1
|
Daccord C, Cottin V, Prévot G, Uzunhan Y, Mornex JF, Bonniaud P, Borie R, Briault A, Collonge-Rame MA, Crestani B, Devouassoux G, Freynet O, Gondouin A, Hauss PA, Khouatra C, Leroy S, Marchand-Adam S, Marquette C, Montani D, Naccache JM, Nadeau G, Poulalhon N, Reynaud-Gaubert M, Salaun M, Wallaert B, Cordier JF, Faouzi M, Lazor R. Lung function in Birt-Hogg-Dubé syndrome: a retrospective analysis of 96 patients. Orphanet J Rare Dis 2020; 15:120. [PMID: 32448321 PMCID: PMC7245949 DOI: 10.1186/s13023-020-01402-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 12/03/2019] [Accepted: 05/06/2020] [Indexed: 12/21/2022] Open
Abstract
Background Birt-Hogg-Dubé syndrome (BHD) is a rare autosomal dominant disorder caused by mutations in the FLCN gene coding for folliculin. Its clinical expression includes cutaneous fibrofolliculomas, renal tumors, multiple pulmonary cysts, and recurrent spontaneous pneumothoraces. Data on lung function in BHD are scarce and it is not known whether lung function declines over time. We retrospectively assessed lung function at baseline and during follow-up in 96 patients with BHD. Results Ninety-five percent of BHD patients had multiple pulmonary cysts on computed tomography and 59% had experienced at least one pneumothorax. Mean values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and total lung capacity were normal at baseline. Mean (standard deviation) residual volume (RV) was moderately increased to 116 (36) %pred at baseline, and RV was elevated > 120%pred in 41% of cases. Mean (standard deviation) carbon monoxide transfer factor (DLco) was moderately decreased to 85 (18) %pred at baseline, and DLco was decreased < 80%pred in 33% of cases. When adjusted for age, gender, smoking and history of pleurodesis, lung function parameters did not significantly decline over a follow-up period of 6 years. Conclusions Cystic lung disease in BHD does not affect respiratory function at baseline except for slightly increased RV and reduced DLco. No significant deterioration of lung function occurs in BHD over a follow-up period of 6 years.
Collapse
Affiliation(s)
- C Daccord
- Service de pneumologie, Centre hospitalier universitaire vaudois, Université de Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - V Cottin
- Service de pneumologie, Centre national coordinateur de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - G Prévot
- Service de pneumologie, Centre hospitalier universitaire de Toulouse, Toulouse, France
| | - Y Uzunhan
- Service de pneumologie, Assistance Publique Hôpitaux de Paris, Hôpital Avicenne, INSERM UMR 1272, Université Paris 13, Bobigny, France
| | - J F Mornex
- Service de pneumologie, Centre national coordinateur de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - P Bonniaud
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre hospitalier universitaire Dijon/Bourgogne, Université Bourgogne-Franche Comté, INSERM U123-1, Dijon, France
| | - R Borie
- Service de pneumologie, Assistance Publique Hôpitaux de Paris, Hôpital Bichat - Claude Bernard, Paris, France
| | - A Briault
- Service de pneumologie, Centre hospitalier universitaire de Grenoble, Grenoble, France
| | - M A Collonge-Rame
- Service de génétique biologique - histologie, UF cytogénétique, UF consultations d'oncogénétique, Centre hospitalier universitaire de Besançon, Besançon, France
| | - B Crestani
- Service de pneumologie, Assistance Publique Hôpitaux de Paris, Hôpital Bichat - Claude Bernard, Paris, France
| | - G Devouassoux
- Service de pneumologie, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - O Freynet
- Service de pneumologie, Assistance Publique Hôpitaux de Paris, Hôpital Avicenne, INSERM UMR 1272, Université Paris 13, Bobigny, France
| | - A Gondouin
- Service de pneumologie, Centre hospitalier universitaire de Besançon, Besançon, France
| | - P A Hauss
- Centre hospitalier intercommunal Elbeuf - Louviers - Val de Reuil, Elbeuf, France
| | - C Khouatra
- Service de pneumologie, Centre national coordinateur de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - S Leroy
- Service de pneumologie, Université Côte d'Azur, Centre hospitalier universitaire de Nice, CNRS, INSERM, FHU OncoAge, Nice, France
| | - S Marchand-Adam
- Service de pneumologie, Centre hospitalier universitaire de Tours, Tours, France
| | - C Marquette
- Service de pneumologie, Université Côte d'Azur, Centre hospitalier universitaire de Nice, CNRS, INSERM, FHU OncoAge, Nice, France
| | - D Montani
- Service de Pneumologie, Université Paris-Sud, Assistance Publique Hôpitaux de Paris, INSERM UMR S999, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - J M Naccache
- Service de Pneumologie, Site constitutif du Centre de référence des maladies pulmonaires rares OrphaLung, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - G Nadeau
- Centre hospitalier Métropole Savoie, UF de Génétique chromosomique, Chambéry, France
| | - N Poulalhon
- Service de dermatologie, Hospices Civils de Lyon, Centre hospitalier Lyon-Sud, Lyon, France
| | - M Reynaud-Gaubert
- Service de pneumologie, Centre de compétences des maladies pulmonaires rares, Assistance Publique Hôpitaux de Marseille, Centre hospitalier universitaire de Marseille, Aix Marseille Université, Marseille, France
| | - M Salaun
- Service de pneumologie, Centre hospitalier universitaire de Rouen, Rouen, France
| | - B Wallaert
- Service de pneumologie, Centre hospitalier universitaire de Lille, Lille, France
| | - J F Cordier
- Service de pneumologie, Centre national coordinateur de référence des maladies pulmonaires rares, hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - M Faouzi
- Division de biostatistique, Centre universitaire de médecine générale et santé publique (Unisanté), Université de Lausanne, Lausanne, Switzerland
| | - R Lazor
- Service de pneumologie, Centre hospitalier universitaire vaudois, Université de Lausanne, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
| | | |
Collapse
|
2
|
Cordier JF. [From heart polyps to tromboembolic disease]. Rev Prat 2019; 69:227-230. [PMID: 30983234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
3
|
Gonano C, Pasquier J, Daccord C, Johnson SR, Harari S, Leclerc V, Falconer L, Miano E, Cordier JF, Cottin V, Lazor R. Air travel and incidence of pneumothorax in lymphangioleiomyomatosis. Orphanet J Rare Dis 2018; 13:222. [PMID: 30545392 PMCID: PMC6293523 DOI: 10.1186/s13023-018-0964-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 10/01/2018] [Accepted: 11/26/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Pulmonary lymphangioleiomyomatosis (LAM) is a rare disease of women characterized by multiple lung cysts leading to respiratory insufficiency and frequent pneumothorax (PT). Air travel (AT) could increase the risk of PT in LAM through rupture of subpleural cysts induced by atmospheric pressure changes in aircraft cabin. To determine whether AT increases the risk of PT in LAM, we performed a retrospective survey of members of European LAM patient associations. A flight-related PT was defined as occurring ≤30 days after AT. RESULTS 145 women reported 207 PT. In 128 patients with available data, the annual incidence of PT was 8% since the first symptoms of LAM and 5% since LAM diagnosis, compared to 0.006% in the general female population. Following surgical or chemical pleurodesis, the probability of remaining free of PT recurrence was respectively 82, 68, and 59% after 1, 5 and 10 years, as compared to only 55, 46 and 39% without pleurodesis (p = 0.026). 70 patients with available data performed 178 AT. 6 flight-related PT occurred in 5 patients. PT incidence since first symptoms of LAM was significantly higher ≤30 days after AT as compared to non-flight periods (22 versus 6%, risk ratio 3.58, confidence interval 1.40-7.45). CONCLUSIONS The incidence of PT in LAM is about 1000 times higher than in the general female population, and is further increased threefold after AT. Chemical or surgical pleurodesis partly reduces the risk of PT recurrence in LAM.
Collapse
Affiliation(s)
- Cynthia Gonano
- Service de médecine interne, Hôpital neuchâtelois, La Chaux-de-Fonds, Switzerland
| | - Jérôme Pasquier
- Institut de médecine sociale et préventive, Centre hospitalier universitaire vaudois, Lausanne, Switzerland
| | - Cécile Daccord
- Service de pneumologie, Centre hospitalier universitaire vaudois, PMU BU44.07, Rue du Bugnon 44, 1011, Lausanne, Switzerland
| | - Simon R Johnson
- National Centre for Lymphangioleiomyomatosis, University of Nottingham, Nottingham, United Kingdom
| | - Sergio Harari
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe, MultiMedica IRCCS, Milan, Italy
| | - Violette Leclerc
- Association France Lymphangioléiomyomatose (FLAM), Plouhinec, France
| | | | - Eleonora Miano
- Associazione Italiana Linfangioleiomiomatosi (A.I.LAM-ONLUS), Arco, Italy
| | - Jean-François Cordier
- National Reference center for rare pulmonary diseases, Claude Bernard University Lyon 1, OrphaLung, UMR 754, Lyon, France
| | - Vincent Cottin
- National Reference center for rare pulmonary diseases, Claude Bernard University Lyon 1, OrphaLung, UMR 754, Lyon, France
| | - Romain Lazor
- Service de pneumologie, Centre hospitalier universitaire vaudois, PMU BU44.07, Rue du Bugnon 44, 1011, Lausanne, Switzerland.
| |
Collapse
|
4
|
Champtiaux N, Cottin V, Chassagnon G, Chaigne B, Valeyre D, Nunes H, Hachulla E, Launay D, Crestani B, Cazalets C, Jego P, Bussone G, Bérezné A, Guillevin L, Revel MP, Cordier JF, Mouthon L. Combined pulmonary fibrosis and emphysema in systemic sclerosis: A syndrome associated with heavy morbidity and mortality. Semin Arthritis Rheum 2018; 49:98-104. [PMID: 30409416 DOI: 10.1016/j.semarthrit.2018.10.011] [Citation(s) in RCA: 23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/10/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The syndrome of combined pulmonary fibrosis and emphysema (CPFE) primarily due to tobacco smoking has been reported in connective tissue disease, but little is known about its characteristics in systemic sclerosis (SSc). METHODS In this retrospective multi-center case-control study, we identified 36 SSc patients with CPFE, and compared them with 72 SSc controls with interstitial lung disease (ILD) without emphysema. RESULTS Rate of CPFE in SSc patients with CT scan was 3.6%, and 7.6% among SSc patients with ILD. CPFE-SSc patients were more likely to be male (75 % vs 18%, p < 0.0001), smokers (83 % vs 33%, p < 0.0001), and to have limited cutaneous SSc (53 % vs 24% p < 0.01) than ILD-SSc controls. No specific autoantibody was significantly associated with CPFE. At diagnosis, CPFE-SSc patients had a greater decrease in carbon monoxide diffusing capacity (DLCO 39 ± 13 % vs 51 ± 12% of predicted value, p < 0.0001) when compared to SSc-ILD controls, whereas lung volumes (total lung capacity and forced vital capacity) were similar. During follow-up, CPFE-SSc patients more frequently developed precapillary pulmonary hypertension (PH) (44 % vs 11%, p < 10-4), experienced more frequent unscheduled hospitalizations (50 % vs 25%, p < 0.01), and had decreased survival (p < 0.02 by Kaplan-Meier survival analysis) as compared to ILD-SSc controls. CONCLUSIONS The CPFE syndrome is a distinct pulmonary manifestation in SSc, with higher morbidity and mortality. Early diagnosis of CPFE by chest CT in SSc patients (especially smokers) may result in earlier smoking cessation, screening for PH, and appropriate management.
Collapse
Affiliation(s)
- N Champtiaux
- Department of Internal Medicine, Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques Autoimmunes Rares d'Ile de France, DHU Authors (Autoimmune and Hormonal Diseases), Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France
| | - V Cottin
- Service de Pneumologie, Centre National de Référence des maladies pulmonaire rares, Hospices Civils de Lyon, Hôpital Louis Pradel, Groupe d'Etudes et de Recherche sur les Maladies « Orphelines » Pulmonaires (GERM«O»P), Université Claude Bernard Lyon 1, UMR754, Lyon, France
| | | | - B Chaigne
- Department of Internal Medicine, Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques Autoimmunes Rares d'Ile de France, DHU Authors (Autoimmune and Hormonal Diseases), Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France
| | - D Valeyre
- Service de Pneumologie, APHP, hôpital Avicenne, Université Paris Nord, 93000 Bobigny, France
| | - H Nunes
- Service de Pneumologie, APHP, hôpital Avicenne, Université Paris Nord, 93000 Bobigny, France
| | - E Hachulla
- Université de Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Service de Médecine Interne, Hôpital Claude Huriez, Centre de Référence pour la Sclérodermie Systémique, FHU IMMInENT, F-59000 Lille, France
| | - D Launay
- Université de Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Service de Médecine Interne, Hôpital Claude Huriez, Centre de Référence pour la Sclérodermie Systémique, FHU IMMInENT, F-59000 Lille, France
| | - B Crestani
- Service de Pneumologie A, Hôpital Bichat, DHU FIRE, Université Paris Diderot, Paris, France
| | - C Cazalets
- Service de médecine interne, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - P Jego
- Service de médecine interne, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - G Bussone
- Department of Internal Medicine, Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques Autoimmunes Rares d'Ile de France, DHU Authors (Autoimmune and Hormonal Diseases), Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France
| | - A Bérezné
- Department of Internal Medicine, Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques Autoimmunes Rares d'Ile de France, DHU Authors (Autoimmune and Hormonal Diseases), Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France
| | - L Guillevin
- Department of Internal Medicine, Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques Autoimmunes Rares d'Ile de France, DHU Authors (Autoimmune and Hormonal Diseases), Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France
| | - M P Revel
- Service de Radiologie, Hôpital Cochin, France
| | - J F Cordier
- Service de Pneumologie, Centre National de Référence des maladies pulmonaire rares, Hospices Civils de Lyon, Hôpital Louis Pradel, Groupe d'Etudes et de Recherche sur les Maladies « Orphelines » Pulmonaires (GERM«O»P), Université Claude Bernard Lyon 1, UMR754, Lyon, France
| | - L Mouthon
- Department of Internal Medicine, Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques Autoimmunes Rares d'Ile de France, DHU Authors (Autoimmune and Hormonal Diseases), Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), 27, rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
| | | |
Collapse
|
5
|
Barba T, Khouatra C, Traclet J J, Cordier JF, Cottin V. Diffuse bronchiectasis and airflow obstruction in granulomatosis with polyangiitis. Sarcoidosis Vasc Diffuse Lung Dis 2018; 35:81-84. [PMID: 32476884 DOI: 10.36141/svdld.v35i1.6298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 03/26/2017] [Indexed: 11/02/2022]
Abstract
Parenchymal lung nodes and diffuse intra-alveolar hemorrhage are the archetypal pulmonary manifestations of Granulomatosis with Polyangiitis (GPA). The occurrence of diffuse bronchiectasis and airflow obstruction during GPA is unusual. We report here 3 patients with GPA who developed diffuse bronchiectasis during follow-up. The airflow obstruction seemed then to evolve independently from the GPA itself and ultimately led to respiratory insufficiency. Bronchiectases promoted the occurrence of opportunistic infections, especially with atypical mycobacteria. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 81-84).
Collapse
Affiliation(s)
- T Barba
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne, Lyon, France
| | - C Khouatra
- Hospices Civils de Lyon, Hôpital Louis Pradel, Centre national de référence des maladies pulmonaires rares, Service de pneumologie, Lyon, France, Univ Lyon, Université Lyon I, INRA, UMR754, Lyon, France
| | - J Traclet J
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Interne, Lyon, France.,Hospices Civils de Lyon, Hôpital Louis Pradel, Centre national de référence des maladies pulmonaires rares, Service de pneumologie, Lyon, France, Univ Lyon, Université Lyon I, INRA, UMR754, Lyon, France
| | - J F Cordier
- Hospices Civils de Lyon, Hôpital Louis Pradel, Centre national de référence des maladies pulmonaires rares, Service de pneumologie, Lyon, France, Univ Lyon, Université Lyon I, INRA, UMR754, Lyon, France
| | - V Cottin
- Hospices Civils de Lyon, Hôpital Louis Pradel, Centre national de référence des maladies pulmonaires rares, Service de pneumologie, Lyon, France, Univ Lyon, Université Lyon I, INRA, UMR754, Lyon, France
| |
Collapse
|
6
|
Petitpierre N, Cottin V, Marchand-Adam S, Hirschi S, Rigaud D, Court-Fortune I, Jouneau S, Israël-Biet D, Molard A, Cordier JF, Lazor R. A 12-week combination of clarithromycin and prednisone compared to a 24-week prednisone alone treatment in cryptogenic and radiation-induced organizing pneumonia. Sarcoidosis Vasc Diffuse Lung Dis 2018; 35:230-238. [PMID: 32476907 DOI: 10.36141/svdld.v35i3.6547] [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] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 02/06/2018] [Indexed: 11/02/2022]
Abstract
Background: Some data suggest that anti-inflammatory macrolides may be effective to treat organizing pneumonia (OP) and prevent relapses, but no formal comparison with prednisone alone is available. To explore this issue, we retrospectively compared the efficacy of a 12-week combined regimen of clarithromycin and prednisone with a 24-week prednisone alone regimen in OP. Methods: A standard 12-week regimen of combined clarithromycin and prednisone was designed for the treatment of cryptogenic or radiation-induced OP, aiming at reducing the cumulated prednisone dose and the relapse rate. Its use was left to the discretion of the treating physicians, members of the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires. Data were compared to a historical control group treated with a standard 24-week prednisone alone regimen. Results: 16 patients were treated with combined therapy and 21 with prednisone alone. Complete radiological remission was achieved in 63% of the combined therapy group and 81% of the prednisone alone group (p=0.38). Symptomatic relapses occurred in 81% of the combined therapy group, and 52% of the prednisone alone group (p=0.14). No side effect of clarithromycin was reported. Conclusions: In patients with cryptogenic or radiation-induced OP, a 12-week regimen of clarithromycin and prednisone showed no benefit on remission rate and relapse rate as compared to a 24-week prednisone only regimen. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 230-238).
Collapse
Affiliation(s)
- Nicolas Petitpierre
- Interstitial and rare lung diseases Unit, Department of Respiratory Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Vincent Cottin
- Department of Respiratory Medicine and Reference Center for rare lung diseases, Lyon University Hospital, Lyon, France
| | | | - Sandrine Hirschi
- Department of Respiratory Medicine, Strasbourg University Hospital, Strasbourg, France
| | | | | | - Stéphane Jouneau
- Department of Respiratory Medicine, Competences center for rare pulmonary diseases, IRSET UMR 1085, Rennes 1 University, Rennes University Hospital, Rennes, France
| | - Dominique Israël-Biet
- Department of Respiratory Medicine, Georges-Pompidou European Hospital, Paris, France
| | - Anita Molard
- Department of Respiratory Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Jean-François Cordier
- Department of Respiratory Medicine and Reference Center for rare lung diseases, Lyon University Hospital, Lyon, France
| | - Romain Lazor
- Interstitial and rare lung diseases Unit, Department of Respiratory Medicine, Lausanne University Hospital, Lausanne, Switzerland.,Department of Respiratory Medicine and Reference Center for rare lung diseases, Lyon University Hospital, Lyon, France
| | | |
Collapse
|
7
|
Cottin V, Bel E, Bottero P, Dalhoff K, Humbert M, Lazor R, Sinico RA, Sivasothy P, Wechsler ME, Groh M, Marchand-Adam S, Khouatra C, Wallaert B, Taillé C, Delaval P, Cadranel J, Bonniaud P, Prévot G, Hirschi S, Gondouin A, Dunogué B, Chatté G, Briault C, Pagnoux C, Jayne D, Guillevin L, Cordier JF. Revisiting the systemic vasculitis in eosinophilic granulomatosis with polyangiitis (Churg-Strauss). Autoimmun Rev 2017; 16:1-9. [DOI: 10.1016/j.autrev.2016.09.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 05/08/2016] [Indexed: 12/17/2022]
|
8
|
Borie R, Tabèze L, Thabut G, Nunes H, Cottin V, Marchand-Adam S, Prevot G, Tazi A, Cadranel J, Mal H, Wemeau-Stervinou L, Bergeron Lafaurie A, Israel-Biet D, Picard C, Reynaud Gaubert M, Jouneau S, Naccache JM, Mankikian J, Ménard C, Cordier JF, Valeyre D, Reocreux M, Grandchamp B, Revy P, Kannengiesser C, Crestani B. Prevalence and characteristics of TERT and TERC mutations in suspected genetic pulmonary fibrosis. Eur Respir J 2016; 48:1721-1731. [PMID: 27836952 DOI: 10.1183/13993003.02115-2015] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 09/03/2016] [Indexed: 02/02/2023]
Abstract
Telomerase reverse transcriptase (TERT) or telomerase RNA (TERC) gene mutation is a major monogenic cause of pulmonary fibrosis. Sequencing of TERT/TERC genes is proposed to patients with familial pulmonary fibrosis. Little is known about the possible predictors of this mutation and its impact on prognosis.We retrospectively analysed all the genetic diagnoses made between 2007-2014 in patients with pulmonary fibrosis. We evaluated the prevalence of TERT/TERC disease-associated variant (DAV), factors associated with a DAV, and the impact of the DAV on survival.237 patients with pulmonary fibrosis (153 with familial pulmonary fibrosis, 84 with telomere syndrome features without familial pulmonary fibrosis) were tested for TERT/TERC DAV. DAV was diagnosed in 40 patients (16.8%), including five with non-idiopathic interstitial pneumonia. Prevalence of TERT/TERC DAV did not significantly differ between patients with familial pulmonary fibrosis or with only telomere syndrome features (18.2% versus 16.4%). Young age, red blood cell macrocytosis, and low platelet count were associated with the presence of DAV; the probability of DAV was increased for patients 40-60 years. Transplant-free survival was lower with than without TERT/TERC DAV (4.2 versus 7.2 years; p=0.046).TERT/TERC DAV were associated with specific clinical and biological features and reduced transplant-free survival.
Collapse
Affiliation(s)
- Raphael Borie
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, Paris, France.,INSERM, Unité 1152; Université Paris Diderot, Paris, France
| | - Laure Tabèze
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, Paris, France.,INSERM, Unité 1152; Université Paris Diderot, Paris, France
| | - Gabriel Thabut
- INSERM, Unité 1152; Université Paris Diderot, Paris, France.,Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | - Hilario Nunes
- APHP, Service de Pneumologie, Hôpital Avicenne, Bobigny, France
| | - Vincent Cottin
- Service de Pneumologie, Centre national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | | | | | - Abdellatif Tazi
- APHP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France
| | - Jacques Cadranel
- APHP, Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpital Tenon, Paris, France
| | - Herve Mal
- Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | - Lidwine Wemeau-Stervinou
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, CHRU de Lille, Lille, France
| | | | | | | | | | - Stephane Jouneau
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpital Pontchaillou; IRSET UMR 1085, université de Rennes 1, Rennes, France
| | - Jean-Marc Naccache
- APHP, Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpital Tenon, Paris, France
| | | | - Christelle Ménard
- Departement de Génétique, APHP, Hôpital Bichat, Paris, France; Université Paris Diderot, Paris, France
| | - Jean-François Cordier
- Service de Pneumologie, Centre national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Marion Reocreux
- Departement de Génétique, APHP, Hôpital Bichat, Paris, France; Université Paris Diderot, Paris, France
| | - Bernard Grandchamp
- Departement de Génétique, APHP, Hôpital Bichat, Paris, France; Université Paris Diderot, Paris, France
| | - Patrick Revy
- INSERM UMR 1163, Laboratory of Genome Dynamics in the Immune System, Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Caroline Kannengiesser
- Departement de Génétique, APHP, Hôpital Bichat, Paris, France; Université Paris Diderot, Paris, France.,Both authors contributed equally to this work
| | - Bruno Crestani
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, Paris, France .,INSERM, Unité 1152; Université Paris Diderot, Paris, France.,Both authors contributed equally to this work
| |
Collapse
|
9
|
Cottin V, Bel E, Bottero P, Dalhoff K, Humbert M, Lazor R, Sinico RA, Sivasothy P, Wechsler ME, Groh M, Marchand-Adam S, Khouatra C, Wallaert B, Taillé C, Delaval P, Cadranel J, Bonniaud P, Prévot G, Hirschi S, Gondouin A, Dunogué B, Chatté G, Briault A, Jayne D, Guillevin L, Cordier JF. Respiratory manifestations of eosinophilic granulomatosis with polyangiitis (Churg–Strauss). Eur Respir J 2016; 48:1429-1441. [DOI: 10.1183/13993003.00097-2016] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 06/01/2016] [Indexed: 11/05/2022]
Abstract
The respiratory manifestations of eosinophilic granulomatosis with polyangiitis (EGPA) have not been studied in detail.In this retrospective multicentre study, EGPA was defined by asthma, eosinophilia and at least one new onset extra-bronchopulmonary organ manifestation of disease.The study population included 157 patients (mean±sd age 49.4±14.1 years), with a mean±sd blood eosinophil count of 7.4±6.4×109 L−1 at diagnosis. There was a mean±sd of 11.8±18.2 years from the onset of asthma to the diagnosis of EGPA, of 1.4±8.4 years from the first onset of peripheral eosinophilia to the diagnosis of EGPA, and of 7.4±6.4 years from EGPA diagnosis to the final visit. Despite inhaled and oral corticosteroid treatment, the severity of asthma increased 3–6 months before the onset of the systemic manifestations. Asthma was severe in 57%, 48%, and 56% of patients at diagnosis, at 3 years, and at the final visit, respectively. Persistent airflow obstruction was present in 38%, 30%, and 46% at diagnosis, at 3 years, and at the final visit, respectively.In EGPA, asthma is severe, antedates systemic manifestations by a mean of 12 years, and progresses to long-term persistent airflow obstruction despite corticosteroids in a large proportion of patients, which affects long-term management and morbidity.
Collapse
|
10
|
Abstract
As the bronchioles have a strategic position between the airways and the alveolar structures, they are at a site where disorders of many origins may develop, including infections, inflammatory and/or fibrosing processes of immune, occupational, environmental, tumoral, and iatrogenic origin, which may result in predominant bronchiolitis and/or organizing pneumonia. This etiologic variety results in many distinct entities and syndromes, common or rare, with new or renewed faces such as bronchiolocentric interstitial pneumonia or organizing pneumonia primed by radiation to the breast.
Collapse
Affiliation(s)
- Jean-François Cordier
- Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Groupement Hospitalier Est, Lyon, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Groupement Hospitalier Est, Lyon, France
| | - Romain Lazor
- Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Groupement Hospitalier Est, Lyon, France
| | | |
Collapse
|
11
|
Roufosse F, Heimann P, Lambert F, Sidon P, Bron D, Cottin V, Cordier JF. Severe Prolonged Cough as Presenting Manifestation of FIP1L1-PDGFRA+ Chronic Eosinophilic Leukaemia: A Widely Ignored Association. Respiration 2016; 91:374-9. [PMID: 27164940 DOI: 10.1159/000446076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 04/11/2016] [Indexed: 11/19/2022] Open
Abstract
Chronic eosinophilic leukaemia associated with the FIP1L1-PDGFRA fusion gene (F/P+ CEL) is a rare cause of marked persistent hypereosinophilia, arising almost exclusively in male patients. Clinical presentations are heterogeneous with a higher incidence of eosinophil-mediated cardiomyopathy than in other hypereosinophilic syndrome variants. Features of chronic myeloproliferative disease are often present, including splenomegaly and elevated serum vitamin B12 levels. The diagnosis is made by fluorescence in situ hybridization (FISH) showing the deletion of the CHIC2 locus and/or RT-PCR showing the FIP1L1-PDGFRA fusion transcript. Treatment with imatinib mesylate, a tyrosine kinase inhibitor, results in rapid and complete resolution of hypereosinophilia and associated symptoms, except for those related to sub-endocardial fibrosis that may be irreversible. We report the case of a male patient in whom isolated intractable cough remained the only clinical manifestation of F/P+ CEL for 4 years. Furthermore, eosinophil autofluorescence, an as yet unreported artefact in this setting, precluded the detection of the CHIC2 deletion and further delayed diagnosis, underlining that both FISH and RT-PCR should be performed when this disease is suspected.
Collapse
Affiliation(s)
- Florence Roufosse
- Department of Internal Medicine, Hx00F4;pital Erasme, Universitx00E9; Libre de Bruxelles, Brussels, Belgium
| | | | | | | | | | | | | |
Collapse
|
12
|
Carras S, Berger F, Chalabreysse L, Callet-Bauchut E, Cordier JF, Salles G, Girard N. Primary cardiac lymphoma: diagnosis, treatment and outcome in a modern series. Hematol Oncol 2016; 35:510-519. [PMID: 27140394 DOI: 10.1002/hon.2301] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 12/17/2015] [Revised: 02/27/2016] [Accepted: 03/28/2016] [Indexed: 12/31/2022]
Abstract
Primary cardiac lymphoma (PCL) represents a rare subset of extranodal lymphomas for which the primary lesion arises from the heart and/or the pericardium. Fundamental characteristics of PCL remain uncertain, regarding optimal diagnosis strategy, pathological features, treatments, as well as prognostic factors. This is a single-institution retrospective study of patients with histologically proven lymphoma, presenting with exclusive or predominant myocardial invasion at time of diagnosis. Thirteen patients were included, all of whom had symptoms related to cardiac tumour location with chronic chest pain in six (46%), dyspnea in seven (54%) and arythmia in three (23%). Sub-acute and acute congestive heart failure were noticed in respectively nine (70%) and one (9%). PCL was identified at transthoracic echocardiography and computed tomography scan in 80 and 100% of patients, respectively. Most frequent location was the right atrium in 10 (77%) patients. Pericardial effusion was identified in 10 (77%). Pathological diagnosis-diffuse large B-cell lymphoma in 12 cases and Burkitt in 1 case-was made on cardiac surgical biopsies in 9 cases and by intravascular procedure in 2 cases. All patients received first-line chemotherapy, with a complete response rate of 62%. Recurrences occurred in 55% of patients, mostly at extracardiac extranodal sites. Our data confirm that PCL harbours specific clinical and anatomical features. The aggressiveness of PCL mainly results from the possible onset of acute cardiac events. Further molecular characterization may help to further individualize PCL among diffuse and intrathoracic lymphomas. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Sylvain Carras
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service d'Hématologie, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Françoise Berger
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service d'Anatomie Pathologique, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Lara Chalabreysse
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service d'Anatomie Pathologique, Groupement Hospitalier Est, Lyon, France
| | - Evelyne Callet-Bauchut
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Laboratoire d'Hématologie, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Jean-François Cordier
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Pneumologie, Hôpital Louis Pradel, Lyon, France
| | - Gilles Salles
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service d'Hématologie, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Nicolas Girard
- Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Service de Pneumologie, Hôpital Louis Pradel, Lyon, France
| |
Collapse
|
13
|
Gabriel L, Delavenne X, Bedouch P, Khouatra C, Bouvaist H, Cordier JF, Mornex JF, Pison C, Cottin V, Bertoletti L. Risk of Direct Oral Anticoagulant Bioaccumulation in Patients with Pulmonary Hypertension. Respiration 2016; 91:307-15. [DOI: 10.1159/000445122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/01/2016] [Indexed: 11/19/2022] Open
|
14
|
Spagnolo P, Cordier JF, Cottin V. Connective tissue diseases, multimorbidity and the ageing lung. Eur Respir J 2016; 47:1535-58. [PMID: 26917611 DOI: 10.1183/13993003.00829-2015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 01/23/2016] [Indexed: 12/14/2022]
Abstract
Connective tissue diseases encompass a wide range of heterogeneous disorders characterised by immune-mediated chronic inflammation often leading to tissue damage, collagen deposition and possible loss of function of the target organ. Lung involvement is a common complication of connective tissue diseases. Depending on the underlying disease, various thoracic compartments can be involved but interstitial lung disease is a major contributor to morbidity and mortality. Interstitial lung disease, pulmonary hypertension or both are found most commonly in systemic sclerosis. In the elderly, the prevalence of connective tissue diseases continues to rise due to both longer life expectancy and more effective and better-tolerated treatments. In the geriatric population, connective tissue diseases are almost invariably accompanied by age-related comorbidities, and disease- and treatment-related complications, which contribute to the significant morbidity and mortality associated with these conditions, and complicate treatment decision-making. Connective tissue diseases in the elderly represent a growing concern for healthcare providers and an increasing burden of global health resources worldwide. A better understanding of the mechanisms involved in the regulation of the immune functions in the elderly and evidence-based guidelines specifically designed for this patient population are instrumental to improving the management of connective tissue diseases in elderly patients.
Collapse
Affiliation(s)
- Paolo Spagnolo
- Medical University Clinic, Canton Hospital Baselland, and University of Basel, Liestal, Switzerland
| | - Jean-François Cordier
- Hospices Civils de Lyon, Hôpital Louis Pradel, National Reference Center for Rare Pulmonary Diseases, Lyon, France Claude Bernard Lyon 1 University, University of Lyon, Lyon, France
| | - Vincent Cottin
- Hospices Civils de Lyon, Hôpital Louis Pradel, National Reference Center for Rare Pulmonary Diseases, Lyon, France Claude Bernard Lyon 1 University, University of Lyon, Lyon, France INRA, UMR754, Lyon, France
| |
Collapse
|
15
|
Cordier JF, Cottin V, Lazor R, Stoppa-Lyonnet D. Monoallelic germline ATM mutation and organising pneumonia induced by radiation therapy to the breast. Eur Respir J 2016; 47:997-1000. [PMID: 26846839 DOI: 10.1183/13993003.01842-2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 12/15/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Jean-François Cordier
- Dept of Respiratory Medicine, Groupement Hospitalier Est, Lyon, France Claude Bernard University, Lyon, France
| | - Vincent Cottin
- Dept of Respiratory Medicine, Groupement Hospitalier Est, Lyon, France Claude Bernard University, Lyon, France
| | - Romain Lazor
- Dept of Respiratory Medicine, Groupement Hospitalier Est, Lyon, France Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | |
Collapse
|
16
|
Chebib N, Khouatra C, Lazor R, Archer F, Leroux C, Gamondes D, Thivolet-Bejui F, Cordier JF, Cottin V. [Pulmonary lymphangioleiomyomatosis: From pathogenesis to management]. Rev Mal Respir 2015; 33:718-734. [PMID: 26604019 DOI: 10.1016/j.rmr.2015.10.005] [Citation(s) in RCA: 3] [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: 07/17/2015] [Accepted: 10/06/2015] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Pulmonary lymphangioleiomyomatosis (LAM) is a rare disease affecting mainly young women. BACKGROUND The respiratory manifestations are characterized by a progressive cystic destruction of the lung parenchyma. Extrapulmonary involvement includes benign renal tumours called angiomyolipomas and abdominal lymphatic masses called lymphangioleiomyomas. At the pathological level, the cellular proliferation found in LAM is in part due to the presence of mutations in the tumour suppressor genes TSC1 and TSC2 (Tuberous Sclerosis Complex). These mutations lead to the activation of the mTOR pathway, which is currently the main therapeutic target. mTOR inhibitors such as sirolimus or everolimus have shown a beneficial effect on the decline in pulmonary function and a reduction of angiomyolipoma size, but are necessary in only some patients. PERSPECTIVES LAM cells have migratory properties mediated by the formation of new lymphatic vessels. They are also able to secrete metalloproteases, which enhance their invasiveness. Moreover, the expression of estrogen and progesterone receptors by LAM cells suggests a possible role for sex hormones in the pathogenesis of the disease. CONCLUSION A better understanding of mTOR-independent mechanisms would allow the development of novel therapeutic approaches.
Collapse
Affiliation(s)
- N Chebib
- Service de pneumologie, centre de référence des maladies pulmonaires rares, hôpital Louis-Pradel, hospices civils de Lyon, 8, avenue du Doyen-Lépine, 69677 Lyon cedex, France; UMR 754 Inra, université de Lyon, université Claude-Bernard Lyon 1, 69366 Lyon cedex, France
| | - C Khouatra
- Service de pneumologie, centre de référence des maladies pulmonaires rares, hôpital Louis-Pradel, hospices civils de Lyon, 8, avenue du Doyen-Lépine, 69677 Lyon cedex, France
| | - R Lazor
- Service de pneumologie, centre de référence des maladies pulmonaires rares, hôpital Louis-Pradel, hospices civils de Lyon, 8, avenue du Doyen-Lépine, 69677 Lyon cedex, France; Unité des pneumopathies interstitielles et maladies pulmonaires rares, service de pneumologie, centre hospitalier universitaire vaudois, 1011 Lausanne, Suisse
| | - F Archer
- UMR 754 Inra, université de Lyon, université Claude-Bernard Lyon 1, 69366 Lyon cedex, France
| | - C Leroux
- UMR 754 Inra, université de Lyon, université Claude-Bernard Lyon 1, 69366 Lyon cedex, France
| | - D Gamondes
- Service de radiologie, hôpital Louis-Pradel, hospices civils de Lyon, 69677 Lyon cedex, France
| | - F Thivolet-Bejui
- Centre de pathologie Est, groupement hospitalier Est, hospices civils de Lyon, 69677 Lyon cedex, France
| | - J F Cordier
- Service de pneumologie, centre de référence des maladies pulmonaires rares, hôpital Louis-Pradel, hospices civils de Lyon, 8, avenue du Doyen-Lépine, 69677 Lyon cedex, France; UMR 754 Inra, université de Lyon, université Claude-Bernard Lyon 1, 69366 Lyon cedex, France
| | - V Cottin
- Service de pneumologie, centre de référence des maladies pulmonaires rares, hôpital Louis-Pradel, hospices civils de Lyon, 8, avenue du Doyen-Lépine, 69677 Lyon cedex, France; UMR 754 Inra, université de Lyon, université Claude-Bernard Lyon 1, 69366 Lyon cedex, France.
| |
Collapse
|
17
|
Cottin V, Bergot E, Bourdin A, Cadranel J, Camus P, Crestani B, Dalphin JC, Delaval P, Dromer C, Israel-Biet D, Kessler R, Marchand-Adam S, Marquette CH, Prévot G, Reynaud-Gaubert M, Valeyre D, Wallaert B, Bouquillon B, Cordier JF. Adherence to guidelines in idiopathic pulmonary fibrosis: a follow-up national survey. ERJ Open Res 2015; 1:00032-2015. [PMID: 27730153 PMCID: PMC5005118 DOI: 10.1183/23120541.00032-2015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/12/2015] [Indexed: 11/28/2022] Open
Abstract
A new survey coordinated by the French expert centres for rare pulmonary diseases investigated French pulmonologists' diagnostic and therapeutic practice for idiopathic pulmonary fibrosis (IPF) and explored changes since a previous survey in 2011-2012. From May 16 to August 30, 2014, 524 pulmonologists were contacted. Those following at least one patient with IPF were invited to complete a questionnaire administered by telephone or e-mail. 166 (31.7%) pulmonologists, 161 (97%) of whom had participated to the first survey, completed the questionnaire. Of those, 46% and 52%, respectively, discussed the cases with radiologists and pathologists. Out of 144 pulmonologists practicing outside of expert centres, 80% indicated referring patients to those centres. The 2013 French practical guidelines for IPF were known by 92% of pulmonologists involved in IPF, 96% of whom considered them appropriate for practice. The multidisciplinary discussion form for IPF diagnosis was known by 74% and considered appropriate by 94%. Diagnosis and management resulted from multidisciplinary discussion in 50% of the cases. About 58% of patients were diagnosed with "mild to moderate IPF" as defined by forced vital capacity ≥50% of the predicted value and diffusing capacity for carbon monoxide ≥35% of predicted. At the time of the survey, 31% of physicians were using pirfenidone to treat patients with "mild-to-moderately severe IPF" and 30% generally prescribed no treatment. Substantial improvement has occurred since the 2011-2012 survey with regard to knowledge of guidelines and proper management of IPF. Early diagnosis still needs to be improved through the network of expert centres.
Collapse
Affiliation(s)
- Vincent Cottin
- National Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Claude Bernard Lyon 1 University, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jean-François Cordier
- National Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Claude Bernard Lyon 1 University, Lyon, France
| |
Collapse
|
18
|
Groh M, Pagnoux C, Baldini C, Bel E, Bottero P, Cottin V, Dalhoff K, Dunogué B, Gross W, Holle J, Humbert M, Jayne D, Jennette JC, Lazor R, Mahr A, Merkel PA, Mouthon L, Sinico RA, Specks U, Vaglio A, Wechsler ME, Cordier JF, Guillevin L. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) Consensus Task Force recommendations for evaluation and management. Eur J Intern Med 2015; 26:545-53. [PMID: 25971154 DOI: 10.1016/j.ejim.2015.04.022] [Citation(s) in RCA: 275] [Impact Index Per Article: 30.6] [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: 10/09/2014] [Revised: 03/09/2015] [Accepted: 04/26/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To develop disease-specific recommendations for the diagnosis and management of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (EGPA). METHODS The EGPA Consensus Task Force experts comprised 8 pulmonologists, 6 internists, 4 rheumatologists, 3 nephrologists, 1 pathologist and 1 allergist from 5 European countries and the USA. Using a modified Delphi process, a list of 40 questions was elaborated by 2 members and sent to all participants prior to the meeting. Concurrently, an extensive literature search was undertaken with publications assigned with a level of evidence according to accepted criteria. Drafts of the recommendations were circulated for review to all members until final consensus was reached. RESULTS Twenty-two recommendations concerning the diagnosis, initial evaluation, treatment and monitoring of EGPA patients were established. The relevant published information on EGPA, antineutrophil-cytoplasm antibody-associated vasculitides, hypereosinophilic syndromes and eosinophilic asthma supporting these recommendations was also reviewed. DISCUSSION These recommendations aim to give physicians tools for effective and individual management of EGPA patients, and to provide guidance for further targeted research.
Collapse
Affiliation(s)
- Matthieu Groh
- Department of Internal Medicine, National Referral Center for Rare Autoimmune and Systemic Diseases (Vasculitis, Scleroderma), INSERM U1016, Hôpital Cochin, APHP, Université Paris Descartes, Paris, France
| | - Christian Pagnoux
- Division of Rheumatology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Chiara Baldini
- Rheumatology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy
| | - Elisabeth Bel
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Paolo Bottero
- Allergy and Clinical Immunology Outpatient Clinic, Ospedale "G. Fornaroli" di Magenta, Azienda Ospedaliera di Legnano, Milan, Italy
| | - Vincent Cottin
- Department of Respiratory Medicine, National Referral Center for Rare Lung Diseases, Hôpital Louis-Pradel, Hospices Civils de Lyon, Lyon, France
| | - Klaus Dalhoff
- Medical Clinic, Department of Rheumatology, Vasculitis Center, University Clinic of Schleswig-Holstein, Lübeck and Bad Bramstedt, Germany
| | - Bertrand Dunogué
- Department of Internal Medicine, National Referral Center for Rare Autoimmune and Systemic Diseases (Vasculitis, Scleroderma), INSERM U1016, Hôpital Cochin, APHP, Université Paris Descartes, Paris, France
| | - Wolfgang Gross
- Medical Clinic, Department of Rheumatology, Vasculitis Center, University Clinic of Schleswig-Holstein, Lübeck and Bad Bramstedt, Germany
| | - Julia Holle
- Medical Clinic, Department of Rheumatology, Vasculitis Center, University Clinic of Schleswig-Holstein, Lübeck and Bad Bramstedt, Germany
| | - Marc Humbert
- Department of Respiratory and Critical Care Medicine, National Referral Center for Severe Pulmonary Hypertension, INSERM UMR-S 999, Hôpital Bicêtre, APHP, Université Paris-Sud, 94270 Le Kremlin-Bicêtre, France
| | - David Jayne
- Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Charles Jennette
- Department of Pathology and Laboratory Medicine, UNC Kidney Center, University of North Carolina, Chapel Hill, NC, USA
| | - Romain Lazor
- Interstitial and Rare Lung Disease Unit, Department of Respiratory Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alfred Mahr
- Department of Internal Medicine, Hôpital Saint-Louis, Université Paris 7 René Diderot, Paris, France
| | - Peter A Merkel
- Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Luc Mouthon
- Department of Internal Medicine, National Referral Center for Rare Autoimmune and Systemic Diseases (Vasculitis, Scleroderma), INSERM U1016, Hôpital Cochin, APHP, Université Paris Descartes, Paris, France
| | - Renato Alberto Sinico
- Clinical Immunology Unit and Renal Unit, Department of Medicine, Azienda Ospedaliera San Carlo Borromeo, Milan, Italy
| | - Ulrich Specks
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Augusto Vaglio
- Nephrology Unit, University Hospital of Parma, Parma, Italy
| | - Michael E Wechsler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | - Jean-François Cordier
- Department of Respiratory Medicine, National Referral Center for Rare Lung Diseases, Hôpital Louis-Pradel, Hospices Civils de Lyon, Lyon, France
| | - Loïc Guillevin
- Department of Internal Medicine, National Referral Center for Rare Autoimmune and Systemic Diseases (Vasculitis, Scleroderma), INSERM U1016, Hôpital Cochin, APHP, Université Paris Descartes, Paris, France.
| |
Collapse
|
19
|
Sanges S, Launay D, Rhee RL, Sitbon O, Hachulla É, Mouthon L, Guillevin L, Rottat L, Montani D, De Groote P, Cottin V, Magro P, Prévot G, Bauer F, Bergot E, Chabanne C, Reynaud-Gaubert M, Leroy S, Canuet M, Sanchez O, Gut-Gobert C, Dauphin C, Pison C, Boissin C, Habib G, Clerson P, Conesa F, Cordier JF, Kawut SM, Simonneau G, Humbert M. A prospective study of the 6 min walk test as a surrogate marker for haemodynamics in two independent cohorts of treatment-naïve systemic sclerosis-associated pulmonary arterial hypertension. Ann Rheum Dis 2015; 75:1457-65. [PMID: 26324844 DOI: 10.1136/annrheumdis-2015-207336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 01/21/2015] [Accepted: 08/12/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Despite the wide use of the 6 min walk distance (6MWD), no study has ever assessed its validity as a surrogate marker for haemodynamics and predictor of outcome in isolated pulmonary arterial hypertension associated with systemic sclerosis (SSc-PAH). We designed this work to address this issue. METHODS Treatment-naïve patients with SSc-PAH were prospectively included from two sources: the French PAH Network (a prospective epidemiological cohort) (n=83) and randomised clinical trials submitted for drug approval (Food and Drug Administration) (n=332). Correlations between absolute values of the 6MWD and haemodynamics at baseline, as well as between variations of 6MWD and haemodynamics during follow-up, were studied in both populations. RESULTS In the French cohort, baseline cardiac output (CO) (R(2)=0.19, p=0.001) and New York Heart Association class (R(2)=0.10, p<0.001) were significantly and independently correlated with baseline 6MWD in multivariate analysis. A significant, independent, but weaker, correlation with CO was also found in the Food and Drug Administration sample (R(2)=0.04, p<0.001). During follow-up, there was no association between the changes in 6MWD and haemodynamic parameters in patients under PAH-specific treatments. CONCLUSIONS In SSc-PAH, CO independently correlates with 6MWD at baseline, but accounts for a small amount of the variance of 6MWD in both study samples. This suggests that other non-haemodynamic factors could have an impact on the walk distance. Moreover, variations of 6MWD do not reflect changes in haemodynamics among treated patients. Our results suggest that 6MWD is not an accurate surrogate marker for haemodynamic severity, nor an appropriate outcome measure to assess changes in haemodynamics during follow-up in treated SSc-PAH.
Collapse
Affiliation(s)
- Sébastien Sanges
- Université de Lille, UFR Médecine, Lille, France Département de Médecine Interne et Immunologie Clinique, CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Lille Cedex, France Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), Lille Cedex, France LIRIC, INSERM UMR 995, EA2686, Lille, France
| | - David Launay
- Université de Lille, UFR Médecine, Lille, France Département de Médecine Interne et Immunologie Clinique, CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Lille Cedex, France Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), Lille Cedex, France LIRIC, INSERM UMR 995, EA2686, Lille, France
| | - Rennie L Rhee
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Olivier Sitbon
- Faculté de Médecine, Université Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM U999, Centre Chirurgical Marie-Lannelongue, LabEx LERMIT, Le Plessis-Robinson, France
| | - Éric Hachulla
- Université de Lille, UFR Médecine, Lille, France Département de Médecine Interne et Immunologie Clinique, CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Lille Cedex, France Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), Lille Cedex, France LIRIC, INSERM UMR 995, EA2686, Lille, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence des Vascularites Nécrosantes et de la Sclérodermie Systémique, Université Paris Descartes, Hôpital Cochin, Paris, France
| | - Loïc Guillevin
- Service de Médecine Interne, Centre de Référence des Vascularites Nécrosantes et de la Sclérodermie Systémique, Université Paris Descartes, Hôpital Cochin, Paris, France
| | - Laurence Rottat
- Faculté de Médecine, Université Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM U999, Centre Chirurgical Marie-Lannelongue, LabEx LERMIT, Le Plessis-Robinson, France
| | - David Montani
- Faculté de Médecine, Université Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM U999, Centre Chirurgical Marie-Lannelongue, LabEx LERMIT, Le Plessis-Robinson, France
| | - Pascal De Groote
- Université de Lille, UFR Médecine, Lille, France Pôle Cardio-Vasculaire et Pulmonaire, Clinique de Cardiologie, CHRU de Lille, Lille, France
| | - Vincent Cottin
- Service de Pneumologie, Hospices Civils de Lyon, Centre de Compétence de l'Hypertension Pulmonaire, Centre de Référence des Maladies Pulmonaires Rares, Lyon, France
| | - Pascal Magro
- Service de Pneumologie, Centre Hospitalier Régional Universitaire, Tours, France
| | - Grégoire Prévot
- Pôle des Voies Respiratoires, Hôpital Larrey, Centre Hospitalier Universitaire, Toulouse, France
| | - Fabrice Bauer
- Service de Cardiologie, Hôpital Charles Nicolle, Centre Hospitalier Universitaire, Rouen, France
| | - Emmanuel Bergot
- Service de Pneumologie, Centre Hospitalier Universitaire Côte-de-Nacre, Caen, France
| | - Céline Chabanne
- Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Universitaire Pontchaillou, Université de Rennes I, Rennes, France
| | - Martine Reynaud-Gaubert
- Service de Pneumologie, Centre Hospitalier Universitaire Nord, APHM, Université de la Méditerranée, Marseille, France
| | - Sylvie Leroy
- Service de Pneumologie, Hôpital Pasteur, Centre Hospitalier Universitaire, Université de Nice Sophia Antipolis, Nice, France
| | - Matthieu Canuet
- Service de Pneumologie, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Olivier Sanchez
- AP-HP, Service de Pneumologie et Soins Intensifs, Université Paris Descartes, Hôpital Européen Georges-Pompidou, INSERM UMR-S 1140, Paris, France
| | - Christophe Gut-Gobert
- Service de Médecine Interne et Pneumologie, Centre Hospitalier Universitaire La Cavale Blanche, Brest, France
| | - Claire Dauphin
- Service de Cardiologie et Maladies Vasculaires, Hôpital Gabriel Montpied, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Christophe Pison
- Clinique Universitaire de Pneumologie, Centre Hospitalier Universitaire, Grenoble, France Université Joseph Fourier, Grenoble, France
| | - Clément Boissin
- Service des Maladies Respiratoires, Hôpital Arnaud-de-Villeneuve, Centre Hospitalier Universitaire, Montpellier, France
| | - Gilbert Habib
- Service de Cardiologie, Hôpital de la Timone, Centre Hospitalier Universitaire, Marseille, France
| | - Pierre Clerson
- Soladis Clinical Studies, Biostatistics, Roubaix, France
| | | | - Jean-François Cordier
- Pôle Cardio-Vasculaire et Pulmonaire, Clinique de Cardiologie, CHRU de Lille, Lille, France
| | - Steven M Kawut
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gerald Simonneau
- Faculté de Médecine, Université Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM U999, Centre Chirurgical Marie-Lannelongue, LabEx LERMIT, Le Plessis-Robinson, France
| | - Marc Humbert
- Faculté de Médecine, Université Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM U999, Centre Chirurgical Marie-Lannelongue, LabEx LERMIT, Le Plessis-Robinson, France
| |
Collapse
|
20
|
Girard C, Charles P, Terrier B, Bussonne G, Cohen P, Pagnoux C, Cottin V, Cordier JF, Guillevin L. Tracheobronchial Stenoses in Granulomatosis With Polyangiitis (Wegener's): A Report on 26 Cases. Medicine (Baltimore) 2015; 94:e1088. [PMID: 26266344 PMCID: PMC4616693 DOI: 10.1097/md.0000000000001088] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Tracheobronchial stenoses (TBSs) are potentially severe manifestations of granulomatosis with polyangiitis (Wegener's) (GPA) that usually respond poorly to corticosteroids and immunosuppressive agents. We describe 26 GPA patients with ≥1 tracheal (mainly subglottic, SGS) and/or bronchial stenosis(ses) (BS(s)).Sixteen patients had solitary SGS and 10 had ≥1 BS(s). The male/female sex ratio was 9:17, and the median age at GPA diagnosis was 32 years (3:13 and 28 years, respectively, for SGS patients). Antineutrophil cytoplasm antibodies were proteinase 3-positive in 65.5% of the patients (50% of those with SGS).Despite conventional GPA therapy, 62% patients experienced ≥1 stenosis relapse(s) (81% of SGS patients, for a total of 1-8 relapses per patient). None of the several systemic or endoscopic treatments prevented future relapses. Cyclophosphamide induction therapy was effective in 4/6 patients with BS(s) and in 1 patient with SGS among the 7 treated. After many relapses, rituximab achieved remission in 3/4 SGS patients. Endoscopic treatments (dilation, laser, corticosteroid injection, etc.) had only transient efficacy. Other GPA manifestations relapsed independently of TBSs. One SGS patient died of acute respiratory distress syndrome.Our findings confirmed that TBSs are severe GPA manifestations that evolve independently of other organ involvements and do not respond to conventional systemic regimens. As previously described, our population was younger and comprised more females than usual GPA patients, especially those with SGS.The small number of patients and the wide variety of local and systemic treatments prevent us from drawing definitive conclusions about the contribution of each procedure. However, cyclophosphamide seemed to effectively treat BSs, but not SGS, and rituximab may be of interest for SGS management.
Collapse
Affiliation(s)
- Charlotte Girard
- From the Department of Internal Medicine (CG, PaC, BT, GB, LG), National Referral Center for Rare Autoimmune and Systemic Diseases, Cochin Hospital; INSERM U1060 (CG, PaC, BT, GB, LG), Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, University of Paris 5-René-Descartes, Paris; Department of Internal Medicine (CG), Department of Rheumatology, Mount Sinaï Hospital, Toronto, Ontario, Canada (CP), Edouard-Herriot University Hospital, Lyon; National Referral Center for Rare Pulmonary Diseases (VC, J-FC), Louis-Pradel Hospital, Lyon, France; and Department of Internal Medicine (PiC), Institut Mutualiste Montsouris, Paris
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Affiliation(s)
- Jean-François Cordier
- Dept of Respiratory Diseases, National Reference Center for Rare Pulmonary Diseases, Louis Pradel University Hospital, Claude Bernard University, Lyon, France
| |
Collapse
|
22
|
Humbert S, Guilpain P, Puéchal X, Terrier B, Rivière S, Mahr A, Pagnoux C, Bagnères D, Cordier JF, Le Quellec A, Altwegg R, Guillevin L. Inflammatory bowel diseases in anti-neutrophil cytoplasmic antibody-associated vasculitides: 11 retrospective cases from the French Vasculitis Study Group. Rheumatology (Oxford) 2015; 54:1970-5. [PMID: 26106214 DOI: 10.1093/rheumatology/kev199] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 04/07/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Coexistence of ANCA-associated vasculitis (AAV) and IBD is a rare condition that is rarely described in the literature. The aim of the study was to describe the main characteristics of patients presenting with both IBD and AAV. METHODS A retrospective study of AAV patients in the French Vasculitis Study Group cohort who also had a diagnosis of IBD was conducted. We reviewed the medical records and outcomes of these patients. RESULTS We identified 11 patients with AAV and IBD. Four patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss) also had ulcerative colitis and seven patients with granulomatosis with polyangiitis (GPA) had Crohn's disease. No Crohn's disease was observed in eosinophilic GPA and no ulcerative colitis in GPA. IBD started before AAV manifestations in six cases, simultaneously in two cases and after AAV manifestations in three cases. CONCLUSION Coexistence of IBD and AAV is a rare condition. The therapeutic management of these patients includes corticosteroids in all cases and immunosuppressive drugs in some patients. Coexistence of IBD and AAV might be explained by common underlying inflammatory responses and cytokine profiles polarized towards either Th1 or Th2. Finally, in the presence of digestive manifestations in the context of AAV, the hypothesis of IBD should be assessed.
Collapse
Affiliation(s)
- Sébastien Humbert
- Service de Médecine Interne, Université Montpellier 1, Maladies Multi-organiques, centre de compétence des maladies systémiques et auto-immunes rares de l'adulte, Hôpital Saint-Eloi, CHRU de Montpellier, Montpellier
| | - Philippe Guilpain
- Service de Médecine Interne, Université Montpellier 1, Maladies Multi-organiques, centre de compétence des maladies systémiques et auto-immunes rares de l'adulte, Hôpital Saint-Eloi, CHRU de Montpellier, Montpellier,
| | - Xavier Puéchal
- Faculté de Médecine, Université Paris Descartes, Pôle de Médecine Interne et Centre National de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, APHP, Paris
| | - Benjamin Terrier
- Faculté de Médecine, Université Paris Descartes, Pôle de Médecine Interne et Centre National de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, APHP, Paris
| | - Sophie Rivière
- Service de Médecine Interne, Université Montpellier 1, Maladies Multi-organiques, centre de compétence des maladies systémiques et auto-immunes rares de l'adulte, Hôpital Saint-Eloi, CHRU de Montpellier, Montpellier
| | - Alfred Mahr
- Service de Médecine Interne, Hôpital Saint-Louis, Université Paris 7, APHP, Paris
| | - Christian Pagnoux
- Faculté de Médecine, Université Paris Descartes, Pôle de Médecine Interne et Centre National de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, APHP, Paris
| | - Denis Bagnères
- Service de médecine interne, hôpital Nord, Assistance publique-Hôpitaux de Marseille, Marseille
| | - Jean-François Cordier
- Service de Pneumologie, Centre de Référence des Maladies Orphelines Pulmonaires, Hôpital Louis Pradel, Université Lyon I, Hospices Civils de Lyon, Lyon and
| | - Alain Le Quellec
- Service de Médecine Interne, Université Montpellier 1, Maladies Multi-organiques, centre de compétence des maladies systémiques et auto-immunes rares de l'adulte, Hôpital Saint-Eloi, CHRU de Montpellier, Montpellier
| | - Romain Altwegg
- Département d'Hépato-Gastroentérologie, Hôpital Saint-Eloi, Université Montpellier 1, CHRU de Montpellier, Montpellier, France
| | - Loïc Guillevin
- Faculté de Médecine, Université Paris Descartes, Pôle de Médecine Interne et Centre National de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, APHP, Paris
| | | |
Collapse
|
23
|
Rabeyrin M, Thivolet F, Ferretti GR, Chalabreysse L, Jankowski A, Cottin V, Pison C, Cordier JF, Lantuejoul S. Usual interstitial pneumonia end-stage features from explants with radiologic and pathological correlations. Ann Diagn Pathol 2015; 19:269-76. [PMID: 26025258 DOI: 10.1016/j.anndiagpath.2015.05.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 01/21/2015] [Revised: 04/20/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is the most frequent and severe idiopathic interstitial pneumonia, with typical high-resolution computed tomography (HRCT) features and histologic pattern of usual interstitial pneumonia (UIP); its main differential diagnosis is fibrotic nonspecific interstitial pneumonia (F-NSIP). Usual interstitial pneumonia was mainly described from lung biopsies, and little is known on explants. Twenty-two UIP/IPF explants were analyzed histologically and compared with previous open lung biopsies (OLBs; n = 11) and HRCT (n = 19), when available. Temporospatial heterogeneity and subpleural and paraseptal fibrosis were similarly found in UIP/IPF explants and OLB (91%-95%). Fibroblastic foci were found in 82% of OLBs and 100% of explants, with a higher mean score in explants (P = .023). Honeycombing was present in 64% of OLBs and 95% of explants, with a higher mean score in explants (P = .005). Almost 60% of UIP/IPF explants showed NSIP areas and 41% peribronchiolar fibrosis; inflammation, bronchiolar metaplasia, and vascular changes were more frequent in UIP/IPF explants; and Desquamative Interstitial Pneumonia (DIP)-like areas were not common (18%-27%). Numerous large airspace enlargements with fibrosis were frequent in UIP/IPF explants (59%). On HRCT, honeycombing was observed in 95% of the cases and ground-glass opacities in 53%, correlating with NSIP areas or acute exacerbation at histology. Six patients had combined IPF and emphysema. Lesions were more severe in UIP/IPF explants, reflecting the worsening of the disease. Usual interstitial pneumonia/IPF explants more frequently presented with confounding lesions such as NSIP areas, peribronchiolar fibrosis, and airspace enlargements with fibrosis sometimes associated with emphysema.
Collapse
Affiliation(s)
- Maud Rabeyrin
- Département de Pathologie, Pôle de Biologie et de Pathologie, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France
| | - Françoise Thivolet
- Centre de Pathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, Université Claude Bernard Lyon I, Inserm UMR 754 and IFR 128, Lyon, France
| | - Gilbert R Ferretti
- Clinique Universitaire de Radiologie et Imagerie Médicale, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France
| | - Lara Chalabreysse
- Centre de Pathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, Université Claude Bernard Lyon I, Inserm UMR 754 and IFR 128, Lyon, France
| | - Adrien Jankowski
- Clinique Universitaire de Radiologie et Imagerie Médicale, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France
| | - Vincent Cottin
- Service de Pneumologie, Centre de référence national des maladies pulmonaires rares, Hospices Civils de Lyon, Hôpital Louis Pradel, Université Claude Bernard Lyon I, UMR754 and IFR128, Lyon, France
| | - Christophe Pison
- Clinique Universitaire de Pneumologie, Pôle Oncologie, Médecine Aiguë et Communautaire, Centre Hospitalier Universitaire, Inserm U1055, Université Joseph Fourier, Grenoble, France
| | - Jean-François Cordier
- Service de Pneumologie, Centre de référence national des maladies pulmonaires rares, Hospices Civils de Lyon, Hôpital Louis Pradel, Université Claude Bernard Lyon I, UMR754 and IFR128, Lyon, France
| | - Sylvie Lantuejoul
- Département de Pathologie, Pôle de Biologie et de Pathologie, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France.
| |
Collapse
|
24
|
Cottin V, Crestani B, Valeyre D, Wallaert B, Cadranel J, Dalphin JC, Delaval P, Israel-Biet D, Kessler R, Reynaud-Gaubert M, Aguilaniu B, Bouquillon B, Carré P, Danel C, Faivre JB, Ferretti G, Just N, Kouzan S, Lebargy F, Marchand-Adam S, Philippe B, Prévot G, Stach B, Thivolet-Béjui F, Cordier JF. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines. Eur Respir Rev 2015; 23:193-214. [PMID: 24881074 DOI: 10.1183/09059180.00001814] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is the most frequent chronic idiopathic interstitial pneumonia in adults. The management of rare diseases in France has been organised by a national plan for rare diseases, which endorsed a network of expert centres for rare diseases throughout France. This article is an overview of the executive summary of the French guidelines for the management of IPF, an initiative that emanated from the French National Reference Centre and the Network of Regional Competence Centres for Rare Lung Diseases. This review aims at providing pulmonologists with a document that: 1) combines the current available evidence; 2) reviews practical modalities of diagnosis and management of IPF; and 3) is adapted to everyday medical practice. The French practical guidelines result from the combined efforts of a coordination committee, a writing committee and a multidisciplinary review panel, following recommendations from the Haute Autorité de Santé. All recommendations included in this article received at least 90% agreement by the reviewing panel. Herein, we summarise the main conclusions and practical recommendations of the French guidelines.
Collapse
Affiliation(s)
- Vincent Cottin
- For a full list of the authors affiliations see the Acknowledgements section
| | - Bruno Crestani
- For a full list of the authors affiliations see the Acknowledgements section
| | - Dominique Valeyre
- For a full list of the authors affiliations see the Acknowledgements section
| | - Benoit Wallaert
- For a full list of the authors affiliations see the Acknowledgements section
| | - Jacques Cadranel
- For a full list of the authors affiliations see the Acknowledgements section
| | | | - Philippe Delaval
- For a full list of the authors affiliations see the Acknowledgements section
| | | | - Romain Kessler
- For a full list of the authors affiliations see the Acknowledgements section
| | | | - Bernard Aguilaniu
- For a full list of the authors affiliations see the Acknowledgements section
| | - Benoit Bouquillon
- For a full list of the authors affiliations see the Acknowledgements section
| | - Philippe Carré
- For a full list of the authors affiliations see the Acknowledgements section
| | - Claire Danel
- For a full list of the authors affiliations see the Acknowledgements section
| | | | - Gilbert Ferretti
- For a full list of the authors affiliations see the Acknowledgements section
| | - Nicolas Just
- For a full list of the authors affiliations see the Acknowledgements section
| | - Serge Kouzan
- For a full list of the authors affiliations see the Acknowledgements section
| | - François Lebargy
- For a full list of the authors affiliations see the Acknowledgements section
| | | | - Bruno Philippe
- For a full list of the authors affiliations see the Acknowledgements section
| | - Grégoire Prévot
- For a full list of the authors affiliations see the Acknowledgements section
| | - Bruno Stach
- For a full list of the authors affiliations see the Acknowledgements section
| | | | | | | | | |
Collapse
|
25
|
Cottin V, Cordier JF. Eosinophilic Pneumonia. Orphan Lung Diseases 2015. [PMCID: PMC7121898 DOI: 10.1007/978-1-4471-2401-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Eosinophilic pneumonia may manifest as chronic or transient infiltrates with mild symptoms, chronic idiopathic eosinophilic pneumonia, or the frequently severe acute eosinophilic pneumonia that may be secondary to a variety of causes (drug intake, new onset of tobacco smoking, infection) and that may necessitate mechanical ventilation. When present, blood eosinophilia greater than 1 × 109 eosinophils/L (and preferably greater than 1.5 × 109/L) is of considerable help for suggesting the diagnosis, however it may be absent, as in the early phase of idiopathic acute eosinophilic pneumonia or when patients are already taking corticosteroids. On bronchoalveolar lavage, high eosinophilia (>25 %, and preferably >40 % of differential cell count) is considered diagnostic of eosinophilic pneumonia in a compatible setting, obviating the need of video-assisted thoracic surgical lung biopsy, which is now performed only on very rare occasions with inconsistency between clinical, biological, and imaging features. Inquiry as to drug intake must be meticulous (www.pneumotox.com) and any suspected drug should be withdrawn. Laboratory investigations for parasitic causes must take into account the travel history or residence and the epidemiology of parasites. In patients with associated extrathoracic manifestations, the diagnosis of eosinophilic granulomatosis with polyangiitis or of the hypereosinophilic syndromes should be raised. Presence of airflow obstruction can be found in hypereosinophilic asthma, allergic bronchopulmonary aspergillosis, idiopathic chronic eosinophilic pneumonia, eosinophilic granulomatosis with polyangiitis, or in the recently identified syndrome of hyperosinophilic obliterative bronchiolitis. Corticosteroids remain the cornerstone of symptomatic treatment for eosinophilic pneumonias, with a generally dramatic response. Relapses are common when tapering the doses or after stopping treatment especially in idiopathic chronic eosinophilic pneumonia. Cyclophosphamide is necessary only in patients with eosinophilic granulomatosis with polyangiitis and poor-prognostic factors. Imatinib is very effective in the treatment of the myeloproliferative variant of hypereosinophilic syndromes. Anti-interleukin-5 monoclonal antibodies are promising in the spectrum of eosinophilic disorders.
Collapse
|
26
|
Cordier JF. [Not Available]. Rev Prat 2015; 65:28. [PMID: 25842420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
27
|
Courand PY, Pina Jomir G, Khouatra C, Scheiber C, Turquier S, Glérant JC, Mastroianni B, Gentil B, Blanchet-Legens AS, Dib A, Derumeaux G, Humbert M, Mornex JF, Cordier JF, Cottin V. Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension. Eur Respir J 2014; 45:139-49. [PMID: 25537560 DOI: 10.1183/09031936.00158014] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Right ventricle ejection fraction (RVEF) evaluated with magnetic resonance imaging is a strong determinant of patient outcomes in pulmonary arterial hypertension. We evaluated the prognostic value of RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change 3-6 months after initiating pulmonary arterial hypertension-specific therapy. In a prospective cohort of newly diagnosed patients with idiopathic, heritable or anorexigen-associated pulmonary arterial hypertension, RVEF was measured at baseline (n=100) and 3-6 months after initiation of therapy (n=78). After a median follow-up of 4.1 years, 41 deaths occurred, including 35 from cardiovascular causes. Patients with a (median) baseline RVEF >25% had better survival than those with a RVEF <25% using Kaplan-Meier analysis (p=0.010). RVEF at baseline was an independent predictor of all-cause and cardiovascular mortality in adjusted Cox regression model (p=0.002 and p=0.007, respectively; HR 0.93 for both). Patients with stable or increased RVEF at 3-6 months had a trend for improved all-cause survival (HR 2.43, p=0.086) and had less cardiovascular mortality (HR 3.25, p=0.034) than those in whom RVEF decreased despite therapy. RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change in RVEF 3-6 months after therapy initiation independently predict outcomes in patients with pulmonary arterial hypertension.
Collapse
Affiliation(s)
- Pierre-Yves Courand
- Dept of Cardiology, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Géraldine Pina Jomir
- Dept of Nuclear Medicine, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France
| | - Chahéra Khouatra
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France
| | - Christian Scheiber
- Dept of Nuclear Medicine, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France
| | - Ségolène Turquier
- Dept of Respiratory Physiology, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France
| | - Jean-Charles Glérant
- Dept of Respiratory Physiology, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France
| | - Bénédicte Mastroianni
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France
| | - Béatrice Gentil
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France
| | - Anne-Sophie Blanchet-Legens
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France
| | - Alfred Dib
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France
| | - Geneviève Derumeaux
- Dept of Echocardiography, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France
| | - Marc Humbert
- Univ. Paris-Sud, Le Kremlin-Bicêtre, France. AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Jean-François Mornex
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France
| | - Jean-François Cordier
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France
| | - Vincent Cottin
- Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France.
| |
Collapse
|
28
|
Grobost V, Khouatra C, Lazor R, Cordier JF, Cottin V. Effectiveness of cladribine therapy in patients with pulmonary Langerhans cell histiocytosis. Orphanet J Rare Dis 2014; 9:191. [PMID: 25433492 PMCID: PMC4268858 DOI: 10.1186/s13023-014-0191-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 11/11/2014] [Indexed: 12/27/2022] Open
Abstract
Background Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disorder characterised by granulomatous proliferation of CD1a-positive histiocytes forming granulomas within lung parenchyma, in strong association with tobacco smoking, and which may result in chronic respiratory failure. Smoking cessation is considered to be critical in management, but has variable effects on outcome. No drug therapy has been validated. Cladribine (chlorodeoxyadenosine, 2-CDA) down-regulates histiocyte proliferation and has been successful in curbing multi-system Langerhans cell histiocytosis and isolated PLCH. Methods and patients We retrospectively studied 5 patients (aged 37–55 years, 3 females) with PLCH who received 3 to 4 courses of cladribine therapy as a single agent (0.1 mg/kg per day for 5 consecutive days at monthly intervals). One patient was treated twice because of relapse at 1 year. Progressive pulmonary disease with obstructive ventilatory pattern despite smoking cessation and/or corticosteroid therapy were indications for treatment. Patients were administered oral trimethoprim/sulfamethoxazole and valaciclovir to prevent opportunistic infections. They gave written consent to receive off-label cladribine in the absence of validated treatment. Results Functional class dyspnea improved with cladribine therapy in 4 out of 5 cases, and forced expiratory volume in 1 second (FEV1) increased in all cases by a mean of 387 ml (100–920 ml), contrasting with a steady decline prior to treatment. Chest high-resolution computed tomography (HRCT) features improved with cladribine therapy in 4 patients. Hemodynamic improvement was observed in 1 patient with pre-capillary pulmonary hypertension. The results suggested a greater treatment effect in subjects with nodular lung lesions and/or thick-walled cysts on chest HRCT, with diffuse hypermetabolism of lung lesions on positron emission tomography (PET)-scan, and with progressive disease despite smoking cessation. Infectious pneumonia developed in 1 patient, with later grade 4 neutrocytopenia but without infection. Discussion Data interpretation was limited by the retrospective, uncontrolled study design and small sample size. Conclusion Cladribine as a single agent may be effective therapy in patients with progressive PLCH.
Collapse
Affiliation(s)
- Vincent Grobost
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France.
| | - Chahera Khouatra
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France.
| | - Romain Lazor
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France. .,Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Jean-François Cordier
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France.
| | - Vincent Cottin
- National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, Louis Pradel Hospital; Claude Bernard Lyon 1 University, Lyon, UMR 754, France. .,Hospices Civils de Lyon, Hôpital Louis Pradel, Centre national de référence des maladies pulmonaires rares, Centre de compétences de l'hypertension pulmonaire, Service de pneumologie, Université de Lyon, Université Claude Bernard Lyon 1, INRA, Lyon, UMR754, France.
| |
Collapse
|
29
|
Borie R, Kannengiesser C, Hirschi S, Le Pavec J, Mal H, Bergot E, Jouneau S, Naccache JM, Revy P, Boutboul D, Peffault de la Tour R, Wemeau-Stervinou L, Philit F, Cordier JF, Thabut G, Crestani B, Cottin V. Severe hematologic complications after lung transplantation in patients with telomerase complex mutations. J Heart Lung Transplant 2014; 34:538-46. [PMID: 25612863 DOI: 10.1016/j.healun.2014.11.010] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [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: 07/08/2014] [Revised: 10/29/2014] [Accepted: 11/04/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Mutations in the telomerase complex (TERT and TR) are associated with pulmonary fibrosis and frequent hematologic manifestations. The aim of this study was to characterize the prognosis of lung transplantation in patients with TERT or TR mutations. METHODS Patients with documented TERT or TR mutations who received a lung transplant between 2007 and 2013 in France were identified via an exhaustive search of the lung transplantation network, one expert genetic laboratory, and the clinical research network on rare pulmonary diseases. RESULTS There were 9 patients (7 men) with TERT (n = 6) or TR (n = 3) mutations who received a single (n = 8) or a double (n = 1) lung transplant for pulmonary fibrosis. Median age was 50 years (range, 35-61 years) at diagnosis and 52 years (range, 37-62 years) at the time of lung transplantation. Thrombocytopenia was present in 7 patients before lung transplantation. After lung transplantation, 6 patients developed myelodysplasia and/or bone marrow failure, directly contributing to death in 4 cases. Anemia was observed in 9 patients, and neutropenia was observed in 3 patients. The median survival after lung transplantation was 214 days (range, 59-1,709 days). CONCLUSIONS Patients with mutations of the telomerase complex are at high risk of severe hematologic complications after lung transplantation, in particular, bone marrow failure. Specific recommendations should be developed for appropriate guidance regarding hematologic risk assessment before transplantation and management of the post-transplantation immunosuppressive regimen.
Collapse
Affiliation(s)
- Raphael Borie
- APHP, Hôpital Bichat, DHU FIRE Service de Pneumologie A, Centre de compétence des maladies pulmonaires rares, INSERM, Unité 1152, Université Paris Diderot, Paris, France
| | | | - Sandrine Hirschi
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jérôme Le Pavec
- Service de chirurgie thoracique et de transplantation pulmonaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France
| | - Hervé Mal
- Service de Pneumologie B, APHP, Hôpital Bichat, Paris, France
| | | | - Stéphane Jouneau
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpital Pontchaillou, IRSET UMR 1085, Université de Rennes 1, Rennes, France
| | - Jean-Marc Naccache
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, Hôpital Tenon, Paris, France
| | - Patrick Revy
- INSERM UMR 1163, Laboratory of Genome Dynamics in the Immune System, Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - David Boutboul
- Service d'Immunopathologie clinique, APHP, Hôpital St Louis, Paris, France
| | - Régis Peffault de la Tour
- Service d'Hématologie greffe, centre de référence maladie rare aplasie médullaire, APHP, Hôpital St Louis, Paris, France
| | - Lidwine Wemeau-Stervinou
- Service de Pneumologie, Centre de compétence des maladies pulmonaires rares, CHRU de Lille, Lille, France
| | - Francois Philit
- Service de Pneumologie, Centre national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | - Jean-François Cordier
- Service de Pneumologie, Centre national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | - Gabriel Thabut
- Service de chirurgie thoracique et de transplantation pulmonaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France
| | - Bruno Crestani
- APHP, Hôpital Bichat, DHU FIRE Service de Pneumologie A, Centre de compétence des maladies pulmonaires rares, INSERM, Unité 1152, Université Paris Diderot, Paris, France.
| | - Vincent Cottin
- Service de Pneumologie, Centre national de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, Lyon, France
| | | |
Collapse
|
30
|
Cordier JF. [Not Available]. Bull Acad Natl Med 2014; 198:1353-1366. [PMID: 27120908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Idiopathic pulmonary fibrosis usually develops after 60 years of age, especially in men, leading to progressive exercise dyspnea. Median survival is about 3 years after diagnosis. This disease emerged in the middle of the last century and is linked to smoking. Mutations of genes encoding surfactant proteins and the telomerase complex may occasionally be present. International diagnostic criteria based on histopathology and computed tomography (CT) define the diagnosis as definite, probable or possible. Recent treatments (pirfenidone and nintedanib) have proven beneficial. Therapeutic advances warrant earlier diagnosis, based on Velcro crackles on pulmonary auscultation or interstitial opacities on CT screening for lung cancer.
Collapse
|
31
|
Cordier JF. [Interstitial lung diseases. A turning point in diagnosis and treatment]. Rev Prat 2014; 64:915-916. [PMID: 25362767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
32
|
Cordier JF. [Wikipedia: a reliable medical reference?]. Rev Prat 2014; 64:913. [PMID: 25362765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
33
|
Lega JC, Fabien N, Reynaud Q, Durieu I, Durupt S, Dutertre M, Cordier JF, Cottin V. The clinical phenotype associated with myositis-specific and associated autoantibodies: A meta-analysis revisiting the so-called antisynthetase syndrome. Autoimmun Rev 2014; 13:883-91. [DOI: 10.1016/j.autrev.2014.03.004] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/30/2014] [Indexed: 10/25/2022]
|
34
|
Affiliation(s)
- Charlotte Girard
- Hôpital Louis Pradel, Claude Bernard Lyon 1 University, Lyon, France
| | | | | | | |
Collapse
|
35
|
Gerfaud-Valentin M, Reboux G, Traclet J, Thivolet-Béjui F, Cordier JF, Cottin V. Occupational hypersensitivity pneumonitis in a baker: a new cause. Chest 2014; 145:856-858. [PMID: 24687706 DOI: 10.1378/chest.13-1734] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Bakers are exposed daily to flour and may be susceptible to immunologic occupational diseases. A 30-year-old, nonsmoking, female baker was referred for progressive dyspnea on exertion, basal crackles on auscultation, restrictive lung function, decreased diffusing capacity of the lung for carbon monoxide, ground glass hyperdensities with a mosaic pattern on high-resolution CT scan, 25% lymphocytosis by BAL, and cellular chronic bronchiolitis with peribronchiolar interstitial inflammation by lung biopsy specimen. Cultures from flours isolated nine species, including Aspergillus fumigatus. Twenty-six antigens were tested. Serum-specific precipitins were found against A fumigatus, the flour mite Acarus siro, and total extracts from maize and oat. Outcome was favorable with cessation of occupational exposure to flours and transient therapy with prednisone and immunosuppressive agents. To our knowledge, this report is the first of a well-documented case of hypersensitivity pneumonitis due to sensitization to fungi- and mite-contaminated flours. Hypersensitivity pneumonitis--and not only asthma and allergic rhinitis--should be suspected in bakers with respiratory symptoms.
Collapse
Affiliation(s)
- Mathieu Gerfaud-Valentin
- Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Pneumologie-Centre de référence national des maladies pulmonaires rares, Université Claude Bernard Lyon 1, Lyon
| | - Gabriel Reboux
- Laboratoire de parasitologie et mycologie, Centre hospitalier universitaire Jean Minjoz, Besançon
| | - Julie Traclet
- Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Pneumologie-Centre de référence national des maladies pulmonaires rares, Université Claude Bernard Lyon 1, Lyon
| | - Françoise Thivolet-Béjui
- Hospices Civils de Lyon, Groupe hospitalier est, Centre de biologie et pathologie est, Université Claude Bernard Lyon 1, Lyon, France
| | - Jean-François Cordier
- Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Pneumologie-Centre de référence national des maladies pulmonaires rares, Université Claude Bernard Lyon 1, Lyon
| | - Vincent Cottin
- Hospices Civils de Lyon, Hôpital Louis Pradel, Service de Pneumologie-Centre de référence national des maladies pulmonaires rares, Université Claude Bernard Lyon 1, Lyon.
| |
Collapse
|
36
|
Cordier JF. [Tobacco weaning in the pregnant woman: failure of nicotine patches]. Rev Prat 2014; 64:769. [PMID: 25090756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
37
|
Chanson P, Cordier JF, Pariente A. [Initial treatment of type 2 diabetes: metformin also for the Chinese!]. Rev Prat 2014; 64:470. [PMID: 24855777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
38
|
Chanson P, Cordier JF, Pariente A. [Not Available]. Rev Prat 2014; 64:472. [PMID: 24855779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
39
|
Chanson P, Cordier JF, Pariente A. [Not Available]. Rev Prat 2014; 64:469. [PMID: 24855776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
40
|
Cordier JF, Cottin V, Khouatra C, Revel D. Screening for lung cancer and idiopathic pulmonary fibrosis: killing two birds with one stone. Radiology 2014; 270:630-1. [PMID: 24471399 DOI: 10.1148/radiol.13131866] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jean-François Cordier
- Department of Respiratory Medicine and National Reference Center for Rare Pulmonary Diseases * and Department of Radiology, † Louis Pradel University Hospital, 28 avenue Doyen Lepine, F-69677 Lyon, France
| | | | | | | |
Collapse
|
41
|
Cordier JF. [Air pollution and acute coronary artery diseases incidence]. Rev Prat 2014; 64:324. [PMID: 24851364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
42
|
Cordier JF. [Effect of beta blockers on mortality after myocardial infarctions in adults with COPD: improved survival]. Rev Prat 2014; 64:184. [PMID: 24701877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
43
|
Cordier JF. [The expert patient]. Rev Prat 2013; 63:1335. [PMID: 24579319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
44
|
|
45
|
Comarmond C, Pagnoux C, Khellaf M, Cordier JF, Hamidou M, Viallard JF, Maurier F, Jouneau S, Bienvenu B, Puéchal X, Aumaître O, Le Guenno G, Le Quellec A, Cevallos R, Fain O, Godeau B, Seror R, Dunogué B, Mahr A, Guilpain P, Cohen P, Aouba A, Mouthon L, Guillevin L. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort. ACTA ACUST UNITED AC 2013; 65:270-81. [PMID: 23044708 DOI: 10.1002/art.37721] [Citation(s) in RCA: 508] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 09/20/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Earlier studies of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA), with limited patient numbers and followup durations, demonstrated that clinical presentation at diagnosis, but not outcome, differed according to antineutrophil cytoplasmic antibody (ANCA) status. This study was undertaken to describe the main characteristics of a larger patient cohort and their long-term outcomes. METHODS A retrospective study of EGPA patients in the French Vasculitis Study Group cohort who satisfied the American College of Rheumatology criteria and/or Chapel Hill definitions was conducted. Patient characteristics and outcomes were compared according to ANCA status and year of diagnosis. RESULTS We identified 383 patients diagnosed between 1957 and June 2009 (128 [33.4%] before 1997 or earlier) and followed up for a mean±SD of 66.8±62.5 months. At diagnosis, their mean±SD age was 50.3±15.7 years, and 91.1% had asthma (duration 9.3±10.8 years). Main manifestations included peripheral neuropathy (51.4%); ear, nose, and throat (ENT) signs (48.0%); skin lesions (39.7%); lung infiltrates (38.6%); and cardiomyopathy (16.4%). Among the 348 patients tested at diagnosis for ANCA, the 108 ANCA-positive patients (31.0%) had significantly more frequent ENT manifestations, peripheral neuropathy, and/or renal involvement, but less frequent cardiac manifestations, than the ANCA-negative patients. Vasculitis relapses occurred in 35.2% of the ANCA-positive versus 22.5% of the ANCA-negative patients (P=0.01), and 5.6% versus 12.5%, respectively, died (P<0.05). The 5-year relapse-free survival rate was 58.1% (95% confidence interval [95% CI] 45.6-68.6) for ANCA-positive and 67.8% (95% CI 59.8-74.5) for ANCA-negative patients (P=0.35). Multivariable analysis identified cardiomyopathy, older age, and diagnosis during or prior to 1996 as independent risk factors for death and lower eosinophil count at diagnosis as predictive of relapse. CONCLUSION The characteristics and long-term outcomes of EGPA patients differ according to their ANCA status. Although EGPA relapses remain frequent, mortality has declined, at least since 1996.
Collapse
Affiliation(s)
- Cloé Comarmond
- Hôpital Cochin, AP-HP, and Université Paris Descartes, Paris 5, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Cottin V, Lazor R, Cordier JF. Adult pulmonary Langerhans’ cell histiocytosis. Respir Med 2013. [DOI: 10.1183/9781849840415.008912] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
47
|
Cottin V, Lazor R, Cordier JF. Lymphangioleiomyomatosis. Respir Med 2013. [DOI: 10.1183/9781849840415.009012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
48
|
Ernande L, Cottin V, Leroux PY, Girerd N, Huez S, Mulliez A, Bergerot C, Ovize M, Mornex JF, Cordier JF, Naeije R, Derumeaux G. Right isovolumic contraction velocity predicts survival in pulmonary hypertension. J Am Soc Echocardiogr 2012; 26:297-306. [PMID: 23265440 DOI: 10.1016/j.echo.2012.11.011] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [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] [Received: 02/16/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Right ventricular function is a strong determinant of prognosis in severe pulmonary hypertension. METHODS The aim of this study was to evaluate the prognostic value of estimates of right ventricular function obtained by echocardiography and Doppler tissue imaging and of functional class and 6-min walk distance (6MWD) in 142 patients with either pulmonary arterial hypertension (n = 104) or chronic thromboembolic pulmonary hypertension (n = 38). Echocardiography was prospectively performed, and demographics, medications, associated medical conditions, New York Heart Association class, and 6MWD at inclusion in addition to vital status, transplantation, and hospital admission related to pulmonary hypertension at follow-up were then collected by review of the medical records. RESULTS Variables associated with overall survival by univariate analysis were 6MWD (P = .009), functional class (P = .024), tricuspid annular plane systolic excursion (P = .03) and isovolumic peak velocity at the tricuspid annulus (IVCv) (P = .003). On multivariate analysis, IVCv (P = .015) and 6MWD (P = .016) were the only independent predictors of survival. Kaplan-Meier estimates of survival at 1 year were 95% in patients with IVCv > 9 cm/sec and 80% in those with IVCv ≤ 9 cm/sec (P = .002). Intraobserver and interobserver variability of IVCv measurement were 5% and 9%, respectively. CONCLUSIONS Measurement of right ventricular function by Doppler tissue imaging, an easy, noninvasive, and reproducible method, is an independent predictor of clinical outcomes in patients with severe pulmonary hypertension.
Collapse
Affiliation(s)
- Laura Ernande
- Explorations Fonctionnelles Cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Cordier JF, Cottin V, Khouatra C, Revel D, Proust C, Freymond N, Thivolet-Béjui F, Glérant JC. Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome. Eur Respir J 2012; 41:1126-34. [PMID: 23258778 DOI: 10.1183/09031936.00099812] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Biopsy-proven cases of eosinophilic bronchiolitis have only been reported in isolation, and all come from Japan. We present six patients with hypereosinophilic obliterative bronchiolitis (HOB), defined by the following criteria: 1) blood eosinophil cell count >1 G·L(-1) and/or bronchoalveolar lavage eosinophil count >25%; 2) persistent airflow obstruction despite high-dose inhaled bronchodilators and corticosteroids; and 3) eosinophilic bronchiolitis at lung biopsy (n=1) and/or direct signs of bronchiolitis (centrilobular nodules and branching opacities) on computed tomography (n=6). Chronic dyspnoea and cough which was often severe, without the characteristic features of asthma, were the main clinical manifestations. Atopy and asthma were present in the history of three and two patients, respectively. One patient met biological criteria of the lymphoid variant of idiopathic hypereosinophilic syndrome. Mean blood eosinophil cell count was 2.7 G·L(-1) and mean eosinophil differential percentage at bronchoalveolar lavage was 63%. Mean initial forced expiratory volume in 1 s/forced vital capacity ratio was 50%, normalising with oral corticosteroid therapy in all patients. HOB manifestations recurred when oral prednisone was decreased to 10-20 mg·day(-1), but higher doses controlled the disease. HOB is a characteristic entity deserving to be individualised among the eosinophilic respiratory disorders. Thorough analysis is needed to determine whether unrecognised and/or smouldering HOB may further be a cause of irreversible airflow obstruction in chronic eosinophilic respiratory diseases.
Collapse
Affiliation(s)
- Jean-François Cordier
- National Reference Centre for Rare Pulmonary Diseases, Louis Pradel University Hospital, Lyon, France.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Launay D, Sitbon O, Hachulla E, Mouthon L, Gressin V, Rottat L, Clerson P, Cordier JF, Simonneau G, Humbert M. Survival in systemic sclerosis-associated pulmonary arterial hypertension in the modern management era. Ann Rheum Dis 2012. [PMID: 23178295 PMCID: PMC3841769 DOI: 10.1136/annrheumdis-2012-202489] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [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] [Indexed: 11/16/2022]
Abstract
Objective To assess the survival and prognostic factors in patients with newly diagnosed incident systemic sclerosis (SSc)–associated pulmonary arterial hypertension (PAH) in the modern management era. Methods Prospectively enrolled SSc patients in the French PAH Network between January 2006 and November 2009, with newly diagnosed PAH and no interstitial lung disease, were analysed (85 patients, mean age 64.9±12.2 years). Median follow-up after PAH diagnosis was 2.32 years. Results A majority of patients were in NYHA functional class III–IV (79%). Overall survival was 90% (95% CI 81% to 95%), 78% (95% CI 67% to 86%) and 56% (95% CI 42% to 68%) at 1, 2 and 3 years from PAH diagnosis, respectively. Age (HR: 1.05, 95% CI 1.01 to 1.09, p=0.012) and cardiac index (HR: 0.49, 95% CI 0.27 to 0.89, p=0.019) were significant predictors in the univariate analysis. We also observed strong trends for gender, SSc subtypes, New York Heart Association functional class, pulmonary vascular resistance and capacitance to be significant predictors in the univariate analysis. Conversely, six-min walk distance, mean pulmonary arterial and right atrial pressures were not significant predictors. In the multivariate model, gender was the only independent factor associated with survival (HR: 4.76, 95% CI 1.35 to 16.66, p=0.015 for male gender). Conclusions Incident SSc-associated PAH remains a devastating disease even in the modern management era. Age, male gender and cardiac index were the main prognosis factors in this cohort of patients. Early detection of less severe patients should be a priority.
Collapse
Affiliation(s)
- David Launay
- Service de Médecine Interne, Centre de référence de la sclérodermie systémique, Université Lille Nord de France, Hôpital Claude-Huriez, , Lille, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|