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Salvator H, Mahlaoui N, Suarez F, Marcais A, Longchampt E, Tcherakian C, Givel C, Chabrol A, Caradec E, Lortholary O, Lanternier F, Goyard C, Couderc LJ, Catherinot E. [Pulmonary complications of Chronic Granulomatous Disease]. Rev Mal Respir 2024; 41:156-170. [PMID: 38272769 DOI: 10.1016/j.rmr.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024]
Abstract
Chronic Granulomatosis Disease (CGD) is an inherited immune deficiency due to a mutation in the genes coding for the subunits of the NADPH oxidase enzyme that affects the oxidative capacity of phagocytic cells. It is characterized by increased susceptibility to bacterial and fungal infections, particularly Aspergillus, as well as complications associated with hyperinflammation and granulomatous tissue infiltration. There exist two types of frequently encountered pulmonary manifestations: (1) due to their being initially pauci-symptomatic, possibly life-threatening infectious complications are often discovered at a late stage. Though their incidence has decreased through systematic anti-bacterial and anti-fungal prophylaxis, they remain a major cause of morbidity and mortality; (2) inflammatory complications consist in persistent granulomatous mass or interstitial pneumoniae, eventually requiring immunosuppressive treatment. Pulmonary complications recurring since infancy generate parenchymal and bronchial sequelae that impact functional prognosis. Hematopoietic stem cell allograft is a curative treatment; it is arguably life-sustaining and may limit the morbidity of the disease. As a result of improved pediatric management, life expectancy has increased dramatically. That said, new challenges have appeared with regard to adults: difficulties of compliance, increased inflammatory manifestations, acquired resistance to anti-infectious therapies. These different developments underscore the importance of the transition period and the need for multidisciplinary management.
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Affiliation(s)
- H Salvator
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; UMR0892 VIM-Suresnes Inrae, université Paris-Saclay, Suresnes, France; Faculté de Sciences de la Vie Simone Veil, Université Versailles Saint Quentin, Montigny-le-Bretonneux, France.
| | - N Mahlaoui
- Centre de référence déficits immunitaires héréditaires (CEREDIH), hôpital Necker-Enfants Malades, institut Imagine, université Paris Cité, Assistance publique-Hôpitaux de Paris, Paris, France; Service d'hématologie-immunologie et rhumatologie pédiatrique, hôpital Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, Paris, France
| | - F Suarez
- Centre de référence déficits immunitaires héréditaires (CEREDIH), hôpital Necker-Enfants Malades, institut Imagine, université Paris Cité, Assistance publique-Hôpitaux de Paris, Paris, France; Service d'hématologie adultes, hôpital Necker-Enfants Malades, université Paris Cité, Assistance publique-Hôpitaux de Paris, Paris, France
| | - A Marcais
- Service d'hématologie adultes, hôpital Necker-Enfants Malades, université Paris Cité, Assistance publique-Hôpitaux de Paris, Paris, France
| | - E Longchampt
- Service d'anatomopathologie, hôpital Foch, Suresnes, France
| | - C Tcherakian
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - C Givel
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - A Chabrol
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - E Caradec
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - O Lortholary
- Service de maladies infectieuses, hôpital Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, Paris, France; Centre national de référence des mycoses invasives et antifongiques, Centre national de la recherche scientifique, unite mixté de recherche (UMR) 2000, Institut Pasteur, université Paris Cité, Paris, France
| | - F Lanternier
- Service de maladies infectieuses, hôpital Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, Paris, France; Centre national de référence des mycoses invasives et antifongiques, Centre national de la recherche scientifique, unite mixté de recherche (UMR) 2000, Institut Pasteur, université Paris Cité, Paris, France
| | - C Goyard
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L J Couderc
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; UMR0892 VIM-Suresnes Inrae, université Paris-Saclay, Suresnes, France
| | - E Catherinot
- Service de pneumologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
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Mouren D, Goyard C, Catherinot E, Givel C, Chabrol A, Tcherakian C, Longchampt E, Vargaftig J, Farfour E, Legal A, Couderc LJ, Salvator H. COVID-19 and Pneumocystis jirovecii pneumonia: Back to the basics. Respir Med Res 2021; 79:100814. [PMID: 33610911 PMCID: PMC7863763 DOI: 10.1016/j.resmer.2021.100814] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/31/2021] [Indexed: 01/15/2023]
MESH Headings
- Aged
- COVID-19/complications
- COVID-19/diagnosis
- COVID-19/diagnostic imaging
- COVID-19 Nucleic Acid Testing
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Pneumocystis carinii
- Pneumonia, Pneumocystis/complications
- Pneumonia, Pneumocystis/diagnostic imaging
- Pneumonia, Pneumocystis/prevention & control
- Radiography, Thoracic
- Tomography, X-Ray Computed
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Affiliation(s)
- D Mouren
- Hôpital Foch, service de pneumologie, Suresnes, France; Hôpital Bichat, service de pneumologie B et transplantation pulmonaire, Paris, France.
| | - C Goyard
- Hôpital Foch, service de pneumologie, Suresnes, France
| | - E Catherinot
- Hôpital Foch, service de pneumologie, Suresnes, France
| | - C Givel
- Hôpital Foch, service de pneumologie, Suresnes, France; Faculté des sciences de la vie Simone-Veil, université Paris-Saclay, Kremlin-Bicêtre, France
| | - A Chabrol
- Hôpital Foch, service de pneumologie, Suresnes, France
| | - C Tcherakian
- Hôpital Foch, service de pneumologie, Suresnes, France
| | - E Longchampt
- Hôpital Foch, service d'anatomie pathologique, Suresnes, France
| | - J Vargaftig
- Hôpital René-Huguenin, département d'hématologie clinique, Saint-Cloud, France
| | - E Farfour
- Hôpital Foch, service de microbiologie, Suresnes, France
| | - A Legal
- Hôpital Foch, service de pneumologie, Suresnes, France
| | - L-J Couderc
- Hôpital Foch, service de pneumologie, Suresnes, France; Faculté des sciences de la vie Simone-Veil, université Paris-Saclay, Kremlin-Bicêtre, France; UPRES EA 220, université Paris-Saclay, Kremlin-Bicêtre, France
| | - H Salvator
- Hôpital Foch, service de pneumologie, Suresnes, France; UPRES EA 220, université Paris-Saclay, Kremlin-Bicêtre, France
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Philippot Q, Roche A, Goyard C, Pastré J, Planquette B, Meyer G, Sanchez O. Prise en charge de l'embolie pulmonaire grave en réanimation. Méd Intensive Réa 2018. [DOI: 10.3166/rea-2018-0037] [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: 11/20/2022]
Abstract
L'embolie pulmonaire (EP) grave, définie par la présence d’un état de choc, est à l'origine d'une mortalité importante. L'objectif de cette mise au point est de synthétiser les dernières avancées et recommandations concernant la prise en charge des formes graves d'EP. La stratification du risque individuel de mortalité précoce permet d'apporter une stratégie diagnostique et thérapeutique optimisée pour chaque patient. Le traitement symptomatique consiste essentiellement en la prise en charge de l'état de choc. L'anticoagulation curative par héparine non fractionnée est réservée aux patients hémodynamiquement instables. Chez ces patients à haut risque, la thrombolyse systémique diminue la mortalité et le risque de récidive d'EP. Chez les patients à risque intermédiaire élevé, la thrombolyse systémique à dose standard diminue le risque de choc secondaire mais sans impact sur la mortalité globale. La thrombolyse est donc réservée aux patients à risque intermédiaire élevé présentant secondairement un état de choc. L'embolectomie chirurgicale reste indiquée en cas de contre-indication absolue à la thrombolyse ou en cas d'échec de celle-ci. Le positionnement dans l'algorithme thérapeutique de l'assistance extracorporelle et des techniques percutanées de revascularisation reste à définir. Leurs indications doivent donc être discutées dans des centres experts après une concertation multidisciplinaire incluant pneumologues, cardiologues, réanimateurs, radiologues interventionnels et chirurgiens cardiaques.
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Rossi E, Goyard C, Cras A, Dizier B, Bacha N, Planquette B, Mignon V, Bernabeu C, Sanchez O, Smadja D. Co-injection of mesenchymal stem cells with endothelial progenitor cells accelerate muscle recovery in Hind limb ischemia by an endoglin-dependent mechanism. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30447-0] [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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Goyard C, Sanchez O, Mourin G, Mussot S, Boudjemaa A, de Montpreville V, Meyer G, Ferre A. [Angiosarcoma mimicking recurrent pulmonary embolism]. Rev Mal Respir 2015; 33:377-82. [PMID: 26603960 DOI: 10.1016/j.rmr.2015.07.001] [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: 10/09/2014] [Accepted: 06/29/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Pulmonary artery sarcoma is a rare disease with non-specific symptoms. The clinical and radiological presentation can mimic pulmonary embolism with chronic thromboembolic pulmonary hypertension. Management is essentially surgical but the prognosis remains poor. CASE REPORT A patient presented with symptoms of pulmonary embolism. Despite vitamin K antagonist therapy, he suffered from extension of the endovascular defects and his pulmonary hypertension increased. Suspicious results of positron emission tomography suggested the diagnosis of pulmonary artery sarcoma that was confirmed by surgery. However, the outcome was unfavourable, leading to death of the patient. CONCLUSION This case reinforces the idea that the clinical and tomodensitometric presentations of pulmonary arterial sarcoma and chronic thromboembolic pulmonary hypertension are similar. The positron emission tomography seems to be a key to distinguishing these two diagnoses.
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Affiliation(s)
- C Goyard
- Service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - O Sanchez
- Service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - G Mourin
- Service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - S Mussot
- Service de chirurgie thoracique, vasculaire et transplantation cardio-pulmonaire, centre chirurgical Marie-Lannelongue, 92350 Le Plessis-Robinson, France
| | - A Boudjemaa
- Service de pneumologie, centre hospitalier intercommunal de Créteil, 94010 Créteil, France
| | - V de Montpreville
- Service d'anatomie et de cytologie pathologiques, centre chirurgical Marie-Lannelongue, 92350 Le Plessis-Robinson, France
| | - G Meyer
- Service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
| | - A Ferre
- Service de pneumologie et soins intensifs, hôpital européen Georges-Pompidou, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France.
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