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Chevalier K, Hamroun S, Bitoun S, Henry J, Roux C, Briot K, Belkhir R, Mariette X, Seror R. High rate of progression to symptomatic multiple myeloma in patients with smoldering myeloma and isolated osteoporotic vertebral fracture. Bone Rep 2024; 21:101755. [PMID: 38577249 PMCID: PMC10987890 DOI: 10.1016/j.bonr.2024.101755] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024] Open
Abstract
Multiple myeloma (MM) frequently causes vertebral fractures (VF). Some are lytic lesions and others have the aspect of benign osteoporotic fractures not requiring anti-myeloma treatment. We explored outcome of these patients with smoldering myeloma (SM) and osteoporotic VF. In this retrospective bi-centric study, patients were identified using a systematic keyword search on electronic medical records. Patients with SM and isolated VF of osteoporotic aspect without indications for myeloma-specific therapy were included. Overall, 13 (7 %) of the 184 identified patients had SM and VF confirmed to be osteoporotic (median number of VF was 3). During follow-up, 12 (92 %) patients evolved to symptomatic MM, 7 (54 %) of them within 18 months (early progressors). Myeloma defining events were new lytic bone lesions in 7 patients (53.8 %). The serum calcium level was significantly higher in the early progressor group (median 2.35 IQR [2.31-2.38] and 2.28 IQR [2.21-2.29] respectively, p = 0.003). Early progressors had a higher number of VF at diagnosis (3.0 [2.0-5.5] vs 1.0 [1.0-2.5], p = 0.18) and more frequently evolved to symptomatic MM because of lytic bone lesions (5 [71 %] vs 2 [33 %], p = 0.13) compared to late progressors. VF of osteoporotic appearance in the context of SM is a rare situation but at high risk of rapid progression to symptomatic MM, suggesting that they may represent bone fragility linked to MM infiltration rather than solely osteoporotic fractures. Further studies are needed to assess if earlier treatment might be beneficial in this population.
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Affiliation(s)
- Kevin Chevalier
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sabrina Hamroun
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Samuel Bitoun
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Julien Henry
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Christian Roux
- Department of Rheumatology, Université Paris-Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Cochin, Paris, France
| | - Karine Briot
- Department of Rheumatology, Université Paris-Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Cochin, Paris, France
| | - Rakiba Belkhir
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Martin de Frémont G, Chevalier K, Roeser A. [Portrait of Claire Le Jeunne, professor and former head of the internal medicine department at Hôpital Cochin, Paris]. Rev Med Interne 2024:S0248-8663(24)00565-4. [PMID: 38760183 DOI: 10.1016/j.revmed.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Affiliation(s)
- G Martin de Frémont
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Suède.
| | - K Chevalier
- Service de médecine interne, hôpital Ambroise-Paré, AP-HP, 92100 Boulogne-Billancourt, France
| | - A Roeser
- Institut Necker-Enfant malades, 160, rue de Vaugirard, 75015 Paris, France
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Chevalier K, de Frémont GM, Roeser A. [Pr Philippe Morlat, Professor in Internal Medicine at Bordeaux University Hospital, medical advisor to the DGOS (Direction générale de l'offre des soins)]. Rev Med Interne 2024:S0248-8663(24)00098-5. [PMID: 38653602 DOI: 10.1016/j.revmed.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Affiliation(s)
- K Chevalier
- Service de médecine interne, hôpital Ambroise-Paré-Assistance publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
| | - G M de Frémont
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Suède
| | - A Roeser
- Équipe auto-immunité et immunité lymphocytaire B, Institut Necker-Enfants malades, Paris, France
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Chevalier K, Chassagnon G, Leonard-Louis S, Cohen P, Dunogue B, Regent A, Thoreau B, Mouthon L, Chaigne B. Anti-U1RNP antibodies are associated with a distinct clinical phenotype and a worse survival in patients with systemic sclerosis. J Autoimmun 2024; 146:103220. [PMID: 38642508 DOI: 10.1016/j.jaut.2024.103220] [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] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES To clarify the impact of anti-U1RNP antibodies on the clinical features and prognosis of patients with SSc. METHODS We conducted a monocentric case-control, retrospective, longitudinal study. For each patient with SSc and anti-U1RNP antibodies (SSc-RNP+), one patient with mixed connective tissue disease (MCTD) and 2 SSc patients without anti-U1RNP antibodies (SSc-RNP-) were matched for age, sex, and date of inclusion. RESULTS Sixty-four SSc-RNP+ patients were compared to 128 SSc-RNP- and 64 MCTD patients. Compared to SSc-RNP-, SSc-RNP+ patients were more often of Afro-Caribbean origin (31.3% vs. 11%, p < 0.01), and more often had an overlap syndrome than SSc-RNP- patients (53.1 % vs. 22.7%, p < 0.0001), overlapping with Sjögren's syndrome (n = 23, 35.9%) and/or systemic lupus erythematosus (n = 19, 29.7%). SSc-RNP+ patients were distinctly different from MCTD patients but less often had joint involvement (p < 0.01). SSc-RNP+ patients more frequently developed interstitial lung disease (ILD) (73.4% vs. 55.5% vs. 31.3%, p < 0.05), pulmonary fibrosis (PF) (60.9% vs. 37.5% vs. 10.9%, p < 0.0001), SSc associated myopathy (29.7% vs. 6.3% vs. 7.8%, p < 0.0001), and kidney involvement (10.9% vs. 2.3% vs. 1.6%, p < 0.05). Over a 200-month follow-up period, SSc-RNP+ patients had worse overall survival (p < 0.05), worse survival without PF occurrence (p < 0.01), ILD or PF progression (p < 0.01 and p < 0.0001). CONCLUSIONS In SSc patients, anti-U1RNP antibodies are associated with a higher incidence of overlap syndrome, a distinct clinical phenotype, and poorer survival compared to SSc-RNP- and MCTD patients. Our study suggests that SSc-RNP+ patients should be separated from MCTD patients and may constitute an enriched population for progressive lung disease.
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Affiliation(s)
- Kevin Chevalier
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France
| | - Guillaume Chassagnon
- Department of Radiology, Hôpital Cochin, AP-HP. Centre Université Paris Cité, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France; Université Paris Cité, 85 Boulevard Saint-Germain, 75006, Paris, France
| | - Sarah Leonard-Louis
- Sorbonne Université, INSERM, Department of Neurormyologie and Neuropathology, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Pascal Cohen
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France
| | - Bertrand Dunogue
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France
| | - Alexis Regent
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France
| | - Benjamin Thoreau
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France
| | - Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, Université Paris Cité, F-75014, Paris, France.
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Dang J, Chevalier K, Letavernier E, Tissandier C, Mouawad S, Debray D, Obadia M, Poujois A. Kidney involvement in Wilson's disease: a review of the literature. Clin Kidney J 2024; 17:sfae058. [PMID: 38660122 PMCID: PMC11040517 DOI: 10.1093/ckj/sfae058] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Indexed: 04/26/2024] Open
Abstract
Wilson's disease (WD) is a rare inherited disease due to the mutation of the ATP7B gene, resulting in impaired hepatic copper excretion and its pathological accumulation in various organs such as the liver, the nervous system, or the kidneys. Whereas liver failure and neuropsychiatric disorders are the most common features, less is known about the renal complications. We conducted a review of the literature to define the characteristics and pathophysiology of kidney involvement during WD. This review shed light on strong evidence for direct copper toxicity to renal tubular cells. Excessive tubular copper accumulation might present with various degrees of tubular dysfunction, ranging from mild hydroelectrolytic and acid-base disorders to complete Fanconi syndrome. Proximal and distal renal tubular acidosis also favors development of nephrolithiasis, nephrocalcinosis, and bone metabolism abnormalities. Indirect complications might involve renal hypoperfusion as occurs in hepatorenal or cardiorenal syndrome, but also tubular casts' formation during acute hemolysis, rhabdomyolysis, or bile cast nephropathy. Acute kidney failure is not uncommon in severe WD patients, and independently increases mortality. Finally, specific and long-term therapy by D-penicillamin, one of the most efficient drugs in WD, can cause glomerular injuries, such as membranous nephropathy, minimal-change disease, and, rarely, severe glomerulonephritis. Altogether, our study supports the need for interdisciplinary evaluation of WD patients involving nephrologists, with regular monitoring of tubular and glomerular functions, to provide adequate prevention of renal and bone involvement.
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Affiliation(s)
- Julien Dang
- Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital de Bicêtre, Service de Néphrologie et Transplantation, Le Kremlin-Bicêtre, France
- Centre de Compétence Maladies Rares «Syndrome Néphrotique Idiopathique», Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kevin Chevalier
- Hôpital Fondation Rothschild, Service de Neurologie, Paris, France
- Centre de Référence de la Maladie de Wilson et autres Maladies Rares Liées au Cuivre, Paris, France
| | - Emmanuel Letavernier
- AP-HP, Hôpital Tenon, Service des Explorations Fonctionnelles Multidisciplinaires, Paris, France
| | - Come Tissandier
- Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital de Bicêtre, Service de Néphrologie et Transplantation, Le Kremlin-Bicêtre, France
- Centre de Compétence Maladies Rares «Syndrome Néphrotique Idiopathique», Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Sarah Mouawad
- Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Hôpital de Bicêtre, Service de Néphrologie et Transplantation, Le Kremlin-Bicêtre, France
- Centre de Compétence Maladies Rares «Syndrome Néphrotique Idiopathique», Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Dominique Debray
- Hôpital Fondation Rothschild, Service de Neurologie, Paris, France
- Centre de Référence de la Maladie de Wilson et autres Maladies Rares Liées au Cuivre, Paris, France
| | - Mickaël Obadia
- Hôpital Fondation Rothschild, Service de Neurologie, Paris, France
- Centre de Référence de la Maladie de Wilson et autres Maladies Rares Liées au Cuivre, Paris, France
| | - Aurélia Poujois
- Hôpital Fondation Rothschild, Service de Neurologie, Paris, France
- Centre de Référence de la Maladie de Wilson et autres Maladies Rares Liées au Cuivre, Paris, France
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Chevalier K, Chaigne B, Mouthon L. Authors reply: Clinical presentation, course, and prognosis of patients with mixed connective tissue disease. J Intern Med 2024; 295:576-578. [PMID: 38178549 DOI: 10.1111/joim.13765] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Affiliation(s)
- Kevin Chevalier
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
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Chevalier K, Thoreau B, Michel M, Godeau B, Agard C, Papo T, Sacre K, Seror R, Mariette X, Cacoub P, Benhamou Y, Levesque H, Goujard C, Lambotte O, Bonnotte B, Samson M, Ackermann F, Schmidt J, Duhaut P, Kahn JE, Hanslik T, Costedoat-Chalumeau N, Terrier B, Regent A, Dunogue B, Cohen P, Guern VL, Hachulla E, Chaigne B, Mouthon L. Clinical presentation, course, and prognosis of patients with mixed connective tissue disease: A multicenter retrospective cohort. J Intern Med 2024; 295:532-543. [PMID: 38013625 DOI: 10.1111/joim.13752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 11/29/2023]
Abstract
OBJECTIVES The objective of this study is to better characterize the features and outcomes of a large population of patients with mixed connective tissue disease (MCTD). METHODS We performed an observational retrospective multicenter cohort study in France. Patients who fulfilled at least one diagnostic criterion set for MCTD and none of the criteria for other differentiated CTD (dCTD) were included. RESULTS Three hundred and thirty patients (88% females, median [interquartile range] age of 35 years [26-45]) were included. The diagnostic criteria of Sharp or Kasukawa were met by 97.3% and 93.3% of patients, respectively. None met other classification criteria without fulfilling Sharp or Kasukawa criteria. After a median follow-up of 8 (3-14) years, 149 (45.2%) patients achieved remission, 92 (27.9%) had interstitial lung disease, 25 (7.6%) had pulmonary hypertension, and 18 (5.6%) died. Eighty-five (25.8%) patients progressed to a dCTD, mainly systemic sclerosis (15.8%) or systemic lupus erythematosus (10.6%). Median duration between diagnosis and progression to a dCTD was 5 (2-11) years. The presence at MCTD diagnosis of an abnormal pattern on nailfold capillaroscopy (odds ratio [OR] = 2.44, 95% confidence interval [95%CI] [1.11-5.58]) and parotid swelling (OR = 3.86, 95%CI [1.31-11.4]) were statistically associated with progression to a dCTD. Patients who did not progress to a dCTD were more likely to achieve remission at the last follow-up (51.8% vs. 25.9%). CONCLUSIONS This study shows that MCTD is a distinct entity that can be classified using either Kasukawa or Sharp criteria, and that only 25.8% of patients progress to a dCTD during follow-up.
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Affiliation(s)
- Kevin Chevalier
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Benjamin Thoreau
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Marc Michel
- Department of Internal Medicine, Henri-Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Est Créteil (UPEC), Créteil, France
| | - Bertrand Godeau
- Department of Internal Medicine, Henri-Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Est Créteil (UPEC), Créteil, France
| | - Christian Agard
- Department of Internal Medicine, Nantes University Hospital, University of Nantes, Nantes, France
| | - Thomas Papo
- Department of Internal Medicine, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Karim Sacre
- Department of Internal Medicine, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Raphaèle Seror
- Department of Rheumatology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Patrice Cacoub
- Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, Université Paris Sorbonne, Paris, France
| | - Ygal Benhamou
- Department of Internal Medicine, CHU de Rouen, UniRouen, Rouen, France
| | - Hervé Levesque
- Department of Internal Medicine, CHU de Rouen, UniRouen, Rouen, France
| | - Cécile Goujard
- Department of Internal Medicine and Clinical Immunology, Université Paris Saclay, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, UMR1184 Inserm, CEA, Le Kremlin Bicêtre, France
| | - Olivier Lambotte
- Department of Internal Medicine and Clinical Immunology, Université Paris Saclay, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, UMR1184 Inserm, CEA, Le Kremlin Bicêtre, France
| | - Bernard Bonnotte
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Félix Ackermann
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Jean Schmidt
- Department of Internal Medicine and RECIF, Amiens University Hospital, Université Picardie Jules Verne, Amiens, France
| | - Pierre Duhaut
- Department of Internal Medicine and RECIF, Amiens University Hospital, Université Picardie Jules Verne, Amiens, France
| | - Jean-Emmanuel Kahn
- Department of Internal Medicine, Ambroise Paré Hospital, Assistance Publique - Hôpitaux de Paris, Université de Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - Thomas Hanslik
- Department of Internal Medicine, Ambroise Paré Hospital, Assistance Publique - Hôpitaux de Paris, Université de Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - Nathalie Costedoat-Chalumeau
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Alexis Regent
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Bertrand Dunogue
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Pascal Cohen
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Véronique Le Guern
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, North-West National Reference Center for Rare Systemic Autoimmune Diseases iques et Auto-Immunes Rares du Nord-Ouest, Hôpital Claude Huriez, Université de Lille, Lille, France
| | - Benjamin Chaigne
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Luc Mouthon
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
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Roeser A, Martin de Frémont G, Chevalier K. [New section: "The journal's portraits"]. Rev Med Interne 2024; 45:186. [PMID: 38575439 DOI: 10.1016/j.revmed.2024.03.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- A Roeser
- Équipe auto-immunité et immunité lymphocytaire B, Institut Necker-Enfants-Malades, 156-160, rue de Vaugirard, 75015 Paris, France.
| | - G Martin de Frémont
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Suède
| | - K Chevalier
- Service de médecine interne, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, Boulogne-Billancourt, France
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Stammler R, Chevalier K, Benhamida S, Le Goff E, Lebut J, Lau N, Thyrault M, Paulet R. The other great imitator among infectious diseases: Leptospirosis. Rev Med Interne 2024; 45:132-137. [PMID: 38123370 DOI: 10.1016/j.revmed.2023.12.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Leptospirosis is a worldwide zoonosis responsible for highly diverse clinical presentations with a wide range of severity. Variable environment exposures to infected urines of rodents have been described. OBSERVATION We report five cases of serologically confirmed leptospirosis leading to hospitalization in an intensive care unit (ICU) of a French center. These patients displayed neurological, respiratory, and abdominal presentation of leptospirosis with variable level of severity. Either professional, leisure related, or daily living exposures have been retrieved. CONCLUSION These cases underline the diversity of clinical presentation and environmental exposure of this infectious disease. They highlight the interest of an exhaustive anamnesis with collection of professional activity, environmental exposures, and leisure activities.
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Affiliation(s)
- R Stammler
- Intensive care unit, Longjumeau Hospital, Longjumeau, France.
| | - K Chevalier
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - S Benhamida
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - E Le Goff
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - J Lebut
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - N Lau
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - M Thyrault
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
| | - R Paulet
- Intensive care unit, Longjumeau Hospital, Longjumeau, France
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Grange L, Chevalier K, Azoyan L. [First junior doctors: State of play one year after the implementation of the consolidation phase within the diploma of specialized studies in internal medicine and clinical immunology]. Rev Med Interne 2024; 45:65-68. [PMID: 37993296 DOI: 10.1016/j.revmed.2023.11.005] [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: 05/14/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION The 2017 reform of the 3rd cycle of medical studies introduced the concept of supervised autonomy with the creation of a new junior doctor (JD) status. The aim of this work was to interview the first class of JDs in internal medicine and clinical immunology (IMCI) regarding the progress and implementation of this final year of internship. METHODS The IMCI JDs were invited to complete an anonymous online survey, contacted by email and social networks. RESULTS The questionnaire received 36 responses out of an estimated fifty JDs. The majority of JDs spent more than 70% of their time on conventional hospitalisation and less than 20% on scheduled hospitalisation. Most of them would have preferred to do more consultations and provide expert counsels. Weekly working hours were not respected for the majority of JDs. Personal education and academic formation were not respected for 77.8% of JDs. Overall, 75% were satisfied with their empowerment and 88.6% felt that the transition to post residency would be easier with the consolidation phase. A third reported that their residency had confirmed their apprehension about practising as an internist, and even that this apprehension might call into question their future practice. CONCLUSION This survey is an initial assessment of the implementation of the JD year in the IMCI residency. A collective effort around this last year of internship seems to be essential to ensure the personal and professional development of young internists.
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Affiliation(s)
- L Grange
- Amicale des Jeunes Internistes, 15, rue de l'École-de-Médecine, 75005 Paris, France; Service de médecine interne, CHU de Saint-Étienne, Saint-Étienne, France.
| | - K Chevalier
- Amicale des Jeunes Internistes, 15, rue de l'École-de-Médecine, 75005 Paris, France; Service de médecine interne, CHU Cochin, AP-HP, Paris, France
| | - L Azoyan
- Amicale des Jeunes Internistes, 15, rue de l'École-de-Médecine, 75005 Paris, France; Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, équipe SUMO, réseau Sentinelles, Sorbonne université, 75012 Paris, France
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11
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Chevalier K, Mouthon L, Chaigne B. Interstitial lung disease phenotype in mixed, differentiated, or overlapping, connective tissue diseases: Comment on the article by Boleto et al. Semin Arthritis Rheum 2024; 64:152331. [PMID: 38129284 DOI: 10.1016/j.semarthrit.2023.152331] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Kevin Chevalier
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, F-75014 Paris, Université Paris Cité, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, F-75014 Paris, Université Paris Cité, France
| | - Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes et Autoinflammatoires Rares d'Ile de France de l'Est et de l'Ouest, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), France; APHP-CUP, Hôpital Cochin, F-75014 Paris, Université Paris Cité, France.
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12
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Chaigne B, Chevalier K, Boucly A, Agard C, Baudet A, Bourdin A, Chabanne C, Cottin V, Fesler P, Goupil F, Jego P, Launay D, Lévesque H, Maurac A, Mohamed S, Tromeur C, Rottat L, Sitbon O, Humbert M, Mouthon L. In-depth characterization of pulmonary arterial hypertension in mixed connective tissue disease: a French national multicentre study. Rheumatology (Oxford) 2023; 62:3261-3267. [PMID: 36727465 DOI: 10.1093/rheumatology/kead055] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Pulmonary arterial hypertension (PAH) is a leading cause of death in MCTD. We aimed to describe PAH in well-characterized MCTD patients. METHODS MCTD patients enrolled in the French Pulmonary Hypertension Registry with a PAH diagnosis confirmed by right heart catheterization were included in the study and compared with matched controls: MCTD patients without PAH, SLE patients with PAH and SSc patients with PAH. Survival rates were estimated by the Kaplan-Meier method and risk factors for PAH in MCTD patients and risk factors for mortality in MCTD-PAH were sought using multivariate analyses. RESULTS Thirty-six patients with MCTD-PAH were included in the study. Comparison with MCTD patients without PAH and multivariate analysis revealed that pericarditis, polyarthritis, thrombocytopenia, interstitial lung disease (ILD) and anti-Sm antibodies were independent predictive factors of PAH/PH in MCTD. Estimated survival rates at 1, 5 and 10 years following PAH diagnosis were 83%, 67% and 56%, respectively. MCTD-PAH presentation and survival did not differ from SLE-PAH and SSc-PAH. Multivariate analysis revealed that tobacco exposure was an independent factor predictive of mortality in MCTD-PAH. CONCLUSION PAH is a rare and severe complication of MCTD associated with a 56% 10-year survival. We identified ILD, pericarditis, thrombocytopenia and anti-Sm antibodies as risk factors for PAH in MCTD and tobacco exposure as a predictor of mortality in MCTD-PAH.
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Affiliation(s)
- Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Kevin Chevalier
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Athenaïs Boucly
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Christian Agard
- Service de Médecine Interne, Nantes Université, CHU Nantes, Nantes, France
| | - Antoine Baudet
- Department of Internal Medicine, Centre de Compétence Maladies Auto-Immunes Systémiques Rares Annecy, CHR Annecy-Genevois, Annecy, France
| | - Arnaud Bourdin
- Physiologie et Médecine Expérimentale du Cœur et des Muscles, Université de Montpellier, Centre National de la Recherche Scientifique, INSERM, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Céline Chabanne
- Service de Cardiologie et Maladies Vasculaires, Centre Hospitalier Universitaire de Rennes, Université de Rennes-Institut National de la Santé et de la Recherche Médicale, Rennes, France
| | - Vincent Cottin
- Unité Mixte de Recherche 754: Infections Virales et Pathologie Comparée, Hospices Civils de Lyon, Université Lyon 1-Institut National de la Recherche Agronomique-Centre National de Référence des Maladies Pulmonaires Rares, Lyon, France
| | - Pierre Fesler
- Service de Médecine Interne, Hôpital Lapeyronie, Montpellier, France
| | | | - Patrick Jego
- Internal Medicine and Clinical Immunology Unit, CHU Rennes, Rennes, France
| | - David Launay
- Service de Médecine Interne et Immunologie Clinique, Centre de Référence Des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France, Université of Lille, Inserm, CHU Lille, U1286 - Institute for Translational Research in Inflammation, Lille, France
| | - Hervé Lévesque
- Department of Internal Medicine, Rouen University Hospital, Rouen, France
- INSERM U 905, University of Rouen IFRMP, Institute for Biochemical Research, Rouen University Hospital, Rouen, France
| | - Arnaud Maurac
- Département de Pneumologie, Hôpital Haut Lévèque, CHU de Bordeaux, Pessac, France
| | - Shirine Mohamed
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Cécile Tromeur
- Internal and Vascular Medicine and Pulmonology Department, CHU Brest, Brest, France
- INSERM U1304 Groupe d'Etude de la Thrombose de Bretagne Occidentale, University Brest, Brest, France
- F-CRIN INNOVTE, Saint-Etienne, France
| | - Laurence Rottat
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université Paris Cité, Paris, France
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Chevalier K, Obadia MA, Djebrani‐Oussedik N, Poujois A. Can Patients with Wilson's Disease Develop Copper Deficiency? Mov Disord Clin Pract 2023; 10:1306-1316. [PMID: 37772303 PMCID: PMC10525062 DOI: 10.1002/mdc3.13813] [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: 07/26/2022] [Revised: 05/15/2023] [Accepted: 05/28/2023] [Indexed: 09/30/2023] Open
Abstract
Background Wilson's disease (WD) is a rare genetic condition characterized by a copper overload in organs secondary to mutation in ATP7B gene. Lifelong decoppering treatments are the keystone of the treatment but must be regularly adapted to obtain a correct copper balance and could lead to copper deficiency (CD). Objectives Study the characteristics of CD in WD patients. Methods CD cases from our cohort of 338 WD patients have been investigated. CD was defined by the association of serum copper, exchangeable copper and urinary copper excretion assays less than two standard deviations from the mean with cytopenia and/or neurological damage of spinal cord origin. A systematic review of literature about cases of CD in WD patient was performed in PubMed database according to PRISMA guidelines. Results Three WD patients were diagnosed with CD in our cohort. Review of the literature found 17 other patients. Most of the patients had anemia and neutropenia associated with neurological symptoms (especially progressive posterior cord syndrome). All the patients were treated with Zinc salts and the symptoms occurred more than a decade after the initiation of treatment. The adaptation of the treatment allowed a correction of the cytopenia but only a partial improvement of the neurological symptoms. Conclusions WD patients can develop CD after many years of zinc therapy. Anemia and neutropenia are red flags that should evoke CD.
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Affiliation(s)
- Kevin Chevalier
- Department of NeurologyRothschild Foundation HospitalParisFrance
- National Reference Center for Wilson's Disease and Other Copper‐Related Rare DiseasesRothschild Foundation HospitalParisFrance
| | - Mickaël Alexandre Obadia
- Department of NeurologyRothschild Foundation HospitalParisFrance
- National Reference Center for Wilson's Disease and Other Copper‐Related Rare DiseasesRothschild Foundation HospitalParisFrance
| | - Nouzha Djebrani‐Oussedik
- National Reference Center for Wilson's Disease and Other Copper‐Related Rare DiseasesRothschild Foundation HospitalParisFrance
- Toxicology LaboratoryLariboisière Hospital, APHPParisFrance
| | - Aurélia Poujois
- Department of NeurologyRothschild Foundation HospitalParisFrance
- National Reference Center for Wilson's Disease and Other Copper‐Related Rare DiseasesRothschild Foundation HospitalParisFrance
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Chevalier K, Rahli D, de Veyrac L, Guillaume J, Obadia MA, Poujois A. Quality of life and depression in Wilson's disease: a large prospective cross-sectional study. Orphanet J Rare Dis 2023; 18:168. [PMID: 37386576 DOI: 10.1186/s13023-023-02777-4] [Citation(s) in RCA: 3] [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: 10/31/2022] [Accepted: 06/18/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Wilson's disease (WD) is an autosomal recessive genetic disorder due to a mutation of the ATP7B gene, resulting in impaired hepatic copper excretion and accumulation in various tissues. Lifelong decoppering treatments are the keystone of the treatment. These treatments can prevent, stabilize, or reverse the symptoms making WD a chronic disease. Quality of life (QoL) is one of the best outcome measures of any therapeutic intervention in chronic diseases but has not been evaluated in large cohorts of WD patients. METHOD To better evaluate the QoL in WD and the correlation with different clinical or demographic factors we have performed a prospective cross-sectional study. RESULTS Two hundred fifty-seven patients (53.3% men, mean age of 39.3 years and median disease duration of 18.8 years) were included between 1st January 2021 and 31st December 2021. Hepatoneurological form of the disease and depression were significantly correlated with low QoL (p < 0.001 for both). However, the patients' quality of life was similar to that of the general population, and only 29 patients (11.3%) had moderate to severe depression. CONCLUSIONS Neurological patients should be closely monitored to prevent and treat symptoms of depression that impact their quality of life.
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Affiliation(s)
- Kevin Chevalier
- Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Adolphe de Rothschild Foundation Hospital, 29 Rue Manin, 75019, Paris, France
| | - Djamila Rahli
- Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Adolphe de Rothschild Foundation Hospital, 29 Rue Manin, 75019, Paris, France
| | - Louise de Veyrac
- Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Adolphe de Rothschild Foundation Hospital, 29 Rue Manin, 75019, Paris, France
| | - Jessica Guillaume
- Clinical Research Department, Adolphe de Rothschild Foundation Hospital, Paris, France
| | - Michaël Alexandre Obadia
- Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Adolphe de Rothschild Foundation Hospital, 29 Rue Manin, 75019, Paris, France
| | - Aurélia Poujois
- Department of Neurology, Adolphe de Rothschild Foundation Hospital, Paris, France.
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Adolphe de Rothschild Foundation Hospital, 29 Rue Manin, 75019, Paris, France.
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Chevalier K, Genin M, Jean TP, Avouac J, Flipo RM, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Servettaz A, Marotte H, Domont F, Chazerain P, Devaux M, Mekinian A, Sellam J, Fautrel B, Rouzaud D, Ebstein E, Costedoat-Chalumeau N, Richez C, Hachulla E, Mariette X, Seror R. CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases. Front Med (Lausanne) 2023; 10:1152587. [PMID: 37035330 PMCID: PMC10075312 DOI: 10.3389/fmed.2023.1152587] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Autoimmune/inflammatory rheumatic diseases (AIRDs) patients might be at-risk of severe COVID-19. However, whether this is linked to the disease or to its treatment is difficult to determine. This study aimed to identify factors associated with occurrence of severe COVID-19 in AIRD patients and to evaluate whether having an AIRD was associated with increased risk of severe COVID-19 or death. Materials and methods Two databases were analyzed: the EDS (Entrepôt des Données de Santé, Clinical Data Warehouse), including all patients followed in Paris university hospitals and the French multi-center COVID-19 cohort [French rheumatic and musculoskeletal diseases (RMD)]. First, in a combined analysis we compared patients with severe and non-severe COVID-19 to identify factors associated with severity. Then, we performed a propensity matched score case-control study within the EDS database to compare AIRD cases and non-AIRD controls. Results Among 1,213 patients, 195 (16.1%) experienced severe COVID-19. In multivariate analysis, older age, interstitial lung disease (ILD), arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory diseases, and treatment with corticosteroids or rituximab were associated with increased risk of severe COVID-19. Among 35,741 COVID-19 patients in EDS, 316 having AIRDs were compared to 1,264 Propensity score-matched controls. AIRD patients had a higher risk of severe COVID-19 [aOR = 1.43 (1.08-1.87), p = 0.01] but analysis restricted to rheumatoid arthritis and spondyloarthritis found no increased risk of severe COVID-19 [aOR = 1.11 (0.68-1.81)]. Conclusion In this multicenter study, we confirmed that AIRD patients treated with rituximab or corticosteroids and/or having vasculitis, auto-inflammatory disease, and sarcoidosis had increased risk of severe COVID-19. Also, AIRD patients had, overall, an increased risk of severe COVID-19 compares general population.
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Affiliation(s)
- Kevin Chevalier
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Michaël Genin
- University of Lille, CHU Lille, ULR 2694–METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | | | | | | | | | | | | | - Thao Pham
- Hospital Sainte Marguerite, Rheumatology, Marseille, France
| | - Amelie Servettaz
- Hospital Robert Debré, Internal Medicine, Infectious Diseases and Clinical Immunology, Reims, France
| | - Hubert Marotte
- University Hospital of Saint-Étienne, Rheumatology, Saint-Priest-en-Jarez, France
| | - Fanny Domont
- University Hospitals Pitié Salpêtrière - Charles Foix, Internal Medicine and Clinical Immunology, Paris, France
| | - Pascal Chazerain
- Hopital de la Croix Saint-Simon, Rheumatology and Internal Medicine, Paris, France
| | - Mathilde Devaux
- Saint-Germain-en-Laye Intercommunal Hospital Center, Internal Medicine, Poissy, France
| | - Arsene Mekinian
- Hospital Saint-Antoine AP-HP, Internal Medicine, Paris, France
| | - Jérémie Sellam
- Hospital Saint-Antoine AP-HP, Rheumatology, Paris, France
| | - Bruno Fautrel
- Sorbonne Universite – APHP, Pitie Salpetriere Hospital, Department of Rheumatology, Pierre Louis Institute of Epidemiology and Public Health, INSERM UMRS 1136, Paris, France
| | - Diane Rouzaud
- Bichat-Claude Bernard Hospital, Internal Medicine, Paris, France
| | - Esther Ebstein
- Bichat-Claude Bernard Hospital, Rheumatology, Paris, France
| | | | | | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for Rare Systemic Autoimmune Diseases North and North-West of France (CeRAINO), CHU Lille, University of Lille, INSERM, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR 1184: Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Chevalier K, Schmidt J, Coppo P, Galicier L, Noël N, Lambotte O. Hemophagocytic Lymphohistiocytosis Associated With Cytomegalovirus Infection: 5 Cases and a Systematic Review of the Literature. Clin Infect Dis 2023; 76:351-358. [PMID: 35974465 DOI: 10.1093/cid/ciac649] [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: 03/23/2022] [Revised: 07/30/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder characterized by an uncontrolled, persistent, hyperimmune response. It can be triggered by an infectious, neoplastic, or autoimmune event. The involvement of cytomegalovirus (CMV) in the onset of HLH is subject to debate, and the epidemiology of CMV-associated HLH (HLH-CMV) remains poorly characterized. We identified 5 cases of HLH-CMV in our hospital, systematically searched the PubMed database for publications on HLH-CMV, and reviewed 57 publications with a total of 67 cases of HLH-CMV. Only 48 patients (71.6%) were immunodeficient, suggesting that HLH-CMV can occur in immunocompetent patients. The major cause of underlying immunodepression (51%) was inflammatory bowel disease (mainly treated with azathioprine). CMV infection was nearly always symptomatic, and lung involvement was frequent (31 cases). Fifty-five patients recovered. Nineteen patients were treated for CMV infection only and had a good outcome, suggesting that antiviral drugs might be the cornerstone of HLH-CMV treatment.
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Affiliation(s)
- Kevin Chevalier
- Université Paris-Saclay, AP-HP, Hôpital Bicêtre, service de Médecine Interne Immunologie Clinique, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes ImVA, UMR1184, INSERM, CEA, Le Kremlin Bicêtre, France
| | - Julien Schmidt
- Université Paris-Saclay, AP-HP, Hôpital Bicêtre, service de Médecine Interne Immunologie Clinique, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes ImVA, UMR1184, INSERM, CEA, Le Kremlin Bicêtre, France
| | - Paul Coppo
- Sorbonne Université, AP-HP, Hôpital St. Antoine, service d'hématologie clinique et thérapie cellulaire, Paris, France
| | - Lionel Galicier
- Université Paris Cité, AP-HP, Hôpital Saint-Louis, service d'immunologie clinique, Paris, France
| | - Nicolas Noël
- Université Paris-Saclay, AP-HP, Hôpital Bicêtre, service de Médecine Interne Immunologie Clinique, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes ImVA, UMR1184, INSERM, CEA, Le Kremlin Bicêtre, France
| | - Olivier Lambotte
- Université Paris-Saclay, AP-HP, Hôpital Bicêtre, service de Médecine Interne Immunologie Clinique, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes ImVA, UMR1184, INSERM, CEA, Le Kremlin Bicêtre, France
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Chevalier K, Thoreau B, Chaigne B, Seror R, Mariette X, Papo T, Sacre K, Lambotte O, Goujard C, Ackermann F, Paule R, Kahn J, Hanslik T, Costedoat-Chalumeau N, Terrier B, Dunogué B, Cohen P, Le Guern V, Hachulla E, Mouthon L. Présentation clinique, évolution et pronostic des patients atteints de connectivite mixte : cohorte rétrospective multicentrique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.075] [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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Affiliation(s)
- K Chevalier
- Department of Neurology, Foundation Adolphe de Rothschild Hospital, Paris, France.
| | - G Poillon
- Department of Neuroradiology, Foundation Adolphe de Rothschild Hospital, Paris, France
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Chevalier K, Genin M, Petit Jean T, Avouac J, Flipo RM, Georgin-Lavialle S, El Mahou S, Pertuiset E, Pham T, Servettaz A, Marotte H, Domont F, Chazerain P, Devaux M, Mekinian A, Sellam J, Fautrel B, Rouzaud D, Ebstein E, Costedoat-Chalumeau N, Richez C, Hachulla E, Mariette X, Seror R. AB1131 IDENTIFICATION OF FACTORS ASSOCIATED WITH THE OCCURRENCE OF SEVERE FORMS OF COVID-19 INFECTION IN PATIENTS WITH AUTOIMMUNE/INFLAMMATORY RHEUMATIC DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3245] [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
BackgroundPatients with autoimmune/inflammatory rheumatic diseases (AIRD) were suspected to be an at-risk population of severe COVID-19. However, whether this higher risk is linked to the disease or to its treatment is difficult to determine.ObjectivesTo identify, among AIRD patients, factors associated with occurrence of moderate-to-severe COVID19 infection and to evaluate if having an AIRD was associated with an increased risk of severe form of COVID19 infection (defined by hospitalization in ICU or death), compared to general population.MethodsData source: The “Entrepôt des Données de Santé (EDS)” collect data from electronic health records of all patients hospitalized or followed in the AP-HP (39 hospitals in Paris area, France). The French RMD COVID19 cohort is a national multi-center cohort that included patients with confirmed AIRD and diagnosed with COVID-19. All AIRD patients diagnosed with COVID-19 before September 2020 from both cohorts were included.-We Identified factors associated with severe COVID-19 was made in a combined analysis of the 2 cohorts.-Then, we compared COVID-19 infection severity in the EDS-COVID database in AIRD patients and controls, by a propensity score (PS)-matched case-control (1:4) studyResultsAmong 1213 patients (334 in EDS and 879 in RMD cohort), 195 (16.1%) experienced a severe COVID19. In multivariate analysis, greater age, history of interstitial lung disease, arterial hypertension, obesity, sarcoidosis, vasculitis, auto-inflammatory disease and treatment with corticosteroids or rituximab were associated with severe COVID-19 (Table 1).Table 1.AIRD patient’s characteristics associated with severity of COVID-19Patients with mild or moderate infectionPatients with severe infectionOR ajustés 95%CIp-value(N = 1018)(N = 195)Patients characteristics Age55.9 (16.7%)70.3 (14.3%)1.05 [1.03;1.07]<0.001 Gender: Female695 (68.3%)105 (54.1%)0.59 [0.38;0.94]0.025 Interstitial pneumonia38 (3.7%)20 (10.3%)2.94 [1.34;6.34]0.008 Obesity143 (17.8%)38 (27.7%)2.09 [1.26;3.43]0.004 Hypertension268 (26.3%)114 (58.5%)1.81 [1.13;2.89]0.013Underlying Disease: Chronic inflammatory arthritis618 (60.8%)72 (36.9%)Ref. Auto-inflammatory disease29 (2.9%)5 (2.6%)3.91 [1.2;11.32]0.025 Other29 (2.9%)4 (2.1%)0.35 [0.06;1.41]0.15 Connectivitis190 (18.7%)34 (17.4%)1.13 [0.62;2.01]0.69 Sarcoidosis40 (3.9%)24 (12.3%)5.19 [2.15;12.3]<0.001 Vasculitis111 (10.9%)56 (28.7%)1.8 [1.02;3.16]0.044Treatments Corticosteroid318 (31.2%)117 (60.0%)2.47 [1.58;3.87]<0.001 Leflunomide44 (4.3%)2 (1.0%)0.13 [0;0.97]0.045 Rituximab37 (3.7%)22 (11.5%)4.05 [1.96;8.27]<0.001Not significant in multivariate analysisCOPD, Asthma, Coronary heart diseases, stroke, diabetes, smoking, cancer, non-steroidal anti-inflammatory drugs, colchicine, hydroxychloroquine, methotrexate, salazopyrine, mycophenolate mofetil, azathioprine, intravenous immunoglobulins, anti-TNFα, anti-IL1, -IL6, -IL17, Abatacept, JAK inhibitorAmong 35741 COVID-19 patients in EDS, 316 with AIRD were compared to 1264 PS-matched controls. Severe form occurred in 118 (37,3%) AIRD cases and 384 (30.4%) controls (Adjusted OR (aOR) for severe form= 1.43 [1.1;1.9], p=0,01). In analysis restricted to rheumatoid arthritis (RA) and spondylarthritis (SpA), no increased risk of severe form (aOR=1.11 [0.68;1.81]) form or death (aOR=1.00 [0.55;1.81]) was observed.ConclusionIn this multicenter study we confirmed that AIRD patients treated with rituximab or corticosteroids were at increased risk of severe COVID-19, as were those with vasculitis, auto-inflammatory disease, and sarcoidosis. Also, when compared to controls from the same cohort of hospitalized patients, AIRD patients had, overall, an increased risk of severe COVID-19, increased risk not observed in an analysis restricted to patients with RA or SpA.AcknowledgementsFAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributorsPatricia MartelAll clinicians/physicians implicated in COVID-19 patient care in APHP hospital and generated EDS patient dataDisclosure of InterestsNone declared
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Chevalier K, Mauget-Faÿsse M, Vasseur V, Azar G, Obadia MA, Poujois A. Eye Involvement in Wilson’s Disease: A Review of the Literature. J Clin Med 2022; 11:jcm11092528. [PMID: 35566651 PMCID: PMC9102176 DOI: 10.3390/jcm11092528] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/28/2022] [Revised: 04/22/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022] Open
Abstract
Wilson’s disease (WD) is an autosomal recessive genetic disorder due to a mutation of the ATP7B gene, resulting in impaired hepatic copper excretion and accumulation in various tissues. Ocular findings are one of the hallmarks of the disease. Many ophthalmological manifestations have been described and new techniques are currently available to improve their diagnosis and to follow their evolution. We have performed a systematic PubMed search to summarize available data of the recent literature on the most frequent ophthalmological disorders associated with WD, and to discuss the newest techniques used for their detection and follow-up during treatment. In total, 49 articles were retained for this review. The most common ocular findings seen in WD patients are Kayser–Fleischer ring (KFR) and sunflower cataracts. Other ocular manifestations may involve retinal tissue, visual systems and eye mobility. Diagnosis and follow-up under decoppering treatment of these ocular findings are generally easily performed with slit-lamp examination (SLE). However, new techniques are available for the precocious detection of ocular findings due to WD and may be of great value for non-experimented ophthalmologists and non-ophthalmologists practitioners. Among those techniques, anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging are discussed.
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Affiliation(s)
- Kevin Chevalier
- Department of Neurology, Rothschild Foundation Hospital, 75019 Paris, France; (K.C.); (M.A.O.)
- National Reference Center for Wilson’s Disease and Other Copper-Related Rare Diseases, 75019 Paris, France
| | - Martine Mauget-Faÿsse
- Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, France; (M.M.-F.); (G.A.)
| | - Vivien Vasseur
- Clinical Research Center Coordinator, Rothschild Foundation Hospital, 75019 Paris, France;
| | - Georges Azar
- Department of Ophthalmology, Rothschild Foundation Hospital, 75019 Paris, France; (M.M.-F.); (G.A.)
| | - Michaël Alexandre Obadia
- Department of Neurology, Rothschild Foundation Hospital, 75019 Paris, France; (K.C.); (M.A.O.)
- National Reference Center for Wilson’s Disease and Other Copper-Related Rare Diseases, 75019 Paris, France
| | - Aurélia Poujois
- Department of Neurology, Rothschild Foundation Hospital, 75019 Paris, France; (K.C.); (M.A.O.)
- National Reference Center for Wilson’s Disease and Other Copper-Related Rare Diseases, 75019 Paris, France
- Correspondence: ; Tel.:+33-(0)1-48-03-66 56; Fax: +33-(0)1-48-03-62-53
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Roeser A, Chevalier K, Azoyan L, Mouthon L. Exercice du droit au remord au sein du Diplôme d’Études Spécialisées de Médecine Interne et Immunologie Clinique : un état des lieux. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.150] [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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Chevalier K, Benyounes N, Obadia MA, Van Der Vynckt C, Morvan E, Tibi T, Poujois A. Cardiac involvement in Wilson disease: Review of the literature and description of three cases of sudden death. J Inherit Metab Dis 2021; 44:1099-1112. [PMID: 34286869 DOI: 10.1002/jimd.12418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/05/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/07/2022]
Abstract
Wilson disease (WD) is a rare genetic condition that results from a build-up of copper in the body. It requires life-long treatment and is mainly characterized by hepatic and neurological features. Copper accumulation has been reported to be related to the occurrence of heart disease, although little is known regarding this association. We have conducted a systematic review of the literature to document the association between WD and cardiac involvement. Thirty-two articles were retained. We also described three cases of sudden death. Cardiac manifestations in WD include cardiomyopathy (mainly left ventricular (LV) remodeling, hypertrophy, and LV diastolic dysfunction, and less frequently LV systolic dysfunction), increased levels of troponin, and/or brain natriuretic peptide, electrocardiogram (ECG) abnormalities, and rhythm or conduction abnormalities, which can be life-threatening. Dysautonomia has also been reported. The mechanism of cardiac damage in WD has not been elucidated. It may be the result of copper accumulation in the heart, and/or it could be due to a toxic effect of copper, resulting in the release of free oxygen radicals. Patients with signs and/or symptoms of cardiac involvement or who have cardiovascular risk factors should be examined by a cardiologist in addition to being assessed by their interdisciplinary treating team. Furthermore, ECG, cardiac biomarkers, echocardiography, and 24-hours or more of Holter monitoring at the diagnosis and/or during the follow-up of patients with WD need to be evaluated. Cardiac magnetic resonance imaging, although not always available, could also be a useful diagnostic tool, allowing assessment of the risk of ventricular arrhythmias and further guidance of the cardiac workup.
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Affiliation(s)
- Kevin Chevalier
- Department of Neurology, Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Rothschild Foundation Hospital, Paris, France
| | - Nadia Benyounes
- Department of Cardiology, Rothschild Foundation Hospital, Paris, France
| | - Michaël Alexandre Obadia
- Department of Neurology, Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Rothschild Foundation Hospital, Paris, France
| | | | - Erwan Morvan
- Department of Neurology, Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Rothschild Foundation Hospital, Paris, France
| | - Thierry Tibi
- Department of Cardiology, Rothschild Foundation Hospital, Paris, France
| | - Aurélia Poujois
- Department of Neurology, Rothschild Foundation Hospital, Paris, France
- National Reference Center for Wilson's Disease and Other Copper-Related Rare Diseases, Rothschild Foundation Hospital, Paris, France
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Chevalier K, Barde F, Benhamida S, Le Meur M, Thyrault M, Bentoumi Y, Lau N, Lebut J. Invasive aspergillosis and endocarditis. Rev Med Interne 2021; 42:678-685. [PMID: 34303547 DOI: 10.1016/j.revmed.2021.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 01/07/2021] [Revised: 05/31/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Aspergillusfumigatus can cause a systemic infection called invasive aspergillosis causing pulmonary and extra-pulmonary damage. Aspergillus endocarditis (AE) is a relatively rare disease but can be life-threatening. CASE REPORTS We report here on five cases of endocarditis due to invasive aspergillosis: a 58-year-old man receiving immunosuppressive medication following a kidney graft, a 58-year-old man undergoing chemotherapy for chronic lymphocytic leukaemia, a 55-year-old man receiving corticosteroids for IgA vasculitis, a 52-year-old HIV-infected woman under no specific treatment and a 17-year-old boy under immunosuppressive therapy for auto-immune chronic neutropenia. DISCUSSION Aspergillus accounts for 25-30% of fungal endocarditis and 0.25% to 8.5% of all cases of infectious endocarditis. Aspergillus endocarditis results from invasion of the lung arterioles by hyphae and blood dissemination. It is associated with a very high mortality rate (42-68%). Diagnosing Aspergillus endocarditis is mainly problematic because blood cultures are almost always negative, and fever may be absent. Immunosuppression, haematological malignancies, recent cardiothoracic surgery, negative blood cultures with endocarditis and/or systemic or pulmonary emboli are predictors of AE. In the setting of endocarditis, some clinical characteristics may raise early suspicions of aspergillosis rather than a non-fungal agent: no fever, vegetations affecting the mitral valve, non-valve or aortotomy sites, aortic abscess or pseudo-aneurysm. The identification of invasive aspergillosis is based on a chest CT scan, microscopy/culture or other serological and molecular tests. The treatment of Aspergillus endocarditis requires triazole antifungal drugs, and frequently additional surgical debridement. CONCLUSION Aspergillus endocarditis is rare but is associated with a very high mortality rate. Knowledge of its predictive factors and key clinical features can help to differentiate aspergillosis from non-fungal endocarditis and may enable improved survival rates.
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Affiliation(s)
- K Chevalier
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France.
| | - F Barde
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - S Benhamida
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - M Le Meur
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - M Thyrault
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - Y Bentoumi
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - N Lau
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - J Lebut
- Department of Intensive Care Unit, Groupe Hospitalier Nord Essonne, Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
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Chevalier K, Stammler R, Paulet R. [A neurological disorder during pregnancy]. Rev Med Interne 2021; 42:581-582. [PMID: 33648777 DOI: 10.1016/j.revmed.2021.02.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/26/2020] [Accepted: 02/06/2021] [Indexed: 11/26/2022]
Affiliation(s)
- K Chevalier
- Service de Réanimation, Groupe Hospitalier Nord Essonne-Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France.
| | - R Stammler
- Service de Réanimation, Groupe Hospitalier Nord Essonne-Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
| | - R Paulet
- Service de Réanimation, Groupe Hospitalier Nord Essonne-Site Longjumeau, 159, rue du Président François Mitterrand, 91160 Longjumeau, France
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Chevalier K, Marie G, Cabon M, Matthias B, Ficko C, Andriamanantena D. Abcès prostatiques à Staphylococcus aureus sécréteur de leucocidine de Panton et Valentine compliqués de localisations secondaires graves : à propos de deux cas. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.259] [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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Chevalier K, Justine F, Cabral D, De Laroche M, Hanslik T, Kahn J. Un abcès de prostate non infectieux. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.258] [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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Chevalier K, Venon MD, Émile JF, Cabral D, Siméon S, Trichet M, Rouveix É, Hanslik T, Coutte L. Une tularémie mimant un lymphome. Rev Med Interne 2020; 41:632-636. [DOI: 10.1016/j.revmed.2020.03.008] [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] [Received: 12/14/2019] [Revised: 02/14/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
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Chevalier K, Ferreira J, Cabral D, de Laroche M, Hanslik T, Kahn JE. [An abscessed granulomatous prostatitis]. Rev Med Interne 2020; 41:562-566. [PMID: 32674890 DOI: 10.1016/j.revmed.2020.05.019] [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: 09/06/2019] [Revised: 04/13/2020] [Accepted: 05/13/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Prostatic abscesses are usually diagnosed in the setting of bacterial prostatitis. Rarely, they reveal or complicate granulomatous prostatitis. CASE REPORT A 55-year-old man was admitted for acute urinary retention. Urine culture was sterile, with leukocyturia > 106/ml. After failure of antibiotic therapy with cefotaxime, CT scan revealed a necrotic prostatic collection and a nodular non-necrotic tissular lesion in the left upper lung lobe. Trans-rectal drainage of the prostatic lesion and lung biopsies revealed granuloma with multinucleated giant cells (without mycobacteria). The diagnosis of granulomatosis with polyangiitis was confirmed by high level of anti-proteinase 3 antibodies. Treatment with steroids and rituximab resulted in apyrexia, regression of the inflammatory syndrome and clinical manifestations. CONCLUSION The diagnosis of granulomatosis with polyangiitis should be considered in the presence of a non-infectious granulomatous prostatitis with systemic involvement.
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Affiliation(s)
- K Chevalier
- Service de Médecine Interne, Hôpital Ambroise Paré, Université Paris Saclay, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France.
| | - J Ferreira
- Service de Médecine Interne, Hôpital Ambroise Paré, Université Paris Saclay, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - D Cabral
- Service de Radiologie, Hôpital Ambroise Paré, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - M de Laroche
- Service de Médecine Interne, Hôpital Ambroise Paré, Université Paris Saclay, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - T Hanslik
- Service de Médecine Interne, Hôpital Ambroise Paré, Université Paris Saclay, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - J-E Kahn
- Service de Médecine Interne, Hôpital Ambroise Paré, Université Paris Saclay, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
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Chevalier K, Belkhir R, Seror R, Mariette X, Nocturne G. Efficacity of a sequential treatment by anti-CD 20 monoclonal antibody and belimumab in type II cryoglobulinaemia associated with primary Sjögren syndrome refractory to rituximab alone. Ann Rheum Dis 2020; 79:1257-1259. [PMID: 32398282 DOI: 10.1136/annrheumdis-2020-217481] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 01/30/2023]
Affiliation(s)
- Kevin Chevalier
- Rheumatology, Hospital Bicetre, 94270 Le Kremlin-Bicêtre, France
| | - Rakiba Belkhir
- Rheumatology, Hospital Bicetre, 94270 Le Kremlin-Bicêtre, France
| | - Raphaele Seror
- Rheumatology, Hospital Bicetre, 94270 Le Kremlin-Bicêtre, France
| | - Xavier Mariette
- Rheumatology, Hospital Bicetre, 94270 Le Kremlin-Bicêtre, France
| | - Gaetane Nocturne
- Rheumatology, Hospital Bicetre, 94270 Le Kremlin-Bicêtre, France
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Beydon M, Chevalier K, Al Tabaa O, Hamroun S, Delettre AS, Thomas M, Herrou J, Riviere E, Mariette X. Myositis as a manifestation of SARS-CoV-2. Ann Rheum Dis 2020; 80:e42. [PMID: 32327427 DOI: 10.1136/annrheumdis-2020-217573] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Maxime Beydon
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Kevin Chevalier
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Omar Al Tabaa
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Sabrina Hamroun
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | | | - Marion Thomas
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Julia Herrou
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France
| | - Elodie Riviere
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, INSERM UMR1184, Le Kremlin Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, Bicetre Hospital, Le Kremlin-Bicêtre, France .,Université Paris-Saclay, INSERM UMR1184, Le Kremlin Bicêtre, France
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Vijayaraghavan S, Lipfert L, Chevalier K, Bushey B, Henley B, Lenhart R, Sendecki J, Beqiri M, Millar H, Packman K, Lorenzi M, Laquerre S, Moores S. B03 JNJ-61186372, an Fc Effector Enhanced EGFR/cMet Bispecific Antibody, Induces EGFR/cMet Downmodulation and Efficacy Through Monocyte and Macrophage Trogocytosis. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.072] [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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Aubignat M, Chevalier K, Lamy C, Bohbot Y, Delpierre Q, Francois G, Poulet C, Godefroy O. Accidents vasculaires cérébraux multiples révélant une endocardite marastique et un adénocarcinome pulmonaire. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.200] [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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Chevalier K, Venon M, Emile J, Cabral D, Simeon S, Trichet M, Rouveix E, Hanslik T, Coutte L. Fièvre et adénopathies médiastinales : penser aussi à la tularémie. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.305] [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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Basille D, Chevalier K, Andrejak C, Jounieaux V. Pleural transudate: pathophysiology during superior vena cava syndrome. ERJ Open Res 2019; 5:00251-2018. [PMID: 30815469 PMCID: PMC6387991 DOI: 10.1183/23120541.00251-2018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 11/05/2022] Open
Abstract
Pathophysiology, diagnosis and treatment of pleural transudates has widely been described in the literature [1–3]. Except for left heart failure, which requires diuretics, thoracoscopic talc pleurodesis appears to be a safe and effective therapeutic option [4–6]. We report the case of a woman who presented with a sudden pleural fluid formation from her parietal pleura during a talc pleurodesis for a recurrent transudative pleural effusion. We discuss the pathophysiology of this phenomenon. Pleural transudative effusion arises from imbalances between the hydrostatic and/or oncotic pressures. Temperature drop following talc poudrage through a spray may accentuate the pressure changes induced by superior vena cava syndrome.http://ow.ly/EpZm30nwVZj
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Imanbaew D, Nosenko Y, Kerner C, Chevalier K, Rupp F, Riehn C, Thiel W, Diller R. Excited-state dynamics of a ruthenium(II) catalyst studied by transient photofragmentation in gas phase and transient absorption in solution. Chem Phys 2014. [DOI: 10.1016/j.chemphys.2014.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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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Schmitt Y, Chevalier K, Rupp F, Becherer M, Grün A, Rijs AM, Walz F, Breher F, Diller R, Gerhards M, Klopper W. In-depth exploration of the photophysics of a trinuclear palladium complex. Phys Chem Chem Phys 2014; 16:8332-8. [DOI: 10.1039/c4cp00175c] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Wade PR, Palmer JM, McKenney S, Kenigs V, Chevalier K, Moore BA, Mabus JR, Saunders PR, Wallace NH, Schneider CR, Kimball ES, Breslin HJ, He W, Hornby PJ. Modulation of gastrointestinal function by MuDelta, a mixed µ opioid receptor agonist/ µ opioid receptor antagonist. Br J Pharmacol 2013; 167:1111-25. [PMID: 22671931 DOI: 10.1111/j.1476-5381.2012.02068.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND & PURPOSE Loperamide is a selective µ opioid receptor agonist acting locally in the gastrointestinal (GI) tract as an effective anti-diarrhoeal but can cause constipation. We tested whether modulating µ opioid receptor agonism with δ opioid receptor antagonism, by combining reference compounds or using a novel compound ('MuDelta'), could normalize GI motility without constipation. EXPERIMENTAL APPROACH MuDelta was characterized in vitro as a potent µ opioid receptor agonist and high-affinity δ opioid receptor antagonist. Reference compounds, MuDelta and loperamide were assessed in the following ex vivo and in vivo experiments: guinea pig intestinal smooth muscle contractility, mouse intestinal epithelial ion transport and upper GI tract transit, entire GI transit or faecal output in novel environment stressed mice, or four weeks after intracolonic mustard oil (post-inflammatory). Colonic δ opioid receptor immunoreactivity was quantified. KEY RESULTS δ Opioid receptor antagonism opposed µ opioid receptor agonist inhibition of intestinal contractility and motility. MuDelta reduced intestinal contractility and inhibited neurogenically-mediated secretion. Very low plasma levels of MuDelta were detected after oral administration. Stress up-regulated δ opioid receptor expression in colonic epithelial cells. In stressed mice, MuDelta normalized GI transit and faecal output to control levels over a wide dose range, whereas loperamide had a narrow dose range. MuDelta and loperamide reduced upper GI transit in the post-inflammatory model. CONCLUSIONS AND IMPLICATIONS MuDelta normalizes, but does not prevent, perturbed GI transit over a wide dose-range in mice. These data support the subsequent assessment of MuDelta in a clinical phase II trial in patients with diarrhoea-predominant irritable bowel syndrome.
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Affiliation(s)
- P R Wade
- Enterology Research Team, Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Spring House, PA 19087, USA
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Rupp F, Chevalier K, Wolf M, Krüger HJ, Wüllen CV, Nosenko Y, Niedner-Schatteburg Y, Riehn C, Diller R. Photoinduced Processes in Cobalt-Complexes: Condensed Phase and Gas Phase. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20134105045] [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: 11/14/2022] Open
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Jin W, Rupp F, Chevalier K, Wolf MMN, Rojas MC, Lefkidis G, Krüger HJ, Diller R, Hübner W. Combined theoretical and experimental study of spin and charge dynamics on the homodinuclear complex [Ni2(II)(L-N4Me2)(emb)]. Phys Rev Lett 2012; 109:267209. [PMID: 23368615 DOI: 10.1103/physrevlett.109.267209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 10/12/2012] [Indexed: 06/01/2023]
Abstract
We present a combined theoretical and experimental study of spin and charge dynamics on the homodinuclear compound [Ni2(II)(L-N4Me2)(emb)]. The theoretically calculated oscillator strengths of the ground-state absorption spectrum show an acceptable agreement with experiment. We predict a local ultrafast laser-induced spin-flip scenario, which involves charge-transfer states. Experimentally, we observe charge dynamics on two different time scales. The two relevant, transient electronic states and their electronic properties are also theoretically characterized. These results provide a joint investigation of the homodinuclear complex and suggest a realistic scenario for ultrafast spin dynamics and other optical-related manipulations.
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Affiliation(s)
- W Jin
- Department of Physics, University of Kaiserslautern, PO Box 3049, 67653 Kaiserslautern, Germany.
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Wade PR, Palmer JM, Mabus J, Saunders PR, Prouty S, Chevalier K, Gareau MG, McKenney S, Hornby PJ. Prokineticin-1 evokes secretory and contractile activity in rat small intestine. Neurogastroenterol Motil 2010; 22:e152-61. [PMID: 19930539 DOI: 10.1111/j.1365-2982.2009.01426.x] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Prokineticins 1 and 2 (PROK1 and PROK2) are so named because they contract gastrointestinal smooth muscle, yet little else is known about their role in gastrointestinal function. Therefore, we used a combination of approaches to elucidate the mechanisms by which PROK1 alters ileal contractility and secretion in rats. METHODS RT-PCR and immunofluorescence were used to determine PROK and receptor (PK-R) mRNA levels and PK-R1 localization, respectively. Upper GI transit and fluid secretion were determined in vivo. Contractility and intestinal epithelial ion transport were assessed in isolated ileal segments. KEY RESULTS In the gastric fundus, PROK1 mRNA is highly expressed (70-fold >PROK2 mRNA) whereas the ileum has the highest mRNA expression of its receptor. PK-R1 immunoreactivity is visualized in ileal crypt cells, and in submucosal and myenteric neurons. In ileal segments, PROK1 evokes biphasic contractile responses consisting of an early, TTX-sensitive response (EC(50) = 87.8 nmol L(-1)) followed by a late, TTX-insensitive (EC(50) = 72.4 nmol L(-1)) component that is abolished in mucosa-free preparations. Oral administration of PROK1 enhances small bowel transit (111 +/- 3% of control) and fluid secretion (340 +/- 90% of control) and in muscle-stripped ileal preparations increases short-circuit current (EC(50) = 8.2 nmol L(-1)) in a TTX-insensitive manner. The PROK1-evoked Cl- secretion is reduced by piroxicam (non-selective cyclooxygenase inhibitor), and a prostaglandin EP(4) receptor antagonist (AH23848), but not a thromboxane receptor antagonist (GR32191B). CONCLUSIONS & INFERENCES These results demonstrate that PROK1 has oral prokinetic and secretogogue activity and that it acts on the intestinal mucosa via PK-R1 and prostaglandin receptors to mediate these effects.
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Affiliation(s)
- P R Wade
- Enterology Research Team, Drug Discovery, Johnson & Johnson Pharmaceutical Research and Development, LLC, Spring House, PA, USA
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