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Cytokine and chemokine profiles in the sera of COVID-19 patients with different stage of severity. Cytokine 2024; 180:156653. [PMID: 38781873 DOI: 10.1016/j.cyto.2024.156653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION COVID-19 is a viral infection that disturbs the host's immune system and causes an overproduction of cytokines leading to a cytokine storm. The present study aimed to evaluate the serum levels of 27 protein biomarkers to determine their association with COVID-19 disease severity. METHODS The serum levels of 89 patients with different degrees of COVID-19 disease severity [asymptomatic (n = 14), moderate (n = 14), severe (n = 30), and critical (n = 31)] and 14 healthy individuals were tested for a panel of 27 cytokines and chemokines using Luminex assay (27 Bio‑Plex Pro Human Cytokine, Bio-rad™). RESULTS IL-12, IL-2 and IL-13, as well as IL-17 and GM-CSF were clearly undetectable in asymptomatic patients. IL-8 levels were higher in asymptomatic compared with other groups. Very high levels of IL-6, IL-10 and the chemokines MIP-1α, MCP-1 and IP10 were associated with disease progression, while IL-4 tends to decrease with disease severity. CONCLUSION Our study provides more evidence that excessive cytokine synthesis is linked to the disease progression.
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Sphingolipidoses in Morocco: Chemical profiling for an affordable and rapid diagnosis strategy. Prostaglandins Other Lipid Mediat 2023; 168:106751. [PMID: 37295489 DOI: 10.1016/j.prostaglandins.2023.106751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/28/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
Sphingolipidoses are a group of metabolic diseases in which lysosomal hydrolases dysfunction disrupt normal sphingolipids' metabolism, leading to excess accumulation in cellular compartments and excretion in urine. These pathologies represent a significant burden among Moroccan population, for which an easy access to enzymatic assays and genetic tests is not guaranteed. Parallel analytical methods thus have to be developed for preliminary screening. In this study, 107 patients were addressed to the metabolic platform of the Marrakesh Faculty of Medicine for diagnosis confirmation. Thin-Layer Chromatography was used as a first step to perform chemical profiling of the patients' urinary lipids, allowing 36% of the patients to be efficiently oriented towards the adequate enzymatic assay. UPLC-MS/MS analyses of urinary sulfatides excreted in urines patient had been used to control the reliability of TLC analysis and to obtain more accurate information related to the sulfatides isoforms. This analytical process combining TLC with UPLC-MS/MS has enabled rapid and appropriate patient management in a reduced time and with reduced resources.
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Hypertrophic Pachymeningitis as an Unusual Cause of Headache and Sphincter Dysfunction in Systemic Lupus Erythematosus. Eur J Case Rep Intern Med 2023; 10:004035. [PMID: 37789986 PMCID: PMC10545157 DOI: 10.12890/2023_004035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023] Open
Abstract
Hypertrophic pachymeningitis (HP) is an uncommon condition characterised by focal or diffuse thickening of the dura mater. An increasing number of cases have been reported of its association with underlying connective tissue diseases. It is a rare complication in systemic lupus erythematosus (SLE) and might be the initial and sole clinical manifestation. We report a case of a 21-year-old man presenting with febrile meningeal syndrome and sphincter dysfunction. Physical examination showed malar rash and joint pain. Biological assessment revealed a regenerative normocytic normochromic anaemia, a leucopenia and a lymphopenia. The 24-hour urine protein was positive at 0.6 g. Immunological evaluation revealed positive antinuclear, anti-Sm and anti-dsDNA antibodies. Brain and spinal magnetic resonance imaging showed hypertrophic pachymeningitis. Cerebrospinal fluid biochemistry was within normal limits. Renal biopsy revealed a mesangial proliferative lupus nephritis. The diagnosis of SLE with neurologic and renal involvement was established, and the patient was treated with intravenous methylprednisolone pulse, followed by oral prednisone in association with azathioprine and hydroxychloroquine. Considering the persistence of symptoms and MRI lesions after 6 months, a treatment with rituximab was initiated with good evolution. LEARNING POINTS Hypertrophic pachymeningitis is a rare condition of diverse aetiologies.A workup including search for infectious, autoimmune and neoplastic aetiologies should be performed.It is an extremely rare complication in systemic lupus erythematosus and might be the initial and sole clinical manifestation.
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Anti-MDA5 antibody-positive dermatomyositis with mild encephalopathy with reversible splenial lesion: a possible rare association? Wien Med Wochenschr 2023; 173:263-266. [PMID: 35729459 PMCID: PMC9211780 DOI: 10.1007/s10354-022-00943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/25/2022] [Indexed: 12/01/2022]
Abstract
Central nervous system (CNS) involvement in dermatomyositis (DM) is seldom observed. However, there are very rare case reports of CNS involvement with juvenile dermatomyositis. Encephalopathy in DM may occur for a number of reasons, such as cerebral vasculitis and hypoperfusion/hypertensive encephalopathy, but mostly as a consequence of immunosuppressant treatment. We report here for the first time the case of a patient with two rare diseases, namely anti-MDA5 antibody-positive dermatomyositis and mild encephalopathy with reversible splenial lesion (MERS).
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Haemorrhagic Pericardial Effusion as the Presenting Symptom of Scurvy. Eur J Case Rep Intern Med 2023; 10:004026. [PMID: 37680776 PMCID: PMC10482132 DOI: 10.12890/2023_004026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction Vitamin C deficiency (or scurvy) usually takes weeks to become apparent as cutaneous signs and impaired wound healing. Haemorrhagic pericarditis remains a rare complication of scurvy, which has never been reported as an isolated condition. We report the case of a haemorrhagic pericarditis revealing a vitamin C deficiency in a 56-year-old patient. Case description A 56-year-old woman presented with a 2-week history of worsening chest pain and dyspnoea, with no significant medical history. Upon admission, the patient exhibited tachycardia, tachypnoea, low blood pressure, elevated jugular venous pressure, muffled heart sounds and multiple petechiae on her lower limbs. An ultrasound revealed a large pericardial effusion, and an emergency pericardiocentesis was performed, which yielded haemorrhagic fluid without atypical cells. An initial workup including haemoculture, PT and PTT, tuberculosis workup, autoantibodies, tumour markers and infectious disease was negative. A whole-body CT scan showed no evidence of tuberculosis or lymphoma. Additional testing showed that her vitamin C level was <3 umol/L. Following stabilisation, high-dose vitamin C therapy was initiated. Subsequently, she showed continued clinical improvement and remained asymptomatic upon her discharge. Discussion While uncommon, it is crucial to investigate vitamin C deficiency when confronted with an unexplained haemorrhagic pericardial effusion, particularly in patients with risk factors. Conclusion Our case highlights the significance of early detection of this condition in promptly addressing the diverse complications of scurvy, thereby enhancing the prognosis of a potentially fatal condition. LEARNING POINTS Haemorrhagic pericarditis could be an initial indication of scurvy.Vitamin C deficiency must be included in the differential diagnostic of haemorrhagic tamponade, even in the absence of a typical signs and symptoms of scurvy.
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Thrombose veineuse extensive du membre supérieur après la vaccination anti-COVID-19. Rev Med Interne 2022. [PMCID: PMC9724757 DOI: 10.1016/j.revmed.2022.10.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction Les événements indésirables après la vaccination COVID-19 ont été une grande préoccupation au monde entier, faits majoritairement de réactions locales, syndrome pseudo-grippal, avec quelques cas de syndrome de Guillain-Barré, de myocardite et/ou de péricardite. En outre, de rares cas de thrombocytopénie thrombotique immunitaire induite par le vaccin (VITT) et de thromboses cérébrales ont été signalés surtout avec les vaccins à vecteur adénoviral. Nous rapportons un cas d’une thrombose du membre supérieur étendue à la veine axillaire, sous-clavière et jugulaire interne après vaccination COVID-19. Observation Patiente de 69 ans, sans antécédents pathologiques particuliers, sans facteurs de risque thrombogènes évidents, ayant présenté 3 semaines après sa première dose de vaccin AstraZeneca COVID-19 (ChAdOx1) une tuméfaction du membre supérieur gauche, au site de la vaccination, dure, chaude, douloureuse, sans signes infectieux. L’écho-Doppler veineux a objectivé une thrombophlébite superficielle et profonde du membre supérieur gauche étendue intéressant les veines radiales, cubitales, brachiales, axillaire, sous-clavière et jugulaire interne. Le bilan étiologique notamment infectieux, néoplasique, immunologique et de thrombophilie était négatif. Il n’y avait pas de thrombopénie. Sur le plan thérapeutique, la patiente a été mise sous héparinothérapie à dose curative avec relais par anti-vitamine K. L’évolution était favorable avec disparition de la tuméfaction du membre supérieur gauche. Conclusion La TVP aiguë après le vaccin AstraZeneca COVID-19 (ChAdOx1) est liée à l’activation de la cascade inflammatoire et à la coagulopathie. Il s’agit plutôt de thromboses cérébrales, abdominales ou d’embolies pulmonaires. La localisation au membre supérieur est exceptionnelle. Nous en discutons les mécanismes possibles.
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Refeeding syndrome : une complication à ne pas oublier. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Vascularite à ANCA mimant une colite inflammatoire. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Maladie de Takayasu révélée par des microanévrysmes rétiniens résolus sous tocilizumab. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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[Stiff person syndrome associated with dermatitis herpetiformis: a case report]. Pan Afr Med J 2021; 40:27. [PMID: 34733395 PMCID: PMC8531973 DOI: 10.11604/pamj.2021.40.27.30313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/15/2021] [Indexed: 11/25/2022] Open
Abstract
Le syndrome de la personne raide (SPR) est une maladie rare affectant le système nerveux central et qui peut être d´origine auto-immune, paranéoplasique ou idiopathique. Sa présentation classique typique est caractérisée par une rigidité progressive du tronc et des membres, associée à des spasmes. Le diagnostic est soutenu par l'existence d'une activité musculaire continue et spontanée en détection à l'électroneuromyogramme, la présence d'anticorps anti-acide glutamique décarboxylase (anti-GAD) sériques, et une réponse aux benzodiazépines. Nous rapportons le cas d'un patient de 46 ans ayant une forme classique de syndrome de la personne raide auto-immune associée à une dermatite herpétiforme.
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Necrotizing Fasciitis of the Breast Underlying an Autoimmune Disease. Eur J Case Rep Intern Med 2021; 8:002434. [PMID: 33987123 DOI: 10.12890/2021_002434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/11/2021] [Indexed: 11/05/2022] Open
Abstract
Necrotizing fasciitis is a serious soft tissue infection that causes necrosis of the subcutaneous tissues and the muscle fascia. It is associated with a high mortality rate of around 25%. Necrotizing fasciitis of the breast is a rare entity. It is a rapidly progressive life-threatening condition which can lead to sepsis with multiple organ failure. We describe a case of necrotizing fasciitis of the right breast in a 48-year-old patient diagnosed with systemic sclerosis-rheumatoid arthritis overlap syndrome. LEARNING POINTS Necrotizing fasciitis of the breast is a very challenging diagnosis due to its rarity and similarity with simple breast infection.It is a life-threatening condition which can lead to systemic shock and multiple organ dysfunction syndrome and death.It may occur in patients with rheumatic diseases treated with corticosteroids and immunosuppressant drugs.
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[Drug-induced toxidermia in a patient receiving hydroxychloroquine as systemic therapy for primary Gougerot-Sjögren syndrome: a case report]. Pan Afr Med J 2021; 38:283. [PMID: 34122710 PMCID: PMC8180004 DOI: 10.11604/pamj.2021.38.283.28478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 11/11/2022] Open
Abstract
Nous rapportons un cas d´exanthème maculo-papuleux apparu après une semaine de prise de l´hydroxychloroquine 400mg prescrite pour une atteinte articulaire d´un syndrome de Gougerot-Sjögren primaire chez une patiente de 41 ans. Cette dernière était suivie pour une lésion glomérulaire minime idiopathique depuis plus d´un an, traitée efficacement avec la corticothérapie. Les exanthèmes maculo-papuleux ont régressé après avoir reçu l´hydrocortisone, la desloratadine et l´arrêt immédiat de l´hydroxychloroquine. Notre cas reflète l´importance d´insister sur la prescription à faible dose de l´hydroxychloroquine chez les sujets avec des pathologies préexistantes rénales et aussi l´intérêt de sensibiliser et d´éduquer les patients des effets secondaires de l´hydroxychloroquine.
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Myasthenia Gravis Revealing Hodgkin's Lymphoma. Eur J Case Rep Intern Med 2021; 8:002375. [PMID: 33987113 DOI: 10.12890/2021_002375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/25/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Myasthenia gravis is a rare autoimmune disease caused by autoantibodies directed against the synapses of the neuromuscular junction. Patient and methods We report the case of a young patient with myasthenia gravis associated with Hodgkin's lymphoma. Results A 22-year-old patient presented with a 2-month history of severe weakness associated with muscle fatigability and intermittent ptosis without dysphonia or respiratory signs. Clinical examination revealed generalized myasthenia. The EMG did not show post-synaptic block, and anti-acetylcholine receptor antibodies were elevated at 3 nmol/l (normal ≤0.3 nmol/l). CT of the thorax showed an anterior medial mass. Immunohistochemistry of the mass revealed mixed cellularity Hodgkin's lymphoma. Conclusion The association of lymphomas with myasthenia gravis has been rarely reported. LEARNING POINTS Myasthenia gravis is an autoimmune disease of the neuromuscular junction and can be associated with malignant haemopathy.The coexistence of myasthenia and Hodgkin's lymphoma is very rare.This association is a therapeutic challenge.
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Fréquence et facteurs prédictifs de thrombose veineuse au cours de la maladie de Behçet. Rev Med Interne 2020; 41:578-582. [DOI: 10.1016/j.revmed.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
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Differential diagnosis of COVID-19 in symptomatic patients at the University Hospital Center Mohammed VI, Marrakesh. Pan Afr Med J 2020; 36:269. [PMID: 33088398 PMCID: PMC7545975 DOI: 10.11604/pamj.2020.36.269.24558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan, China. Clinical spectrum of this disease has nonspecific symptoms shared by many other frequent infectious diseases of the respiratory tract and other respiratory tract diseases. This study explains the importance of differential diagnosis between COVID-19 and other lung diseases. METHODS we analyzed in this study, the demographic features, clinical presentations, laboratory data and radiologic findings of the COVID-19 patients in comparison to those with other respiratory infections or diseases. RESULTS the mean age of all patients was 38.04 years; 35 patients were later confirmed to be positive for SARS-CoV-2 infection. The most common symptoms reported by both groups included nonproductive cough and myalgia. Two of the non-COVID-19 patients were having below 92% oxygen saturation and low systolic blood pressure. The patients shared relatively similar laboratory findings except 3% of the non-COVID-19 patients who had lympho-neutropenia and 22.6% had high levels of C-reactive protein. Pulmonary tuberculosis and autoimmune disease respiratory disorder were suspected in 2 of the non-COVID-19 patients respectively. CONCLUSION we emphasize the importance of good screening protocols, rapid detection of SARS-CoV-2 and other most common respiratory pathogens, which may help for a better control of COVID-19 spread and avoid delayed care of other lung diseases.
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La mucormycose orbito-facial et pulmonaire mimant une granulomatose avec polyangéite. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Manifestations cardiaques au cours de la granulomatose éosinophilique avec polyangéite. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Transformation maligne et syndrome de Gougerot-Sjögren. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chevauchement entre syndrome des antisynthétases à anti-PL12 et syndrome de Gougerot-Sjögren compliqué d’hypertension pulmonaire. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Efficacité du tocilizumab dans un cas de sarcoïdose oculaire. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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[Extensive digital gangrene revealing late-onset systemic lupus erythematosus]. JOURNAL DE MÉDECINE VASCULAIRE 2017; 42:50-53. [PMID: 28705448 DOI: 10.1016/j.jdmv.2017.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/30/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Late-onset systemic lupus erythematosus represents a specific sub-group of the disorder, beginning after 50 years of age. The incidence is rarer and the course of the disease is considered to be more benign. Digital gangrene is an uncommon complication of systemic lupus erythematosus reported especially among middle-aged patients with long disease duration. OBSERVATION We report a 53-year-old man, who presented with systemic lupus erythematosus revealed by an extensive digital gangrene. CONCLUSION Digital gangrene is a rare complication of late onset systemic lupus erythematosus. Clinicians should be aware of this complication in order to initiate early and aggressive treatment.
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Efficacy and safety of tocilizumab in neuro-Behçet's disease: A case report. Rev Neurol (Paris) 2017; 173:171-172. [DOI: 10.1016/j.neurol.2017.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/19/2016] [Accepted: 02/22/2017] [Indexed: 10/19/2022]
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Neurolupus : aspects cliniques, radiologiques et corrélations. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Le lupus masculin : à propos de 25 cas. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maladie thromboembolique veineuse en médecine interne : une étude descriptive de 157 patients hospitalisés. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nouveaux critères de classification du lupus systémique (SLICC) : quel apport en pratique ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Influence du sexe sur la présentation clinique et le pronostic de la maladie de Behçet. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Maladie de Still de l’adulte réfractaire traitée par tocilizumab : à propos d’un cas et revue de la littérature. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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CO 40 : Les sclérodermies systémiques à travers une série de 73 cas. Ann Dermatol Venereol 2016. [DOI: 10.1016/s0151-9638(16)30167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Adénome de Conn simulant une polymyosite déficitaire. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fréquence, implication clinique et valeur pronostique de la lymphopénie au cours du lupus érythémateux systémique : étude cas témoin. Pan Afr Med J 2015; 21:3. [PMID: 26401197 PMCID: PMC4561153 DOI: 10.11604/pamj.2015.21.3.5593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 03/04/2015] [Indexed: 11/24/2022] Open
Abstract
Le lupus érythémateux systémique (LES) est une maladie auto-immune dotée d'un grand polymorphisme clinique et caractérisée par la production d'une grande variété d'autoanticorps. Sa définition repose sur les critères de l'ACR dont fait partie la lymphopénie. Afin de déterminer s'il existe une corrélation entre la présence de la lymphopénie d'une part et les manifestations cliniques, immunologiques et l'activité du lupus érythémateux systémique d'autre part, nous avons réalisé une étude rétrospective, comparative portant sur 148 cas de LES colligés dans un service de médecine interne entre 2006 et 2012. Ces patients ont été subdivisés en 2 groupes: Groupe 1 avec lymphopénie (taux de lymphocytes < 1500/mm3) et groupe 2 sans lymphopénie (taux de lymphocytes ≥ 1500/mm3). Les 2 groupes ont été comparés en fonction de la présentation clinique et immunologique et l'activité de la maladie mesurée par le SLEDAI (Systemic Lupus Erythematosus Disease Activity Index). L’âge moyen des patients (134 femmes et 14 hommes) était de 35,64 ans. L'atteinte hématologique était présente dans 81,1% des cas avec une lymphopénie dans 69,2% des cas. Une association statistiquement significative était notée entre la lymphopénie et l'atteinte rénale (p = 0,025), l'atteinte cardiaque (p = 0,004), l'anémie hémolytique (p = 0,020), la présence d'anticorps anti DNA (p = 0,046), le traitement par cyclophosphamide (p = 0.035) et l'activité de la maladie (p < 0,01). En revanche il n'y avait pas de corrélation entre la présence de lymphopénie et les atteintes cutanées, articulaires et neuropsychiatriques. La lymphopénie est une manifestation fréquente du lupus systémique. Notre étude a démontré que sa présence est associée à plusieurs manifestations cliniques graves dont les atteintes cardiaque et rénale. Ceci pourrait faire d'elle un outil utile dans l’évaluation du pronostic de la maladie.
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[Lupus nephritis: frequency, histological forms and predictors of renal disease]. LA TUNISIE MEDICALE 2014; 92:626-630. [PMID: 25860678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Lupus nephritis is a common and serious damage in systemic lupus erythematosus. The aim of our study is to define the frequency and to identify the predictors of lupus nephritis in patients with systemic lupus erythematosus. METHODS multicenter retrospective study on all systemic lupus erythematosus patients followed between 2005 and 2012. We analyzed the epidemiological, clinical and biological presentation at admission and during follow-up. We have identified two groups of patients: group 1 involving systemic lupus erythematosus without renal disease, group 2 : patient with lupus nephritis. RESULTS We collected 105 patients including 100 women, 41 (39%) with lupus nephritis occurred after a period of 30±10 months of development of lupus. 4 patients (3%) were initially presented with acute renal failure requiring hemodialysis. The pathological findings of renal biopsy is respectively: class IV, III and II in 19 patients (63.3%), 4 patients (13.3%), and 4 patients (13.3%). Our patients with lupus nephritis received various treatment regimens: 38 patients (92.7%) received corticosteroids and combined with cyclophosphamide in 33 (80.5%) cases. Only young age, anemia and antinuclear antibodies were correlated with the risk of occurrence of renal damage. Predictors of the severity of lupus nephritis were the short time of occurrence of renal and renal failure. CONCLUSION Lupus nephritis in our series is characterized by a severity of the clinical and biological explained by the frequency of proliferative forms, hence the necessity for early and adequate management.
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L’atteinte myéloradiculaire dans le lupus. Rev Neurol (Paris) 2014; 170:140-1. [DOI: 10.1016/j.neurol.2013.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/21/2013] [Accepted: 05/24/2013] [Indexed: 10/26/2022]
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Polyradiculonévrite aiguë révélant un lupus érythémateux systémique : une présentation inhabituelle d’évolution fatale. Rev Med Interne 2014; 35:65-7. [DOI: 10.1016/j.revmed.2012.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 11/02/2012] [Accepted: 11/26/2012] [Indexed: 11/30/2022]
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Neurolupus : aspects cliniques, radiologiques et corrélations. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Maladie de Eales : à propos de 3 cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maladie thromboembolique veineuse au cours de la maladie de Behçet : particularités épidémiologiques, topographiques et évolutives et corrélation avec les autres atteintes. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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[Drug induced interstitial lung disease in systemic diseases]. REVUE DE PNEUMOLOGIE CLINIQUE 2013; 69:307-314. [PMID: 24183295 DOI: 10.1016/j.pneumo.2013.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 06/28/2013] [Accepted: 08/04/2013] [Indexed: 06/02/2023]
Abstract
Immunosuppressants and immunomodulators are designed to regulate excessive immune response responsible for inflammatory lesions and are prescribed more and more in internal medicine. These drugs are known for their efficiency but with a significant toxicity including interstitial lung disease (ILD). Some factors liable to pulmonary toxicity include advanced age, genetic polymorphism and the existence of prior pulmonary disease. Cytotoxicity and hypersensitivity are the main mechanisms of pulmonary toxicity. There is no universal classification of drug induced-lung disease. Theoretically, drugs may be responsible for all histological aspects of ILD. Methotrexate is the most well-known drug as a provider of ILD with a prevalence of 0.3 to 11.6%. Some cases of ILD have also been reported with the new biologics used in systemic diseases. The diagnostic approach to the suspicion of drug ILD is to eliminate non-medicinal causes of pneumonia including infections and tumors before exploring the clinical symptomatology and the results of imaging and bronchoalveolar lavage cell profile. The analysis of the clinical symptomatology check the compatibility of the chronology of clinical and/or radiological pneumonia with the medication suspected. Subsequently, data from the clinical case are compared with those of the literature. Treatment involves stopping the suspected drug. The use of corticosteroids may be required in case of signs of severity or a lingering evolution.
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Coexistence of renal artery stenosis, primary antiphospholipid syndrome and polycythaemia vera: an exceptional association. Lupus 2013; 23:84-7. [PMID: 24197551 DOI: 10.1177/0961203313512010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Renal artery stenosis is the narrowing of the renal artery which causes hypertension and atrophy of the affected kidney, ultimately leading to renal failure if not treated and most often caused by atherosclerosis or fibromuscular dysplasia. Recently, renal artery stenosis has also been documented in patients with the antiphospholipid syndrome and in very few cases with myeloproliferative disease. In this paper, we describe a 31-year-old female with a history of gangrene affecting the toes with severe hypertension (200/110 mmHg), whose investigations revealed a combination of renal artery stenosis, primary antiphospholipid syndrome and polycythaemia vera.
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Répartition saisonnière du lupus érythémateux systémique et sa corrélation avec les facteurs météorologiques. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Score des dommages définitifs (SLICC/ACR :DI) et score d’activité (SLEDAI) comme éléments prédictifs du pronostic du lupus érythémateux systémique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fréquence et valeur clinique et pronostic de la lymphopénie au cours du lupus érythémateux systémique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Aspects radiologiques du neurobehçet. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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[About two particular aspects of sarcoid-like reaction]. REVUE DE PNEUMOLOGIE CLINIQUE 2013; 69:117-119. [PMID: 23498718 DOI: 10.1016/j.pneumo.2013.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 01/20/2013] [Accepted: 01/21/2013] [Indexed: 06/01/2023]
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[A multiple myeloma associated with autoimmune hemolytic anemia]. Presse Med 2013; 42:1533-5. [PMID: 23474050 DOI: 10.1016/j.lpm.2012.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 10/24/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022] Open
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Les manifestations neurologiques du syndrome de Gougerot-Sjögren primitif. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lupus érythémateux systémique et qualité de vie. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Thromboses veineuses splanchniques. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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