rue Larrey, 49933 Angers, France
| | - Fanny Rialland
- 0000 0004 0472 0371grid.277151.7Unité d’Onco-Hémato-Immunologie pédiatrique, CHU Nantes, Nantes, France
| | - André Baruchel
- 0000 0001 2175 4109grid.50550.35Unité d’Hémato-Immunologie pédiatrique, CHU Robert Debré, Hôpitaux de Paris, Paris, France
| | - Marie-Françoise Auclerc
- 0000 0001 2175 4109grid.50550.35Unité d’Hémato-Immunologie pédiatrique, CHU Robert Debré, Hôpitaux de Paris, Paris, France ,Université de Paris, UFR Paris Diderot, Paris, France
| | - Véronique Despert
- 0000 0001 2175 0984grid.411154.4Service de Pédiatrie générale, CHU Rennes, Rennes, France
| | - Marie Desgranges
- 0000 0001 2175 0984grid.411154.4Service de Pédiatrie générale, CHU Rennes, Rennes, France
| | - Sylvie Jean
- 0000 0001 2175 0984grid.411154.4Service de Pédiatrie générale, CHU Rennes, Rennes, France
| | - Albert Faye
- Université de Paris, UFR Paris Diderot, Paris, France ,0000 0001 2175 4109grid.50550.35Service de Pédiatrie générale Maladies Infectieuses et Médecine Interne, Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l’enfant RAISE, CHU Robert Debré, Hôpitaux de Paris, Paris, France
| | - Ulrich Meinzer
- 0000 0001 2175 4109grid.50550.35Service de Pédiatrie générale Maladies Infectieuses et Médecine Interne, Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l’enfant RAISE, CHU Robert Debré, Hôpitaux de Paris, Paris, France
| | - Mathie Lorrot
- 0000 0001 2175 4109grid.50550.35Service de Pédiatrie générale Maladies Infectieuses et Médecine Interne, Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l’enfant RAISE, CHU Robert Debré, Hôpitaux de Paris, Paris, France
| | - Chantal Job-Deslandre
- 0000 0001 2175 4109grid.50550.35Service de Pédiatrie générale Maladies Infectieuses et Médecine Interne, Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l’enfant RAISE, CHU Robert Debré, Hôpitaux de Paris, Paris, France
| | - Brigitte Bader-Meunier
- 0000 0004 0593 9113grid.412134.1Unité d’Immuno-Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants Malades, Hôpitaux de Paris, Paris, France
| | - Virginie Gandemer
- 0000 0001 2175 0984grid.411154.4Unité d’Onco-Hémato-Immunologie pédiatrique, CHU Rennes, Rennes, France
| | - Isabelle Pellier
- 0000 0004 0472 0283grid.411147.6Unité d’Onco-Hémato-Immunologie pédiatrique, CHU Angers, 4 rue Larrey, 49933 Angers, France
| | | |
Collapse
|
3
|
Launay E, Neez E, Brasme JF, Cohen JF, Chalumeau M. Diagnosis delays: a threat for patients and researchers? J Pediatr 2018; 197:318-319. [PMID: 29551310 DOI: 10.1016/j.jpeds.2018.01.055] [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: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Elise Launay
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service de pédiatrie générale Hôpital Mère-Enfant CHU de Nantes Nantes, France
| | - Emilie Neez
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France
| | - Jean-François Brasme
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service d'oncologie et hématologie pédiatrique CHU d'Angers Angers, France
| | - Jérémie F Cohen
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service de pédiatrie générale et maladies infectieuses Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris Paris Descartes University Paris, France
| | - Martin Chalumeau
- Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris Descartes University Paris, France; Service de pédiatrie générale et maladies infectieuses Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris Paris Descartes University Paris, France
| |
Collapse
|
4
|
Affiliation(s)
- Jean-François Brasme
- Inserm U1153, Center for Epidemiology and Statistics Sorbonne Paris Cité; Hôpital Necker-Enfants Malades; Paris Descartes University, Paris; and Institut Gustave Roussy, Villejuif; Université Paris Sud, Le Kremlin Bicêtre, France
| | - Martin Chalumeau
- Inserm U1153, Center for Epidemiology and Statistics Sorbonne Paris Cité; Hôpital Necker-Enfants Malades; Paris Descartes University, Paris, France
| | - Odile Oberlin
- Institut Gustave Roussy, Villejuif; Université Paris Sud, Le Kremlin Bicêtre, France
| | | | - Nathalie Gaspar
- Institut Gustave Roussy, Villejuif; Université Paris Sud, Le Kremlin Bicêtre, France
| |
Collapse
|
5
|
Brasme JF, Chalumeau M, Oberlin O, Valteau-Couanet D, Gaspar N. Time to diagnosis of Ewing tumors in children and adolescents is not associated with metastasis or survival: a prospective multicenter study of 436 patients. J Clin Oncol 2014; 32:1935-40. [PMID: 24841977 DOI: 10.1200/jco.2013.53.8058] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The time to diagnosis (TtD) of Ewing tumors is one of the longest among pediatric tumors. Its precise consequences, however, have not been studied well. We analyzed the distribution of TtD for Ewing tumors in children and adolescents and its association with clinical features, tumor characteristics, surgical outcome, and long-term survival. PATIENTS AND METHODS We analyzed prospectively collected data from two multicenter clinical trials of patients younger than 21 years old who had Ewing bone tumors treated in France between 1988 and 2000. Clinical and tumoral features, TtD, and outcome associations were studied by univariable and multivariable analyses. RESULTS The median TtD for the 436 patients was 70 days (interquartile range, 27 to 146 days), with no significant decrease during the study period (P > .2). The factors associated with long TtD were older age and some tumor sites (pelvis, extremities of limbs). Increased tumor volume and decreased histologic response to chemotherapy were associated with long TtD on univariable analysis (P < .05) but not after adjustment. Presence of a nerve or spinal-cord compression at diagnosis, presence or site of metastasis, surgical treatment, mutilating surgery, complete resection, or survival were not associated with TtD. CONCLUSION TtD of Ewing tumors was long, especially for adolescents and for certain tumor sites, and did not improve over time. But TtD was not associated with metastasis, surgical outcome, or survival. These findings could be used to comfort parents at diagnosis and in expert testimony produced for malpractice claims.
Collapse
Affiliation(s)
- Jean-François Brasme
- Jean-François Brasme, Martin Chalumeau, INSERM U953; Jean-François Brasme, Martin Chalumeau, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris; Jean-François Brasme, Martin Chalumeau, Université Paris Descartes, Paris; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Institut Gustave Roussy, Villejuif; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Université Paris Sud, Le Kremlin Bicêtre, France.
| | - Martin Chalumeau
- Jean-François Brasme, Martin Chalumeau, INSERM U953; Jean-François Brasme, Martin Chalumeau, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris; Jean-François Brasme, Martin Chalumeau, Université Paris Descartes, Paris; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Institut Gustave Roussy, Villejuif; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Université Paris Sud, Le Kremlin Bicêtre, France
| | - Odile Oberlin
- Jean-François Brasme, Martin Chalumeau, INSERM U953; Jean-François Brasme, Martin Chalumeau, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris; Jean-François Brasme, Martin Chalumeau, Université Paris Descartes, Paris; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Institut Gustave Roussy, Villejuif; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Université Paris Sud, Le Kremlin Bicêtre, France
| | - Dominique Valteau-Couanet
- Jean-François Brasme, Martin Chalumeau, INSERM U953; Jean-François Brasme, Martin Chalumeau, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris; Jean-François Brasme, Martin Chalumeau, Université Paris Descartes, Paris; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Institut Gustave Roussy, Villejuif; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Université Paris Sud, Le Kremlin Bicêtre, France
| | - Nathalie Gaspar
- Jean-François Brasme, Martin Chalumeau, INSERM U953; Jean-François Brasme, Martin Chalumeau, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris; Jean-François Brasme, Martin Chalumeau, Université Paris Descartes, Paris; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Institut Gustave Roussy, Villejuif; Jean-François Brasme, Odile Oberlin, Dominique Valteau-Couanet, Nathalie Gaspar, Université Paris Sud, Le Kremlin Bicêtre, France
| |
Collapse
|
6
|
Brasme JF, Morfouace M, Grill J, Martinot A, Amalberti R, Bons-Letouzey C, Chalumeau M. Delays in diagnosis of paediatric cancers: a systematic review and comparison with expert testimony in lawsuits. Lancet Oncol 2012; 13:e445-59. [PMID: 23026830 DOI: 10.1016/s1470-2045(12)70361-3] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Delayed diagnosis of paediatric cancers is reported regularly and is a source of remorse for physicians and parents and a leading cause of malpractice claims. We did a systematic review of information about the distribution, determinants, and consequences of time to diagnosis of paediatric malignancies and compared these findings with those of court-appointed expert witnesses in malpractice claims in Canada and France. Time to diagnosis varied widely between tumour types in the 98 relevant studies (medians ranged from 2-260 weeks) without any significant decrease with time. Determinants of a long delay in diagnosis included older age, qualification of the first physician contacted, non-specific symptoms, histological type, and tumour localisation. Delayed diagnosis was associated with poor outcome for retinoblastoma and possibly for leukaemia, nephroblastoma, and rhabdomyosarcoma (data were insufficient for definitive conclusions). It was not associated with an adverse outcome for most CNS tumours, osteosarcoma or Ewing's sarcoma, and, paradoxically, was frequently associated with better outcomes than was short time to diagnosis in these cancers. A third of the court-appointed experts provided testimony concordant with the medical literature. The relations between delay in diagnosis and outcome are complex and probably depend more on tumour biology than on parental or medical factors.
Collapse
Affiliation(s)
- Jean-François Brasme
- INSERM U953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, Hôpital Saint-Vincent-de-Paul, Paris, France.
| | | | | | | | | | | | | |
Collapse
|
7
|
Geoerger B, Brasme JF, Daudigeos-Dubus E, Opolon P, Venot C, Debussche L, Vrignaud P, Vassal G. Anti-insulin-like growth factor 1 receptor antibody EM164 (murine AVE1642) exhibits anti-tumour activity alone and in combination with temozolomide against neuroblastoma. Eur J Cancer 2010; 46:3251-62. [PMID: 20591650 DOI: 10.1016/j.ejca.2010.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 05/28/2010] [Accepted: 06/02/2010] [Indexed: 12/16/2022]
Abstract
Insulin-like growth factor 1 receptor (IGF-1R) is overexpressed in many tumours and contributes to tumourigenicity, cell proliferation, metastasis and resistance, thus representing a promising therapeutic target. The human IGF-1R antagonistic monoclonal antibody EM164 (murine AVE1642) has shown activity in adult cancers and is being evaluated in patients with advanced malignancies. We investigated the EM164 for its therapeutic potential against childhood neuroblastoma. EM164 at 0.07, 0.7 and 7 μg/mL exhibited anti-proliferative activity against all nine cell lines tested in (3)H-thymidine incorporation assay in vitro. Cell proliferation after EM164 exposure ranged between 24% and 80% compared to controls. Sensitivity was independent from culture serum conditions, intensity of IGF-1R expression and IGF-II secretion, although associated with inhibition of AKT activation. In vivo, EM164 administered intravenously at 40 mg/kg twice weekly for 4 weeks yielded significant tumour growth delays (TGD) of 13.4d in advanced stage IGR-N91 and 12.9 d in SK-N-AS tumours compared to controls (p = 0.02 and p = 0.0059, respectively). Simultaneous treatment of EM164 0.7 μg/mL and temozolomide resulted in enhanced activity in vitro. In vivo, treatment with temozolomide at the maximum tolerated dose (100mg/kg/d for 5 consecutive days) and EM164 yielded a significantly greater TGD of 29.1d (p<0.01) and two complete tumour regressions (CR) compared to 18.1d (p = ns) and one CR for EM164 alone and 16.1d (p = ns) for temozolomide alone. Our results demonstrate the potential of the anti-IGF-1R antibody alone and in combination with alkylating agents and support the therapeutic development of the AVE1642 for aggressive neuroblastoma.
Collapse
Affiliation(s)
- Birgit Geoerger
- UPRES EA 3535, Pharmacology and New Treatments of Cancer, Université Paris-Sud XI, Institut Gustave Roussy, 94805 Villejuif, France.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Brasme JF, Mille F, Benhayoun M, Bavoux F, Faye A, Teissier N, Lachassinne E, Dauger S. Uncomplicated outcome after an accidental overdose of nevirapine in a newborn. Eur J Pediatr 2008; 167:689-90. [PMID: 17605042 DOI: 10.1007/s00431-007-0541-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Accepted: 06/05/2007] [Indexed: 10/23/2022]
Abstract
We report the first case of a massive accidental overdose of nevirapine in a 1-week newborn, due to confusion between nevirapine (Viramune) and nelfinavir (Viracept). The drug was eliminated spontaneously and quickly. We only observed mild neutropenia and hyperlactatemia, which regressed on its own without any clinical complication. Despite the good evolution of this massive overdose, physicians should be aware of confusion risks between some antiretroviral drugs.
Collapse
Affiliation(s)
- Jean-François Brasme
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Pediatric Intensive Care Unit, 48, boulevard Sérurier, 75019 Paris, France
| | | | | | | | | | | | | | | |
Collapse
|