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Huang F, Khellaf LR, Lefèvre G, Berti A, d'Humières T, Sionis A, Solé AA, Bello F, Bermeo Garrido JA, Crickx E, Delvino P, Emmi G, Gaillet A, Garcia G, Gavand PE, George JL, Gilles F, Golden C, de Groote P, Guffroy A, Martis N, Monti S, Mourlanette P, Pineton de Chambrun M, Prunier F, Regola F, Seret G, Terrier B, Tréfond L, Souteyrand G, Varenne O, Zilio F, Haziza F, Benamer H, Kahn JE, Vallée A, Groh M. Clinical picture, outcomes, and predictors of relapse in eosinophilia-associated coronary vasospasm: Data from a European multicentric study. J Allergy Clin Immunol Pract 2024; 12:1377-1381.e2. [PMID: 38307204 DOI: 10.1016/j.jaip.2024.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Affiliation(s)
- Florent Huang
- ACTION Study Group, Department of Cardiology, Foch Hospital, Suresnes, France; French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Lucas Rémi Khellaf
- French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Guillaume Lefèvre
- French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France; Department of Internal Medicine and Clinical Immunology, University of Lille, CHU de Lille, Lille, France; Inserm U1286 Institute for Translational Research in Inflammation, University of Lille, CHU Lille, Lille, France
| | - Alvise Berti
- Center for Medical Sciences, Department of Cellular, Computational, and Integrative Biology, University of Trento, Trento, Italy; Rheumatology Unit, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari Trento, Trento, Italy
| | - Thomas d'Humières
- Physiology Department, CHU Henri Mondor, Assistance Publique Hôpitaux de Paris, Créteil, France
| | - Alessandro Sionis
- Intensive Cardiac Care Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Ariza Solé
- Intensive Cardiac Care Unit, Cardiology Department, Bellvitge University Hospital, Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Federica Bello
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy; Interdisciplinary Internal Medicine Unit, Behçet Centre and Lupus Clinic, AOU Careggi Hospital of Firenze, Firenze, Italy
| | - Juan Andres Bermeo Garrido
- Intensive Cardiac Care Unit, Cardiology Department, Bellvitge University Hospital, Bioheart, Grup de Malalties Cardiovasculars, Institut d'Investigació Biomèdica de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Etienne Crickx
- Internal Medicine Department, Centre National de Référence des Cytopénies Auto-immunes de l'Adulte, Hôpital Henri Mondor, Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders, Assistance Publique Hôpitaux de Paris, Université Paris Est Créteil, Créteil, France
| | - Paolo Delvino
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy; Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy; Interdisciplinary Internal Medicine Unit, Behçet Centre and Lupus Clinic, AOU Careggi Hospital of Firenze, Firenze, Italy; Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, Monash University, Clayton, Victoria, Australia
| | - Antoine Gaillet
- French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France; Medical Intensive Care Unit, Hôpitaux Universitaires Henri Mondor, Assistance Publique Hôpitaux de Paris, Créteil, France
| | - Gilles Garcia
- Department of Pulmonology, Antony Private Hospital, Antony, France
| | | | - Jean-Louis George
- Department of Cardiology, Centre Hospitalier de Versailles, André Mignot Hospital, Le Chesnay-Rocquencourt, France
| | - Floriane Gilles
- Department of Cardiology, Centre Hospitalier de Versailles, André Mignot Hospital, Le Chesnay-Rocquencourt, France
| | | | - Pascal de Groote
- French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France; CHU Lille, Service de Cardiologie, Lille, France; Inserm U1167, Institut Pasteur de Lille, Lille, France
| | - Aurélien Guffroy
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nihal Martis
- Internal Medicine Department, Hôpital de Larchet, University Hospital of Nice, Côte d'Azur University, Nice, France
| | - Sara Monti
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
| | | | - Marc Pineton de Chambrun
- Department of Intensive Care Medicine, APHP, Sorbonne Université, Pitié Salpétrière, Paris, France
| | - Fabrice Prunier
- Department of Cardiology, Universitary Hospital of Angers, Angers, France
| | - Francesca Regola
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Gabriel Seret
- Department of Cardiology, University of Sorbonne-Paris Cité, APHP, Cochin Hospital, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, Hôpital Cochin, APHP, Paris, France
| | - Ludovic Tréfond
- Internal Medicine, Gabriel Montpied Hospital, Clermond-Ferrand, France
| | - Géraud Souteyrand
- Department of Cardiology, Gabriel Montpied Hospital, Clermond-Ferrand, France
| | - Olivier Varenne
- Department of Cardiology, University of Sorbonne-Paris Cité, APHP, Cochin Hospital, Paris, France
| | - Filippo Zilio
- Department of Cardiology, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari Trento, Trento, Italy
| | - Franck Haziza
- ACTION Study Group, Department of Cardiology, Foch Hospital, Suresnes, France
| | - Hakim Benamer
- ACTION Study Group, Department of Cardiology, Foch Hospital, Suresnes, France
| | - Jean-Emmanuel Kahn
- French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France; Department of Internal Medicine, University of Paris Saclay, APHP, CHU Ambroise Paré, Boulogne-Billancourt, France
| | - Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
| | - Matthieu Groh
- French National Reference Center for Hypereosinophilic Syndromes, Department of Internal Medicine, Foch Hospital, Suresnes, France.
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Delaval L, Samson M, Schein F, Agard C, Tréfond L, Deroux A, Dupuy H, Garrouste C, Godmer P, Landron C, Maurier F, le Guenno G, Rieu V, Desblache J, Durel CA, Jousselin-Mahr L, Kassem H, Pugnet G, Queyrel V, Swiader L, Blockmans D, Sacré K, Lazaro E, Mouthon L, Aumaître O, Cathébras P, Guillevin L, Terrier B. Temporal Arteritis Revealing Antineutrophil Cytoplasmic Antibody-Associated Vasculitides: A Case-Control Study. Arthritis Rheumatol 2020; 73:286-294. [PMID: 32951354 DOI: 10.1002/art.41527] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 08/20/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Temporal arteritis (TA) is a typical manifestation of giant cell arteritis (GCA). Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are rarely revealed by TA manifestations, leading to a risk of misdiagnosis of GCA and inappropriate treatments. This study was undertaken to describe the clinical, biologic, and histologic presentations and outcomes in cases of TA revealing AAV (TA-AAV) compared to controls with classic GCA. METHODS In this retrospective case-control study, the characteristics of patients with TA-AAV were compared to those of control subjects with classic GCA. Log-rank test, with hazard ratios (HRs) and 95% confidence intervals (95% CIs), was used to assess the risk of treatment failure. RESULTS Fifty patients with TA-AAV (median age 70 years) were included. Thirty-three patients (66%) presented with atypical symptoms of GCA (ear, nose, and throat involvement in 32% of patients, and renal, pulmonary, and neurologic involvement in 26%, 20%, and 16% of patients, respectively). Blood samples were screened for ANCAs at the time of disease onset in 33 patients, and results were positive in 88%, leading to a diagnosis of early TA-AAV in 20 patients. The diagnosis of AAV was delayed a median interval of 15 months in 30 patients. Compared to controls with GCA, patients with TA-AAV were younger (median age 70 years versus 74 years), were more frequently men (48% versus 30%), and had high frequencies of atypical manifestations and higher C-reactive protein levels (median 10.8 mg/dl versus 7.0 mg/dl). In patients with TA-AAV, temporal artery biopsy (TAB) showed fibrinoid necrosis and small branch vasculitis in 23% of patients each, whereas neither of these characteristics was evident in controls with GCA. Treatment failure-free survival was comparable between early TA-AAV cases and GCA controls, whereas those with delayed TA-AAV had a significantly higher risk of treatment failure compared to controls (HR 3.85, 95% CI 1.97-7.51; P < 0.0001). CONCLUSION TA-AAV should be considered diagnostically in cases of atypical manifestations of GCA, refractoriness to glucocorticoid treatment, or early relapse. Analysis of TAB specimens for the detection of small branch vasculitis and/or fibrinoid necrosis could be useful. Detection of ANCAs should be performed in cases of suspected GCA with atypical clinical features and/or evidence of temporal artery abnormalities on TAB.
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Affiliation(s)
- Laure Delaval
- Centre de Référence des Maladies Auto-Immunes Systémiques Rares d'Ile-de-France, Hôpital Cochin, Paris, France
| | - Maxime Samson
- Centre Hospitalier Universitaire (CHU) de Dijon Bourgogne, Dijon, France
| | | | | | | | | | | | | | - Pascal Godmer
- Centre Hospitalier Bretagne Atlantique, Vannes, France
| | | | | | | | | | | | | | | | - Hassan Kassem
- Centre Hospitalier Sud Essonne Dourdan-Etampes, Dourdan, France
| | | | | | - Laure Swiader
- CHU de Marseille, Hôpital de la Timone, Marseille, France
| | | | - Karim Sacré
- Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | | | - Luc Mouthon
- Centre de Référence des Maladies Auto-Immunes Systémiques Rares d'Ile-de-France, Hôpital Cochin, and Université Paris Descartes, Paris, France
| | | | | | - Loic Guillevin
- Centre de Référence des Maladies Auto-Immunes Systémiques Rares d'Ile-de-France, Hôpital Cochin, and Université Paris Descartes, Paris, France
| | - Benjamin Terrier
- Centre de Référence des Maladies Auto-Immunes Systémiques Rares d'Ile-de-France, Hôpital Cochin, and Université Paris Descartes, Paris, France
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