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Ratti N, Ly KH, Dumonteil S, François M, Sailler L, Lambert M, Hot A, Gondran G, Palat S, Bezanahary H, Desvaux E, Aslanbekova N, Parreau S, Fauchais AL, Sève P, Liozon E. Recurrent (or episodic) fever of unknown origin (FUO) as a variant subgroup of classical FUO: A French multicentre retrospective study of 170 patients. Clin Med (Lond) 2024; 24:100202. [PMID: 38642612 DOI: 10.1016/j.clinme.2024.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/23/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Recurrent FUO (fever of unknown origin) is a rare subtype of FUO for which diagnostic procedures are ill-defined and outcome data are lacking. METHODS We performed a retrospective multicentre study of patients with recurrent FUO between 1995 and 2018. By multivariate analysis, we identified epidemiological, clinical and prognostic variables independently associated with final diagnosis and mortality. RESULTS Of 170 patients, 74 (44%) had a final diagnosis. Being ≥ 65 years of age (OR = 5.2; p < 0.001), contributory history (OR = 10.4; p < 0.001), and abnormal clinical examination (OR = 4.0; p = 0.015) independently increased the likelihood of reaching a diagnosis, whereas lymph node and/or spleen enlargement decreased it (OR = 0.2; p = 0.004). The overall prognosis was good; 58% of patients recovered (70% of those with a diagnosis). Twelve (7%) patients died; patients without a diagnosis had a fatality rate of 2%. Being ≥ 65 years of age (OR = 41.3; p < 0.001) and presence of skin signs (OR = 9.5; p = 0.005) significantly increased the risk of death. CONCLUSION This study extends the known yield of recurrent FUO and highlights the importance of repeated complete clinical examinations to discover potential diagnostic clues during follow-up. Moreover, their overall prognosis is excellent.
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Affiliation(s)
- N Ratti
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France.
| | - K H Ly
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - S Dumonteil
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - M François
- Departments of Internal Medicine, University Hospitals of Lyon Sud, Pierre-Bénite, France
| | - L Sailler
- Departments of Internal Medicine, University Hospitals of Toulouse, Purpan, France
| | - M Lambert
- Departments of Internal Medicine, University Hospitals of Lille, Claude Huriez, France
| | - A Hot
- Departments of Internal Medicine, University Hospitals of Lyon, Édouard Herriot, France
| | - G Gondran
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - S Palat
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - H Bezanahary
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - E Desvaux
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - N Aslanbekova
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - S Parreau
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - A L Fauchais
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
| | - P Sève
- Departments of Internal Medicine, University Hospitals of Lyon, La Croix-Rousse, France
| | - E Liozon
- Departments of Internal Medicine, University Hospitals of Limoges, Dupuytren, France
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Salvador B, Lades G, Parreau S, Dumonteil S, Brisset J, Jamilloux Y, Gerfaud-Valentin M, Hot A, Abraham J, Jaccard A, Gondran G, Liozon E, Fauchais A, Monteil J, Ly K. Comparaison de la tomographie par émission de positons entre maladie de Still et lymphome non hodgkinien. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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La M, Richard Colmant G, Fauvernier M, Ghesquieres H, Hot A, Sève P, Jamilloux Y. Mortalité et causes associées dans le syndrome d’activation histiolymphocytaire : une analyse de causes multiples de décès. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Hemmer M, Terriou L, Malphettes M, Ginoux M, Puyade M, Sève P, Hot A, Godeau B, Lobbes H. Érythroblastopénies auto-immunes associées aux tumeurs thymiques, cohorte nationale rétrospective française. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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El Jammal T, Fermon C, Kodjikian L, Burillon C, Hot A, Perard L, Mathis T, Jamilloux Y, Sève P. Phénotypes des patients porteurs d’uvéites sarcoïdosiques : identification de clusters à l’aide d’une classification hiérarchique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Robert M, Lessard L, Fenouil T, Hot A, Laumonier T, Bouche A, Chazaud B, Streichenberger N, Gallay L. POS0490 USEFULNESS OF MHC-II IMMUNO-STAINING ON MUSCLE BIOPSIES IN IDIOPATHIC INFLAMMATORY MYOPATHIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5186] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIdiopathic inflammatory myopathies (IIMs) constitute a group of acquired muscular diseases that occur during childhood and adulthood, exhibit a variety of phenotypes and are potentially life-threatening. IIM diagnosis considers clinical, serological, and histological data. Muscle pathological analysis of IIM patients gives relevant elements for the diagnosis (immune cell infiltrate, vascular and connective tissues, as well as myofiber morphology). Immunochemistry (IHC) labeling for major histocompatibility complex class I (MHC-I), and C5b9, that are negative in normal muscle, appeared of interest in IIM diagnosis and the understanding of IIM pathogenesis. In normal muscle, myofibers are negative for MHC-II IHC. Its interest in the neuropathological exam of IIM muscle remains to be better characterized.ObjectivesThis study aims to analyze the pattern of MHC-II expression in various IIMs.MethodsA historical cohort was designed using the MYOLYON register (IIM patients diagnosed between 2016 and 2020 at the University Hospital of Lyon, France). Inclusion criteria were IIM diagnosis that was established histologically and available frozen muscle samples for additional analyses. Exclusion criterium was any treatment before muscle biopsy. Demographical data and final diagnosis were collected retrospectively from medical records. A centralized, standardized, and blind analysis of muscle MHC-II immuno-staining was conducted to define the various patterns of MHC-II by myofibers and by capillaries. The study complied with ethical requirements.ResultsSeventy-three patients were included: 23 dermatomyositis (DM), 13 anti-synthetase syndrome (ASS), 13 immune-mediated necrotizing myopathies (IMNM), 13 inclusion body myositis (IBM), and 11 overlap myositis (OM). MHC-II immuno-staining of myofibers or capillaries was abnormal for 91.8% of the analyzed biopsies (Figure 1). The analysis of MHC-II myofiber immuno-staining revealed distinguishable patterns according to IIM subtype: the labeling was diffuse in IBM (69.2%, n=9/13), perifascicular in ASS (61.5%, n=8/13), and variable in OM (patchy for 27.3% n=3/11 or clustered for 36.4%, n=4/11). MHC-II immuno-staining was negative in IMNM (84.6%, n=11/13) and in DM (47.8%, n=11/23). DM exhibiting positive MHC-II myofibers (n=12) were associated with the presence of anti-TIF1γ, anti-NXP2 and anti-SAE auto antibodies (n=5, n=3 and n=2, respectively). Among the 12 patients, there were juvenile cases (n=5, 41.7%) or DM associated with ongoing neoplasia (n=4, 33.3%). Three main architectures were described for capillaries: giant, leaky and capillary dropout. Patterns of MHC-II positive capillaries were the following: DM was characterized by capillary dropout (68.2%), IMNM showed leaky capillaries (75.0%), IBM giant capillaries (66.7%), ASS exhibited both giant (61.5%) and/or leaky (58.3%) capillaries, while OM showed giant (63.6%) or/and leaky (80.0%) capillaries and capillaries dropout (60.0%).ConclusionThe present work establishes the usefulness of MHC-II immuno-staining for IIM diagnosis, and gives additional elements on the impairment of myofibers and capillaries in the various IIM subgroups. MHC-II expression is known to be induced by inflammatory cytokine such as interferon type II. This could be linked to myofiber and/or capillary impairment in some IIMs, such as IBM, ASS and OM. These results also support the implication of vasculopathy in IIM pathogenesis, with various structural and cellular consequences regarding the different subgroups. Finally, MHC-II immuno-staining in IIM muscle biopsies enables a foremost analysis of myofibers and capillaries, and represents an additional biomarker to distinguish IIM subgroups.References[1]De Bleecker, J.L. et al. 205th ENMC International Workshop: Pathology diagnosis of idiopathic inflammatory myopathies part II 28-30 March 2014, Naarden, The Netherlands. Neuromuscul Disord 2015, 25, 268-272.Disclosure of InterestsNone declared.
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Guédon A, Carrat F, Mouthon L, Launay D, Chaigne B, Pugnet G, Lega J, Hot A, Cottin V, Agard C, Allanore Y, Fauchais A, Jego P, Dhôte R, Papo T, Chatelus E, Fain O, Mekinian A, Hachulla E, Riviere S. Atteintes cardiaques de la sclérodermie systémique : résultats d’une étude de cohorte nationale française. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Robert M, Gallay L, Petiot P, Fenouil T, Lessard L, Perard L, Svahn J, Fiscus J, Fabien N, Bouhour F, Maucort-Boulch D, Durieu I, Coury-Lucas F, Streichenberger N, Hot A. POS0862 INAUGURAL DROPPED HEAD SYNDROME AND CAMPTOCORMIA IN INFLAMMATORY MYOPATHIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1605] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of diseases that can affect the muscles, skin, lungs, heart, and joints. Increase knowledge about histopathological findings, clinical manifestations and auto-antibodies have allowed further novel classification of IIMs. Today, the main IMs subgroups are: dermatomyositis (DM), inclusion body myositis (IBM), immune-mediated necrotizing myopathies (IMNM), overlap myositis (OM) and immune-checkpoint inhibitor-related myositis (ICIrm). Axial muscle involvement results either in a “Dropped Head Syndrome (DHS)”, with a marked weakness of the neck extensors, or in a camptocormia (CC), with a weakness of the thoracolumbar paraspinal muscles. This atypical presentation is poorly described in the course of IMs while it may results in a major disability, and may lead to myositis diagnosis delay.ObjectivesThis study aimed to describe IMs revealed by DHS and/or CC. Secondary outcomes were to define subgroups of patients according to clinical, biological and histopathological characteristics. Then, the effects of treatments used were analyzed.MethodsA historical cohort was designed using the register MYOLYON which includes all IMs followed at the University Hospital of Lyon (France) between 2000 and 2021. All patients with IM revealed by DHS and/or CC and having an histologically proven IMs were included, after exclusion of alternative (e.g., myasthenia gravis, motoneuron disease). Clinical, biological, immunological, histopathological data as well as outcome and care were collected through a standardized form. Agreement for the study was obtained from the French Ministry of the Research and the study was approved by the Local Research Ethics Committee.ResultsTwenty-two patients were fully characterized: DM (n=4), IBM (n=7), OM (n=8), ICIrm (n=2) and one myositis with anti-Hu antibodies. Two groups of patients were identified according to the age at first symptoms and to the type of muscle axial involvement (e.g, DHS and/or CC). Before the age of 70 (n=13/22), the two most common diagnoses (n=11/13) were DM (n=4/4) and OM (n=7/8). Axial muscle involvement was diffuse (DHS and CC) in 10/13 patients. After 70 years old (n=9/22), there were a majority of IBM (n=6/9) and all cases of ICIrm (n=2). Axial involvement was restricted to one group of muscles (DHS or CC) in 5/9 patients. Finally, 77% (17/22) of patients had refractory disease and required a second line treatment (e.g, immunoglobulins). All of these results are summarized in the Figure 1.Figure 1.ConclusionWhile IM diagnosis is challenging in the presence of inaugural axial involvement, these results highlight the subset of IM to be considered according to the age at first symptoms and the type of axial involvement (e.g., DHS and/or CC).References[1]Mariampillai, K. et al. Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies. JAMA Neurol75, 1528-1537 (2018).[2]Landon-Cardinal, O. et al. Recognising the spectrum of scleromyositis: HEp-2 ANA patterns allow identification of a novel clinical subset with anti-SMN autoantibodies. RMD Open6 (2020).[3]Suarez, G.A. & Kelly, J.J., Jr. The dropped head syndrome. Neurology42, 1625-1627 (1992).[4]Oerlemans, W.G. & de Visser, M. Dropped head syndrome and bent spine syndrome: two separate clinical entities or different manifestations of axial myopathy? J Neurol Neurosurg Psychiatry65, 258-259 (1998).Disclosure of InterestsNone declared
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Cannas G, Virot E, Reynes C, Bourgeay R, Hot A. Traitement par Voxelotor dans la drépanocytose : premières expériences d’un centre français. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Baverez C, Gallay L, Petiot P, Streichenberger N, Pérard L, Hot A. Myosite focale et cancer: une association non fortuite. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Javaux C, El-Jamal T, Neau P, Fournier N, Gerfaud-Valentin M, Pérard L, Fouillet-Desjonqueres M, Le Scanff J, Vignot E, Durupt S, Hot A, Belot A, Durieu I, Henri T, Sève P, Jamilloux Y. Détection et prédiction du syndrome d’activation macrophagique dans la maladie de Still : étude rétrospective de 20 cas. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bert A, Gilbert T, Cottin V, Mercier J, Gerfaud-Valentin M, Durieu I, Hot A, Hicks J, Varron L, Seve P, Jamilloux Y. Sarcoidosis diagnosed in the elderly: a case-control study. QJM 2021; 114:238-245. [PMID: 32569362 DOI: 10.1093/qjmed/hcaa171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 04/18/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Studies on sarcoidosis in elderly patients are scarce and none have specifically evaluated patients aged ≥75 at onset. AIM We aimed to analyse the characteristics of patients with sarcoidosis diagnosed after 75 and to compare them with those of younger patients. DESIGN Multicenter case-control study comparing elderly-onset sarcoidosis (EOS) with young-onset sarcoidosis (YOS) seen at Lyon University Hospitals between 2006 and 2018. METHODS Using our institutional database, we included 34 patients in the EOS group and compared them with 102 controls from the YOS group in a 1:3 ratio. Demographic characteristics, medical history, clinical presentation, laboratory and imaging findings, sites of biopsies, histological analyses, treatments and outcomes were recorded using a comprehensive questionnaire. RESULTS There were more Caucasians in the EOS group (94.1% vs. 59.8%; P < 0.001), who had significantly more comorbidities (mean, 3.1 ± 2 vs. 1.1 ± 1.6; P < 0.001). In the EOS group, there was less pulmonary involvement (26.5% vs. 49%; P = 0.022), less lymphadenopathy (2.9% vs. 16.7%; P = 0.041), no erythema nodosum (0% vs. 12.8%; P = 0.029) and no arthralgia (0% vs. 25.5%; P = 0.001). Conversely, uveitis was more common in the EOS group (55.9% vs. 20.6%; P < 0.001). Pathological confirmation was obtained significantly less frequently in the EOS group (67.7% vs. 85.3%; P = 0.023). Corticosteroid-related side effects were significantly more common in the EOS group (100% vs. 75.9%; P = 0.030). CONCLUSION Epidemiology and clinical presentation of EOS differs from YOS, including more comorbidities and more uveitis. Elderly patients are more prone to corticosteroid side effects.
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Affiliation(s)
- A Bert
- Department of Internal Medicine, University Hospital Lyon Croix-Rousse, Claude Bernard University Lyon 1, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - T Gilbert
- Short Stay Geriatric Unit, Lyon Sud University Hospital, University Claude Bernard University Lyon 1, 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
| | - V Cottin
- National Reference Center for Rare Pulmonary Diseases, Louis Pradel University Hospital, University Claude Bernard University Lyon 1, 59 Boulevard Pinel, 69500 Bron, France
| | - J Mercier
- Department of Internal Medicine, University Hospital Lyon Croix-Rousse, Claude Bernard University Lyon 1, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - M Gerfaud-Valentin
- Department of Internal Medicine, University Hospital Lyon Croix-Rousse, Claude Bernard University Lyon 1, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - I Durieu
- Department of Internal Medicine, Lyon Sud University Hospital, University Claude Bernard University Lyon 1, 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
| | - A Hot
- Department of Internal Medicine, Edouard Herriot University Hospital, University Claude Bernard University Lyon 1, 5 Place d'Arsonval, 69003 Lyon, France
| | - J Hicks
- Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - L Varron
- Department of Internal Medicine, Montélimar Hospital, Quartier Beausseret, Route de Sauzet, 26200 Montélimar, France
| | - P Seve
- Department of Internal Medicine, University Hospital Lyon Croix-Rousse, Claude Bernard University Lyon 1, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - Y Jamilloux
- Department of Internal Medicine, University Hospital Lyon Croix-Rousse, Claude Bernard University Lyon 1, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
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Robert M, Gallay L, Fenouil T, Svahn J, Fabien N, Bouhour F, Petiot P, Maucort-Boulch D, Durieu I, Coury F, Streichenberger N, Hot A. Syndrome de tête tombante et camptocormie inaugurales au cours des myopathies idiopathiques inflammatoires. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bera S, Jamilloux Y, Gerfaud-Valentin M, Durupt S, Nove-Josserand R, Lega J, Durieu I, Hot A, Sève P. Étiologies et pronostic des syndromes inflammatoires prolongés inexpliqués : à propos de 57 cas. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Senni N, Gerfaud-Valentin M, Hot A, Huissoud C, Gaucherand P, Tebib J, Broussolle C, Jamilloux Y, Sève P. [Spontaneous adrenal hematomas. Retrospective analysis of 20 cases from a tertiary center]. Rev Med Interne 2021; 42:375-383. [PMID: 33775473 DOI: 10.1016/j.revmed.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 02/23/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Spontaneous adrenal hemorrhages (AH) are a rare condition with no consensus about their management. METHODS Patients were identified using the Medicalization of the Information System Program database, imaging software and a call for observations to internists, intensivists and obsetricians working at our institution. Adult patients whose medical records were complete and whose diagnosis was confirmed by medical imaging were included. RESULTS From 2000 to 2007, 20 patients were identified, including 15 were women. The clinical onset of AH was non-specific. In five cases, AH occurred during pregnancy; four of them were unilateral and right sided. The etiology of the other fifteen (bilateral adrenal hemorrhage in 11) were as follows: antiphospholipid syndrome (n=8), heparin-induced thrombocytopenia (n=4), essential thrombocythemia (n=3), spontaneous AH due to oral anticoagulants (n=1), complication of a surgical act (n=3), and sepsis (n=3). In seven cases, two causes were concomitant. The diagnosis of AH was often confirmed by abdominal CT. An anticoagulant treatment was initiated in 16 cases. Ten of the eleven patients presenting with bilateral adrenal hematomas were treated using a long-term substitute opotherapy. One patient died because of a catastrophic antiphospholipid syndrome. CONCLUSION The clinical onset of HS is heterogeneous and non-specific. The confirmatory diagnosis is often based on abdominal CT. The search for an underlying acquired thrombophilia is essential and we found in this study etiological data comparable to the main series in the literature. Adrenal insufficiency is most of the time definitive in cases of bilateral involvement.
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Affiliation(s)
- N Senni
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - M Gerfaud-Valentin
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - A Hot
- Service de médecine interne, hôpital Edouard-Herriot, Lyon, France
| | - C Huissoud
- Service d'obstétrique, hôpital de la Croix-Rousse, Lyon, France
| | - P Gaucherand
- Service d'obstétrique, hôpital Femme Mère-Enfant, Lyon, France
| | - J Tebib
- Service de rhumatologie, hôpital Lyon Sud, Lyon, France
| | - C Broussolle
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - Y Jamilloux
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France
| | - P Sève
- Service de médecine interne, hôpital de la Croix-Rousse, hospices civils de Lyon, université Claude-Bernard Lyon 1, Lyon, France; Hospices civils de Lyon, pôle IMER, 69003 Lyon, France; University Lyon, University Claude Bernard Lyon 1, HESPER EA 7425, 69008 Lyon, France.
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Fauter M, Jamilloux Y, Hot A, Gerfaud-Valentin M, Saurin J, Durieu I, Bailly F, Sève P. La cytolyse hépatique associée à l’évolution grave dans la sarcoïdose hépatique–Sarcoïdoses hépatiques histologiquement prouvées–cohorte de 51 cas. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lobbes H, Mahevas M, Alviset S, Galicier L, Costedoat-Chalumeau N, Amoura Z, Alric L, Hot A, Durupt S, Michel M, Godeau B. Cohorte nationale rétrospective d’érythroblastopénies auto-immunes associées au lupus systémique. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Roussotte M, Gerfaud-Valentin M, Lega J, Thibault T, Lobbes H, Goulabchand R, Cathébras P, Varron L, Dufour J, Deroux A, Le Guenno G, Compain C, Baudet A, Karkowski L, Perard L, Ebbo M, Hot A, Sève P. Traitement de la thrombopénie immunologique cliniquement significative secondaire au lupus érythémateux systémique : étude rétrospective de 90 patients en vie réelle. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lekieffre M, Mainbourg S, Dumortier J, Hot A, Sève P, Durieu I, Zoulim F, Miossec P, Perard L, Kollop-Sarda M, Lega J. Cryoglobulinémie à IgA : prévalence et signification clinique. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Didier K, Sobanski V, Barbe C, Robbins A, Truchetet M, Barnetche T, Hot A, Fort R, Guilpain P, Maria A, Agard C, Pennaforte J, Viguier M, Martin T, Pham B, Launay D, Servettaz A. Auto-anticorps dans la sclérodermie systémique : méta-analyse de la prévalence de 9 auto-anticorps spécifiques dans différentes régions du monde. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chabert P, Hot A. [Cytomegalovirus infection in systemic lupus erythematosus patients. A series of 12 case reports and literature review]. Rev Med Interne 2020; 42:237-242. [PMID: 33139080 DOI: 10.1016/j.revmed.2020.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/14/2020] [Accepted: 08/30/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Patients with systemic lupus erythematosus (SLE) are at risk of cytomegalovirus (CMV) infection, due to the disease itself or to drug-induced immunosuppression. Also, active CMV infection may trigger or worsen SLE flare-up. METHODS In this retrospective single-centre cohort study, we reported all adult inpatients with a diagnosis of SLE, presenting with active and confirmed CMV infection. The goal was to describe their characteristics and outcomes (evolution of CMV infection, secondary infections and SLE flare-up), and to review the existing literature. RESULTS We identified 400 patients with confirmed SLE, including 12 who presented with active CMV infection. Severe CMV manifestations were present in 7 patients treated with immunosuppressive regimen out of 10, and in one patient out of two without immunosuppressive therapy. Six patients developed other infections, and 3 showed characterised SLE flare-up over the 3-month follow-up. All patients were alive at end of follow-up. DISCUSSION Among patients with SLE, CMV infection affected more frequently those treated with immunosuppressive drugs, but treatment-free patients were sometimes severely affected. CMV infection was associated with an increased incidence of SLE flare-up and infectious complications. Our results suggest that early anti-viral chemotherapy may be beneficial in these patients.
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Affiliation(s)
- P Chabert
- Service de réanimation médicale, hôpital de la Croix Rousse, 104, grande rue de la Croix Rousse, 69004 Lyon, France; Hospices civils de Lyon, Lyon, France.
| | - A Hot
- Service de médecine interne - pavillon O, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France; Hospices civils de Lyon, Lyon, France.
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Weber E, Grangeon F, Reynaud Q, Hot A, Sève P, Jardel S, Tazarourte K, Fouque D, Juillard L, Salles G, Grange C, Durieu I, Rousset P, Lega JC. Acute renal and splenic infarctions: a review. QJM 2020; 113:186-193. [PMID: 31593227 DOI: 10.1093/qjmed/hcz252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Renal and splenic infarctions are close entities, with few data concerning their clinical, biological and radiological features. AIM The aim of this study was to compare the clinical presentations, etiologies and outcomes of acute renal infarctions (RI) and splenic infarctions (SI). DESIGN A retrospective multicentric cohort study included patients of the 6 university hospitals in Lyon with RI, SI, or associated RI-SI infarctions was conducted. METHODS All consecutive cases diagnosed by CT imaging, between January 2013 and October 2016, were included. The exclusion criteria were causes of infarction that did not require additional investigations. RESULTS A total of 161 patients were selected for analysis: 34 patients with RI, 104 patients with SI and 23 patients with both RI-SI. Mean ± SD age of patients was 63.2 ± 16.6 years; 59.6% were male. Only 5/161 (3.1%) were healthy prior to the event. The main symptoms were diffuse abdominal pain (26.4%), followed by nausea/vomiting (18.3%) and fever (16.4%).The causes of RI or SI varied significantly within the three groups. Hypercoagulable state was associated with SI, and embolic disease and arterial injury were associated with RI. Extensive (i.e.>2/3 of organ volume) (OR 6.22, 95%CI 2.0119.22) and bilateral infarctions (OR 15.05, 95%CI 1.79-126.78) were significantly associated with hemodynamic shocks. The survival at 1 month follow-up did not significantly differ between the three groups. CONCLUSION Acute RI and SI are heterogenous entities in regards to their clinical presentation, etiology, associated venous or arterial thrombosis, but prognoses were not different at short term follow-up.
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Affiliation(s)
- E Weber
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
| | - F Grangeon
- Service de radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
| | - Q Reynaud
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, Health Services and Performance Research EA7425, Claude Bernard University Lyon, F-69003 Lyon
| | - A Hot
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Hôpital Edouard Herriot, F-69003 Lyon
| | - P Sève
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Service de médecine interne, Hospices Civils de Lyon, Hôpital de la Croix Rousse, F-69004 Lyon
| | - S Jardel
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
| | - K Tazarourte
- Service d'accueil des Urgences, Hospices Civils de Lyon, Hôpital Edouard Herriot, F-69003 Lyon
| | - D Fouque
- Service de Néphrologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
| | - L Juillard
- Service de Néphrologie, Hospices Civils de Lyon, Hôpital Edouard Herriot, F-69310 Lyon
| | - G Salles
- Service d'Hématologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
| | - C Grange
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Groupe d'Etude Multidisciplinaire des Maladies Thrombotiques (GEMMAT), Hospices Civils de Lyon, Lyon
| | - I Durieu
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Univ Lyon, Health Services and Performance Research EA7425, Claude Bernard University Lyon, F-69003 Lyon
| | - P Rousset
- Service de radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
| | - J C Lega
- From the Service de médecine interne et médecine vasculaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite
- Univ Lyon, 143 Boulevard du 11 Novembre 1918, 69100 Villeurbanne
- Groupe d'Etude Multidisciplinaire des Maladies Thrombotiques (GEMMAT), Hospices Civils de Lyon, Lyon
- Univ Lyon, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, CNRS, Claude Bernard University, F-69003 Lyon, France
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Roussotte M, Gerfaud-Valentin M, Lega J, Audia S, Ruivard M, Goulabchand R, Cathébras P, Varron L, Dufour J, Alban D, Le Guenno G, Compain C, Baudet A, Karkowski L, Perard L, Hot A, Sève P. Thrombopénie immunologique cliniquement significative secondaire au lupus érythémateux systémique : description d’une cohorte rétrospective de 74 cas. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fauquier A, Fort R, Hot A, Feugier P, Tronc F, Durel C. Reconstruction chirurgicale de la veine cave supérieure chez un jeune patient porteur d’un vasculo-Behçet avec thrombose de la veine cave supérieure, permettant de faire régresser de volumineuses varices œsophagiennes. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Antoine M, Fort R, Fauquier A, Hot A, Durel C. Purpura fébrile avec arthralgies sous rituximab : savoir évoquer une maladie sérique. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ratti N, Francois M, Liozon E, Sailler L, Lambert M, Gondran G, Palat S, Bezananary H, Fauchais A, Sève P, Hot A, Ly K. Facteurs prédictifs du diagnostic étiologique des fièvres prolongées épisodiques : étude d’une cohorte multicentrique de 191 patients. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baverez C, Hot A, Emilie V. Un poumon blanc au cours d’une neurofibromatose. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hequet O, Poutrel S, Connes P, Revesz D, Chelghoum Y, Kebaili K, Cannas G, Gauthier A, Guironnet-Paquet A, Vocanson M, Nicolas JF, Renoux C, Raba M, Cognasse F, Bertrand Y, Hot A, Joly P. Automatic depletion with Spectra Optia allows a safe 16% reduction of red blood cell pack consumption in exchanged sickle cell anemia patients. Transfusion 2019; 59:1692-1697. [PMID: 30747440 DOI: 10.1111/trf.15188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Chronic red blood cell exchanges (RBCXs) are frequently used to prevent complications in patients with sickle cell anemia, but the scarcity of matched red blood cell packs (RBCPs) is a serious concern. The main goal of this study was to compare the number of RBCPs used during RBCXs between the Spectra Optia (SO) device (with the automatic depletion step) and the former Cobe Spectra (CSP) device. STUDY DESIGN AND METHODS The performances and safety of 300 SO sessions using the automatic depletion step (SO/DE) in 50 patients with sickle cell anemia under a chronic transfusion program over a 1-year period were prospectively analyzed. The numbers of RBCPs saved using this protocol compared to the SO device without depletion and to the CSP device were determined. RESULTS The SO/DE protocol appeared to be safe, as only 5% and 17% of the sessions were characterized by a significant decrease in blood pressure and increase in heart rate (grade 2 adverse events), respectively. Postapheresis hematocrit and fraction of cells remaining reached expected values. The SO/DE protocol required 16% fewer RBCPs compared to SO without depletion, allowing a mean saving of 12 RBCPs per patient and per year and 13% fewer compared to CSP device. Interestingly, the saving was more important for patients with high total blood volume and/or high preapheresis hematocrit. CONCLUSION The SO/DE protocol is an efficient, safe and cost-effective procedure for patients with sickle cell anemia under a chronic transfusion program.
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Affiliation(s)
- O Hequet
- Établissement Français du Sang Auvergne-Rhône-Alpes, Apheresis unit, Centre Hospitalier Lyon Sud Pierre Bénite, France.,Scientific Department, Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France.,Laboratory of Allergology and Clinical Immunology, CIRI, Lyon, France
| | - S Poutrel
- Centre de référence constitutif des syndromes drépanocytaires majeurs, des thalassémies et des autres maladies de l'érythropoïèse, Service de Médecine interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - P Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE Lyon, Villeurbanne, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,Institut Universitaire de France, Paris, France
| | - D Revesz
- Établissement Français du Sang Auvergne-Rhône-Alpes, Apheresis unit, Centre Hospitalier Lyon Sud Pierre Bénite, France
| | - Y Chelghoum
- Établissement Français du Sang Auvergne-Rhône-Alpes, Apheresis unit, Centre Hospitalier Lyon Sud Pierre Bénite, France
| | - K Kebaili
- Hospices Civils de Lyon, Pediatric Hematology, Institut d'Hematologie et d'Oncologie Pédiatrique, Lyon, France
| | - G Cannas
- Centre de référence constitutif des syndromes drépanocytaires majeurs, des thalassémies et des autres maladies de l'érythropoïèse, Service de Médecine interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - A Gauthier
- Hospices Civils de Lyon, Pediatric Hematology, Institut d'Hematologie et d'Oncologie Pédiatrique, Lyon, France
| | - A Guironnet-Paquet
- Scientific Department, Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France.,Laboratory of Allergology and Clinical Immunology, CIRI, Lyon, France
| | - M Vocanson
- Laboratory of Allergology and Clinical Immunology, CIRI, Lyon, France
| | - J F Nicolas
- Laboratory of Allergology and Clinical Immunology, CIRI, Lyon, France
| | - C Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE Lyon, Villeurbanne, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,Laboratoire de Biochimie et Biologie moléculaire Grand Est, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - M Raba
- Etablissement Français du Sang Rhône Alpes, Distribution unit, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - F Cognasse
- Scientific Department, Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Etienne, France.,EA3064-GIMAP, Université de Lyon, Saint-Étienne, France
| | - Y Bertrand
- Hospices Civils de Lyon, Pediatric Hematology, Institut d'Hematologie et d'Oncologie Pédiatrique, Lyon, France
| | - A Hot
- Centre de référence constitutif des syndromes drépanocytaires majeurs, des thalassémies et des autres maladies de l'érythropoïèse, Service de Médecine interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - P Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Equipe "Biologie vasculaire et du globule rouge", Université Claude Bernard Lyon 1, COMUE Lyon, Villeurbanne, France.,Laboratoire d'Excellence sur le globule rouge (Labex GR-Ex), Paris, France.,Laboratoire de Biochimie et Biologie moléculaire Grand Est, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France
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Fort R, Monneret G, Venet F, Hot A. L’expression diminuée de HLA-DR monocytaire comme indicateur d’immunodépression chez les patients drépanocytaires en crise. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gallay L, Hot A, Streichenberger N, Mouchiroud G, Chazaud B. Analyse des capacités de régénération des cellules souches musculaires dans la dermatomyosite. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Leroy C, Barba T, Reynaud Q, Fabien N, Grange C, Francois M, Hot A, Cottin V, Durieu I, Lega J. Prévalence et phénotype clinique associés aux anticorps anti-Th/To dans la sclérodermie systémique. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Richard-Colmant G, Buron F, Thaunat O, Morelon E, Hot A. Lupus érythémateux disséminé et transplantation rénale : premiers résultats de l’étude Outcome of Kidney Transplantation And Lupus Erythematosus (OKTALE). Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Yailian A, Marquet A, Berton B, Perard L, Durel C, Janoly-Dumenil A, Hot A, Pivot C, Dhelens C. Entretiens-patient sur la thérapie immunomodulatrice par rituximab : conception et évaluation d’un support pédagogique. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gallay L, Petiot P, Maucort-Boulch D, Streichenberger N, Hot A. Myosite focale : nouveaux éléments cliniques et anatomopathologiques. Étude d’une cohorte de 37patients. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Leroy C, Barba T, Fabien N, Cottin V, Grange C, Durieu I, Francois M, Hot A, Reynaud Q, Lega J. Phénotype clinique des sclérodermies systémiques avec anticorps anti-fibrillarine. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Virot E, Thuret I, Galactéros F, Lachenal F, Lionnet F, Lucchini-Lecomte M, Nimubona S, Pegourie B, Ribeil J, Rose C, Steschenko D, Hot A. Devenir de la grossesse chez les patientes béta-thalassémiques transfusées : données du registre national français. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Deshayes S, Georgin-Lavialle S, Hot A, Durel C, Hachulla E, Rouanes N, Audia S, Le Gallou T, Urbanski G, Bienvenu B, Aouba A, Grateau G. Traitement continu par anti-interleukine–1 dans le déficit en mévalonate kinase : étude rétrospective multicentrique française de 13 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Durel C, Hot A, Trefond L, Pugnet G, Samson M, Guillevin L, Terrier B. Pseudo-tumeurs inflammatoires orbitaires au cours des vascularites associées aux ANCA : étude rétrospective portant sur 57 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Garros A, Marjoux S, Khouatra C, Coppere B, Grange C, Hot A, Roman S, Damon H, Mion F. Prevalence of fecal incontinence in a cohort of systemic sclerosis patients within a regional referral network. United European Gastroenterol J 2017; 5:1046-1050. [PMID: 29163972 DOI: 10.1177/2050640616688129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/12/2016] [Indexed: 12/15/2022] Open
Abstract
Background The prevalence of gastrointestinal involvement in systemic sclerosis is higher than 75%. The estimated prevalence of fecal incontinence varies from 22% to 77%, but suffers from recruitment bias and patient reluctance. Our goal was to evaluate the prevalence of fecal incontinence in systemic sclerosis, and to identify associated risk factors. Methods Patients were recruited in the referral systemic sclerosis network of the Lyon University Hospitals, using self-administered questionnaires including constipation, fecal incontinence and Bristol Stool scales, quality of life, anxiety and depression. The cohort was compared with the historical ORALIA cohort that established the prevalence of fecal incontinence in the general population of the Rhône-Alpes region (France). Results Seventy-seven patients were included (mean age: 60 years, range: 32-84), and 86% were female. These were compared to 153 ORALIA individuals matched for age and sex. Fecal incontinence was present in 38% of patients and 6% of the general population. A longer duration of systemic sclerosis was the only characteristic associated with fecal incontinence. Abnormal stool consistency was more frequent in patients with fecal incontinence. Conclusion Fecal incontinence and abnormal stool consistency are common in systemic sclerosis and should be systematically addressed.
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Affiliation(s)
- A Garros
- Hospices Civils de Lyon, Hospital Edouard Herriot, Digestive Physiology, Lyon I University, and INSERM 1032 LabTAU, Lyon, France
| | - S Marjoux
- Hospices Civils de Lyon, Hospital Edouard Herriot, Digestive Physiology, Lyon I University, and INSERM 1032 LabTAU, Lyon, France
| | - C Khouatra
- Hospices Civils de Lyon, Hospital Louis Pradel, Pneumology, Bron, France
| | - B Coppere
- Hospices Civils de Lyon, Hospital Edouard Herriot, Internal Medicine, Lyon, France
| | - C Grange
- Hospices Civils de Lyon, Hospital Jules Courmont, Internal Medicine, Lyon, France
| | - A Hot
- Hospices Civils de Lyon, Hospital Edouard Herriot, Internal Medicine, Lyon, France
| | - S Roman
- Hospices Civils de Lyon, Hospital Edouard Herriot, Digestive Physiology, Lyon I University, and INSERM 1032 LabTAU, Lyon, France
| | - H Damon
- Hospices Civils de Lyon, Hospital Edouard Herriot, Digestive Physiology, Lyon I University, and INSERM 1032 LabTAU, Lyon, France
| | - F Mion
- Hospices Civils de Lyon, Hospital Edouard Herriot, Digestive Physiology, Lyon I University, and INSERM 1032 LabTAU, Lyon, France
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Pegat A, Perard L, Girard-Madoux MH, Aubineau M, Poutrel S, Giannoli C, Marie M, Ninet J, Hot A. Syndrome catastrophique des antiphospholipides familial chez deux sœurs. Existence d’un facteur génétique prédisposant ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bert A, Coppere B, Boulez J, Hervieu V, Hot A. Hématopoïèse extra-médullaire surrénalienne chez une patiente drépanocytaire : à propos d’un cas. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dhelft F, Laville M, Ninet J, Miossec P, Jullien D, Hot A. Une cohorte prospective sur la morbi/mortalité cardiovasculaire chez des patients atteints de sclérodermie systémique. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Langlois M, Reynaud Q, Salles G, Hot A, Sève P, Duclos A, Durieu I, Lega J. Anémie hémolytique auto-immune à anticorps chauds chez l’adulte : une série monocentrique de 146 patients consécutifs. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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44
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Verkimpe M, Ninet J, Girard-Madoux M, Aubineau M, Rouvière O, Hot A. Micro-anévrysmes rénaux chez des patients atteints de polyangéite microscopique. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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45
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Chambrun MPD, Gousseff M, Mauhin W, Hot A, Lega J, Lambert M, Ruivard M, Bonnet D, Lhote F, Rivière S, Dossier A, Amoura Z. Survie et facteurs associés à la mortalité au cours du syndrome de fuite capillaire idiopathique. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Durel C, Achille A, Bienvenu B, Gombert B, Hachulla É, Ninet J, Maucort-Boulch D, Cuisset L, Touitou I, Moutschen M, Lequerré T, Hot A. Étude observationnelle d’une cohorte multicentrique de 23 patients atteints d’un déficit en mévalonate kinase diagnostiqué à l’âge adulte. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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47
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Pineton de Chambrun M, Gousseff M, Mauhin W, Hot A, Lega J, Ruivard M, Lhote F, Bonnet D, Rivière S, Lambert M, Dossier A, Amoura Z. Évolution du syndrome de fuite capillaire idiopathique lors de la décroissance des imunoglobulines polyvalentes intraveineuses. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Barba T, Boileau JC, Pasquet F, Hot A, Pavic M. [Inherited primitive and secondary polycythemia]. Rev Med Interne 2016; 37:460-5. [PMID: 26827274 DOI: 10.1016/j.revmed.2015.12.022] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 10/21/2015] [Accepted: 12/28/2015] [Indexed: 12/12/2022]
Abstract
Myeloproliferative disorders and secondary polycythemia cover most of the polycythemia cases encountered in daily practice. Inherited polycythemias are rare entities that have to be suspected when the classical causes of acquired polycythemia have been ruled out. Recent advances were made in the understanding of these pathologies, which are still little known to the physicians. This review reports the state of knowledge and proposes an algorithm to follow when confronted to a possible case of inherited polycythemia.
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Affiliation(s)
- T Barba
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - J-C Boileau
- Service d'hématologie-oncologie, faculté de médecine et des sciences de la santé, CHU de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, Canada
| | - F Pasquet
- Service de médecine interne, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - A Hot
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - M Pavic
- Service d'hématologie-oncologie, faculté de médecine et des sciences de la santé, CHU de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, Canada
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Thery-Casari C, Kollop-Sarda M, Hot A, Sève P, Laville M, Tebib J, Chapurlat R, Debarbieux S, Rheims S, Durieu I, Lega J. Intérêt de l’analyse du cryoprécipité pour le diagnostic des vascularites cryoglobulinémiques chez des patients symptomatiques. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Virot E, Duclos A, Lelievre L, Adelaide L, Hot A, Ferry T, Sève P. Manifestations auto-immunes et infection VIH : étude de cohorte. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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