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Collignon C, Benaboud S, Gana I, Bendavid M, Fournier B, Oualha M, de Marcellus C. Pharmacokinetic of ceftazidime-avibactam in a critically ill patient under high-volume continuous venovenous haemodiafiltration: A first paediatric case report. Br J Clin Pharmacol 2024; 90:890-894. [PMID: 38178624 DOI: 10.1111/bcp.15993] [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: 09/13/2023] [Revised: 12/01/2023] [Accepted: 12/16/2023] [Indexed: 01/06/2024] Open
Abstract
Ceftazidime-avibactam is a novel cephalosporin/B-lactamase inhibitor developed in the context of increasing resistance. This case reports the pharmacokinetics of ceftazidime-avibactam in a critically ill child under continuous renal replacement (CRRT) therapy for fluid overload. The patient was a 6-month-old female with sepsis due to bloodstream infection to Stenotrophomonas maltophilia following stem cell transplantation for severe combined immunodeficiency. CRRT was started on Day 2. Concentrations have been monitored using liquid chromatography-tandem mass spectrometry. Treatment was given every 8 h with a 2 h infusion of 30-7,5 mg/kg and did not reach pharmacokinetic/pharmacodynamic targets. Total clearance was respectively 1.7 and 3.02 L/h, with CRRT clearance respectively 28.8%-60% for ceftazidime and 14%-33% for avibactam. Those clearances are higher than reported in adult literature leading to a risk of treatment failure and emerging resistance. This supports the benefit of monitoring antimicrobial therapy under CRRT and the necessity to assess higher dosing or continuous infusion of ceftazidime-avibactam.
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Affiliation(s)
- Charlotte Collignon
- Pediatric Intensive Care Unit, APHP University Hospital Necker-Enfants Malades, Paris, France
| | - Sihem Benaboud
- Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Department of Clinical Pharmacology, Cochin Hospital, Paris Descartes University, Paris Descartes University, Paris, France
| | - Inès Gana
- Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Department of Clinical Pharmacology, Cochin Hospital, Paris Descartes University, Paris Descartes University, Paris, France
| | - Matthieu Bendavid
- Pediatric Intensive Care Unit, APHP University Hospital Necker-Enfants Malades, Paris, France
| | - Benjamin Fournier
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mehdi Oualha
- Pediatric Intensive Care Unit, APHP University Hospital Necker-Enfants Malades, Paris, France
- Université de Paris, Paris, France
| | - Charles de Marcellus
- Pediatric Intensive Care Unit, APHP University Hospital Necker-Enfants Malades, Paris, France
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Grapin M, Mirand A, Pinquier D, Basset A, Bendavid M, Bisseux M, Jeannoël M, Kireche B, Kossorotoff M, L'Honneur AS, Robin L, Ville Y, Renolleau S, Lemee V, Jarreau PH, Desguerre I, Lacaille F, Leruez-Ville M, Guillaume C, Henquell C, Lapillonne A, Schuffenecker I, Aubart M. Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023. Euro Surveill 2023; 28:2300253. [PMID: 37261730 PMCID: PMC10236930 DOI: 10.2807/1560-7917.es.2023.28.22.2300253] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 06/02/2023] Open
Abstract
We report nine severe neonatal infections caused by a new variant of echovirus 11. All were male, eight were twins. At illness onset, they were 3-5 days-old and had severe sepsis and liver failure. This new variant, detected in France since April 2022, is still circulating and has caused more fatal neonatal enterovirus infections in 2022 and 2023 (8/496; 1.6%, seven associated with echovirus 11) compared with 2016 to 2021 (7/1,774; 0.4%). National and international alerts are warranted.
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Affiliation(s)
- Mathilde Grapin
- Paediatric Intensive Care Unit, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
- These authors contributed equally to the work and share the first authorship
| | - Audrey Mirand
- These authors contributed equally to the work and share the first authorship
- Clermont-Ferrand University Hospital, 3IHP - Infection Inflammation et Interaction Hôtes Pathogènes Virology Department, French Reference Centre for enteroviruses and parechovirus, coordination laboratory, Clermont-Ferrand, France
- Auvergne University, LMGE UMR CNRS 6023, Team Epidemiology and pathophysiology of enterovirus Infection, Clermont-Ferrand, France
| | - Didier Pinquier
- Neonatal and Paediatric Intensive Care Units, Rouen University Hospital, Rouen, France
| | - Aurélie Basset
- Neonatal Intensive Care Unit, Cochin-Port Royal University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Matthieu Bendavid
- Paediatric Intensive Care Unit, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Maxime Bisseux
- Clermont-Ferrand University Hospital, 3IHP - Infection Inflammation et Interaction Hôtes Pathogènes Virology Department, French Reference Centre for enteroviruses and parechovirus, coordination laboratory, Clermont-Ferrand, France
- Auvergne University, LMGE UMR CNRS 6023, Team Epidemiology and pathophysiology of enterovirus Infection, Clermont-Ferrand, France
| | - Marion Jeannoël
- Hospices Civils de Lyon, Virology Department, French Reference Centre for enteroviruses and parechoviruses, associated laboratory, Lyon, France
| | - Bérengère Kireche
- Neonatal and Paediatric Intensive Care Units, Orléans Regional Hospital, Orléans, France
| | - Manoelle Kossorotoff
- Paediatric Neurology Department, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Anne-Sophie L'Honneur
- Virology laboratory, Cochin University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Lila Robin
- Neonatal and Paediatric Intensive Care Units, Orléans Regional Hospital, Orléans, France
| | - Yves Ville
- Obstetrics and Fetal Medicine Department, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Sylvain Renolleau
- Paediatric Intensive Care Unit, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Véronique Lemee
- Virology Department, Rouen University Hospital, Rouen, France
| | - Pierre-Henri Jarreau
- Neonatal Intensive Care Unit, Cochin-Port Royal University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Isabelle Desguerre
- Paediatric Neurology Department, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Florence Lacaille
- Pediatric Gastroenterology-Hepatology-Nutrition Unit, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, University of Paris, Paris, France
| | - Marianne Leruez-Ville
- Clinical Microbiology laboratory and Virology unit, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | | | - Cécile Henquell
- Clermont-Ferrand University Hospital, 3IHP - Infection Inflammation et Interaction Hôtes Pathogènes Virology Department, French Reference Centre for enteroviruses and parechovirus, coordination laboratory, Clermont-Ferrand, France
- Auvergne University, LMGE UMR CNRS 6023, Team Epidemiology and pathophysiology of enterovirus Infection, Clermont-Ferrand, France
| | - Alexandre Lapillonne
- Neonatal Intensive Care Unit, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Isabelle Schuffenecker
- These authors contributed equally to the work and share the last authorship
- Hospices Civils de Lyon, Virology Department, French Reference Centre for enteroviruses and parechoviruses, associated laboratory, Lyon, France
| | - Mélodie Aubart
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Imagine Institute, Institut National de la Santé et de la Recherche Médicale U1163, Paris, France
- These authors contributed equally to the work and share the last authorship
- Paediatric Neurology Department, Necker-Enfants malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France
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Diana JS, Manceau S, Leblanc T, Magnani A, Magrin E, Bendavid M, Couzin C, Joseph L, Soulier J, Cavazzana M, Lefrère F. A new step in understanding stem cell mobilization in patients with Fanconi anemia: A bridge to gene therapy. Transfusion 2021; 62:165-172. [PMID: 34751952 DOI: 10.1111/trf.16721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fanconi anemia (FA) is an inherited disorder characterized clinically by congenital abnormalities, progressive bone marrow failure (BMF), and a predisposition to malignancy. Gene therapy (GT) of FA, via the infusion of gene-corrected peripheral blood (PB) autologous hematopoietic stem cells (HSCs), may constitute a cure for BMF. GT bypasses the donor restrictions and adverse events associated with allogenic HSC transplantation. However, adequate harvesting of PB-HSCs is a crucial determinant of successful engraftment in gene therapy. Harvesting the low numbers of HSCs in patients with FA is particularly challenging. STUDY DESIGN AND METHODS This open-label phase I/II trial evaluates the feasibility and safety of co-administration of G-CSF and plerixafor in patients with FA for the mobilization and harvesting of peripheral HSCs, intending to use them in a gene therapy trial. Patients with mutations in the FANCA gene received two subcutaneous injections of G-CSF (6 μg/kg × 2/d from D1 to D8. Plerixafor (0.24 mg/kg/d) was administered 2 h before apheresis (from D5 onward). RESULTS CD34+ cells were mobilized for four patients quickly but transiently after the plerixafor injection. One patient had a CD34+ cell count of over 100/μl; the mobilization peaked 2 h after the injection and lasted for more than 9 h. There were no short-term adverse events associated with the mobilization or harvesting procedures. CONCLUSION Our data in patients with FA show that the mobilization of HSCs with G-CSF and plerixafor is safe and more efficient in younger individuals without BMF.
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Affiliation(s)
- Jean-Sébastien Diana
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Sandra Manceau
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Thierry Leblanc
- Pediatric Hematology Unit, Hôpital Robert Debré, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Alessandra Magnani
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Elisa Magrin
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Matthieu Bendavid
- Pediatric Immunology and Hematology Unit, Hôpital Necker, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Chloe Couzin
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Laure Joseph
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Jean Soulier
- Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (APHP), Universite de Paris, Paris, France
| | - Marina Cavazzana
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
| | - Francois Lefrère
- Biotherapy Department, Hôpital Necker Enfants Malades, Asistance Publique-Hôpitaux de Paris, Universite de Paris, Paris, France
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Oualha M, Bendavid M, Berteloot L, Corsia A, Lesage F, Vedrenne M, Salvador E, Grimaud M, Chareyre J, de Marcellus C, Dupic L, de Saint Blanquat L, Heilbronner C, Drummond D, Castelle M, Berthaud R, Angoulvant F, Toubiana J, Pinhas Y, Frange P, Chéron G, Fourgeaud J, Moulin F, Renolleau S. Severe and fatal forms of COVID-19 in children. Arch Pediatr 2020; 27:235-238. [PMID: 32518045 PMCID: PMC7269941 DOI: 10.1016/j.arcped.2020.05.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/11/2022]
Abstract
Objectives The aim of this study was to describe severe forms of novel coronavirus disease 2019 in children, including patient characteristics, clinical, laboratory, and imaging findings, as well as the disease management and outcomes. Methods This was a retrospective, single-center, observational study conducted in a pediatric intensive and high-dependency care unit (PICU, HDU) in an urban hospital in Paris. All patients, aged from 1 month to 18 years, admitted for confirmed or highly suspected SARS-CoV-2 were included. Results We analyzed the data of 27 children. Comorbidities (n = 19, 70%) were mainly neurological (n = 7), respiratory, (n = 4), or sickle cell disease (n = 4). SARS-CoV-2 PCR results were positive in 24 children (nasopharyngeal swabs). The three remaining children had a chest CT scan consistent with COVID-19. Respiratory involvement was observed in 24 patients (89%). Supportive treatments were invasive mechanical ventilation (n = 9), catecholamine (n = 4), erythropheresis (n = 4), renal replacement therapy (n = 1), and extracorporeal membrane oxygenation (n = 1). Five children died, of whom three were without past medical history. Conclusion This study highlighted the large spectrum of clinical presentation and time course of disease progression as well as the non-negligible occurrence of pediatric life-threatening and fatal cases of COVID-19 mostly in patients with comorbidities. Additional laboratory investigations are needed to further analyze the mechanism underlying the variability of SARS-Cov-2 pathogenicity in children.
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Affiliation(s)
- M Oualha
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France.
| | - M Bendavid
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - L Berteloot
- Pediatric Radiology Department, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; INSERM U1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, France
| | - A Corsia
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - F Lesage
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - M Vedrenne
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - E Salvador
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - M Grimaud
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - J Chareyre
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - C de Marcellus
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - L Dupic
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - L de Saint Blanquat
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - C Heilbronner
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - D Drummond
- Department of pediatric pneumology and allergology, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; INSERM UMR 1138, Université de Paris, Paris, France
| | - M Castelle
- Department of pediatric Immuno-hematology and rhumatology, Necker-Enfants Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - R Berthaud
- Department of Pediatric Nephrology, Necker-Enfants Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - F Angoulvant
- Pediatric Emergency Department, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université de Paris, Paris, France
| | - J Toubiana
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - Y Pinhas
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - P Frange
- Clinical microbiology laboratory, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; EHU 7328 PACT, Imagine institute, Université de Paris, Paris, France
| | - G Chéron
- Pediatric Emergency Department, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - J Fourgeaud
- Virology laboratory, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, EHU 7328 PACT, Imagine Institute, University of Paris, Paris, France
| | - F Moulin
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - S Renolleau
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
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Grimaud M, Starck J, Levy M, Marais C, Chareyre J, Khraiche D, Leruez-Ville M, Quartier P, Léger PL, Geslain G, Semaan N, Moulin F, Bendavid M, Jean S, Poncelet G, Renolleau S, Oualha M. Acute myocarditis and multisystem inflammatory emerging disease following SARS-CoV-2 infection in critically ill children. Ann Intensive Care 2020; 10:69. [PMID: 32488505 PMCID: PMC7266128 DOI: 10.1186/s13613-020-00690-8] [Citation(s) in RCA: 198] [Impact Index Per Article: 49.5] [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: 05/07/2020] [Accepted: 05/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A recent increase in children admitted with hypotensive shock and fever in the context of the COVID-19 outbreak requires an urgent characterization and assessment of the involvement of SARS-CoV-2 infection. This is a case series performed at 4 academic tertiary care centers in Paris of all the children admitted to the pediatric intensive care unit (PICU) with shock, fever and suspected SARS-CoV-2 infection between April 15th and April 27th, 2020. RESULTS 20 critically ill children admitted for shock had an acute myocarditis (left ventricular ejection fraction, 35% (25-55); troponin, 269 ng/mL (31-4607)), and arterial hypotension with mainly vasoplegic clinical presentation. The first symptoms before PICU admission were intense abdominal pain and fever for 6 days (1-10). All children had highly elevated C-reactive protein (> 94 mg/L) and procalcitonin (> 1.6 ng/mL) without microbial cause. At least one feature of Kawasaki disease was found in all children (fever, n = 20, skin rash, n = 10; conjunctivitis, n = 6; cheilitis, n = 5; adenitis, n = 2), but none had the typical form. SARS-CoV-2 PCR and serology were positive for 10 and 15 children, respectively. One child had both negative SARS-CoV-2 PCR and serology, but had a typical SARS-CoV-2 chest tomography scan. All children but one needed an inotropic/vasoactive drug support (epinephrine, n = 12; milrinone, n = 10; dobutamine, n = 6, norepinephrine, n = 4) and 8 were intubated. All children received intravenous immunoglobulin (2 g per kilogram) with adjuvant corticosteroids (n = 2), IL 1 receptor antagonist (n = 1) or a monoclonal antibody against IL-6 receptor (n = 1). All children survived and were afebrile with a full left ventricular function recovery at PICU discharge. CONCLUSIONS Acute myocarditis with intense systemic inflammation and atypical Kawasaki disease is an emerging severe pediatric disease following SARS-CoV-2 infection. Early recognition of this disease is needed and referral to an expert center is recommended. A delayed and inappropriate host immunological response is suspected. While underlying mechanisms remain unclear, further investigations are required to target an optimal treatment.
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Affiliation(s)
- Marion Grimaud
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Julie Starck
- Pediatric and Neonatal Intensive Care Unit, Armand-Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Michael Levy
- Pediatric Intensive Care Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Clémence Marais
- Pediatric and Neonatal Intensive Care Unit, Kremlin-Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Judith Chareyre
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Diala Khraiche
- M3C-Necker, Congenital and Pediatric Cardiology, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Pierre Quartier
- Paediatric Hematology-Immunology and Rheumatology Unit, Reference center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, IMAGINE Institute, Université de Paris, Paris, France
| | - Pierre Louis Léger
- Pediatric and Neonatal Intensive Care unit, Armand-Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
| | - Guillaume Geslain
- Pediatric Intensive Care Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Nada Semaan
- Pediatric and Neonatal Intensive Care Unit, Kremlin-Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florence Moulin
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthieu Bendavid
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sandrine Jean
- Pediatric and Neonatal Intensive Care Unit, Armand-Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Géraldine Poncelet
- Pediatric Intensive Care Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Sylvain Renolleau
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, EA7323, 75006, Paris, France
| | - Mehdi Oualha
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, EA7323, 75006, Paris, France.
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6
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Welfringer-Morin A, Moulin F, Drummond D, Oualha M, De Saint Blanquat L, Bendavid M, Aoust L, Belahda A, Kossorotoff M, Fertitta L, Bellon N, Hadj-Rabia S, Delacourt C, Leclerc-Mercier S, Frassati-Biaggi A, De Prost N, Oro S, Renolleau S, Bodemer C. Nécrolyse épidermique toxique de l’enfant : deux observations inhabituelles d’évolution fatale. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.186] [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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Baer S, Schaefer É, Michot C, Fischbach M, Morelle G, Bendavid M, Castelle M, Moshous D, Collet C. Intermediate autosomal recessive osteopetrosis with a large noncoding deletion in SNX10: A case report. Pediatr Blood Cancer 2019; 66:e27751. [PMID: 30977576 DOI: 10.1002/pbc.27751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Sarah Baer
- Service de Génétique Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Élise Schaefer
- Service de Génétique Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Caroline Michot
- Service de Génétique, INSERM U781, Hôpital Necker-Enfants Malades, Institut Imagine, Université Sorbonne-Paris-Cité, Paris, France
| | - Michel Fischbach
- Service de Pédiatrie 1, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Guillaume Morelle
- Unité d'Immunologie-Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Matthieu Bendavid
- Unité d'Immunologie-Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Martin Castelle
- Unité d'Immunologie-Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Despina Moshous
- Unité d'Immunologie-Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France.,INSERM UMR1163, Institut Imagine, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Corinne Collet
- UF de Génétique Moléculaire, Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière, Paris, France
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Neven B, Diana JS, Castelle M, Magnani A, Rosain J, Touzot F, Moreira B, Fremond ML, Briand C, Bendavid M, Levy R, Morelle G, Vincent M, Magrin E, Bourget P, Chatenoud L, Picard C, Fischer A, Moshous D, Blanche S. Haploidentical Hematopoietic Stem Cell Transplantation with Post-Transplant Cyclophosphamide for Primary Immunodeficiencies and Inherited Disorders in Children. Biol Blood Marrow Transplant 2019; 25:1363-1373. [PMID: 30876929 DOI: 10.1016/j.bbmt.2019.03.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [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: 12/21/2018] [Accepted: 03/08/2019] [Indexed: 01/25/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for some inherited disorders, including selected primary immunodeficiencies (PIDs). In the absence of a well-matched donor, HSCT from a haploidentical family donor (HIFD) may be considered. In adult recipients high-dose post-transplant cyclophosphamide (PTCY) is increasingly used to mitigate the risks of graft failure and graft-versus-host disease (GVHD). However, data on the use of PTCY in children (and especially those with inherited disorders) are scarce. We reviewed the outcomes of 27 children transplanted with an HIFD and PTCY for a PID (n = 22) or osteopetrosis (n = 5) in a single center. The median age was 1.5 years (range, .2 to 17). HSCT with PTCY was a primary procedure (n = 21) or a rescue procedure after graft failure (n = 6). The conditioning regimen was myeloablative in most primary HSCTs and nonmyeloablative in rescue procedures. After a median follow-up of 25.6 months, 24 of 27 patients had engrafted. Twenty-one patients are alive and have been cured of the underlying disease. The 2-year overall survival rate was 77.7%. The cumulative incidences of acute GVHD grade ≥ II, chronic GVHD, and autoimmune disease were 45.8%, 24.2%, and 29.6%, respectively. There were 2 cases of grade III acute GVHD and no extensive cGVHD. The cumulative incidences of blood viral replication and life-threatening viral events were 58% and 15.6%, respectively. There was evidence of early T cell immune reconstitution. In the absence of an HLA-identical donor, HIFD HSCT with PTCY is a viable option for patients with life-threatening inherited disorders.
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Affiliation(s)
- Bénédicte Neven
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France.
| | - Jean-Sébastien Diana
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Martin Castelle
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alessandra Magnani
- INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jérémie Rosain
- INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Study Center for Primary Immunodeficiencies, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabien Touzot
- INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Baptiste Moreira
- Immunology Laboratory, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Louise Fremond
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Coralie Briand
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Matthieu Bendavid
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Romain Levy
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Guillaume Morelle
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Marc Vincent
- INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Elsa Magrin
- INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Bourget
- Functional explorations Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Lucienne Chatenoud
- Immunology Laboratory, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Capucine Picard
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Study Center for Primary Immunodeficiencies, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alain Fischer
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France; College de France, Paris, France
| | - Despina Moshous
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1163 and Institut Imagine, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Stéphane Blanche
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
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9
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Boisson B, Honda Y, Ajiro M, Bustamante J, Bendavid M, Gennery AR, Kawasaki Y, Ichishima J, Osawa M, Nihira H, Shiba T, Tanaka T, Chrabieh M, Bigio B, Hur H, Itan Y, Liang Y, Okada S, Izawa K, Nishikomori R, Ohara O, Heike T, Abel L, Puel A, Saito MK, Casanova JL, Hagiwara M, Yasumi T. Rescue of recurrent deep intronic mutation underlying cell type-dependent quantitative NEMO deficiency. J Clin Invest 2018; 129:583-597. [PMID: 30422821 DOI: 10.1172/jci124011] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 08/08/2018] [Accepted: 11/08/2018] [Indexed: 12/20/2022] Open
Abstract
X-linked dominant incontinentia pigmenti (IP) and X-linked recessive anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID) are caused by loss-of-function and hypomorphic IKBKG (also known as NEMO) mutations, respectively. We describe a European mother with mild IP and a Japanese mother without IP, whose 3 boys with EDA-ID died from ID. We identify the same private variant in an intron of IKBKG, IVS4+866 C>T, which was inherited from and occurred de novo in the European mother and Japanese mother, respectively. This mutation creates a new splicing donor site, giving rise to a 44-nucleotide pseudoexon (PE) generating a frameshift. Its leakiness accounts for NF-κB activation being impaired but not abolished in the boys' cells. However, aberrant splicing rates differ between cell types, with WT NEMO mRNA and protein levels ranging from barely detectable in leukocytes to residual amounts in induced pluripotent stem cell-derived (iPSC-derived) macrophages, and higher levels in fibroblasts and iPSC-derived neuronal precursor cells. Finally, SRSF6 binds to the PE, facilitating its inclusion. Moreover, SRSF6 knockdown or CLK inhibition restores WT NEMO expression and function in mutant cells. A recurrent deep intronic splicing mutation in IKBKG underlies a purely quantitative NEMO defect in males that is most severe in leukocytes and can be rescued by the inhibition of SRSF6 or CLK.
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Affiliation(s)
- Bertrand Boisson
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Yoshitaka Honda
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiko Ajiro
- Department of Anatomy and Developmental Biology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jacinta Bustamante
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Matthieu Bendavid
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA
| | - Andrew R Gennery
- Institute of Cellular Medicine, Newcastle University and Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - Yuri Kawasaki
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Jose Ichishima
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Mitsujiro Osawa
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Hiroshi Nihira
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Shiba
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Tanaka
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Maya Chrabieh
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Benedetta Bigio
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA
| | - Hong Hur
- Center for Clinical and Translational Science, The Rockefeller University, New York, New York, USA
| | - Yuval Itan
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA.,The Charles Bronfman Institute for Personalized Medicine, and.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yupu Liang
- Center for Clinical and Translational Science, The Rockefeller University, New York, New York, USA
| | - Satoshi Okada
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Kazushi Izawa
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Osamu Ohara
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,Kazusa DNA Research Institute, Kisarazu, Japan
| | - Toshio Heike
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Laurent Abel
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Anne Puel
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Megumu K Saito
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France.,Howard Hughes Medical Institute (HHMI), New York, New York, USA
| | - Masatoshi Hagiwara
- Department of Anatomy and Developmental Biology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahiro Yasumi
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
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10
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Girard B, Bendavid M, Faivre JC, Salleron J, Debillon T, Claris O, Chabrol B, Schweitzer C, Gajdos V. Enseignement théorique du Diplôme d’études spécialisées de pédiatrie en France : évaluation nationale par les internes. Arch Pediatr 2017; 24:728-736. [DOI: 10.1016/j.arcped.2017.05.009] [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: 03/02/2017] [Revised: 05/03/2017] [Accepted: 05/21/2017] [Indexed: 10/19/2022]
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11
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Bacquet M, Bendavid M, Foucambert H, Girard B, Morand A, Ploton MC. Réforme de la maquette du diplôme d’études spécialisées de pédiatrie : vision des juniors. Arch Pediatr 2016; 23:784-6. [DOI: 10.1016/j.arcped.2016.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
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12
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Gray S, Raschetti R, Beşer ÖF, Elicin PU, Aversa S, Pamuk G, Ozdil M, Berlese P, Ferreira-Magalhães M, Magner M, Ignat A, Lupu VV, Zsigmond B, Ghazaryan H, Rosenbaum S, Bendavid M, Bacquet M, Varga N, James D, Bon A, Vecchio D. European Young Pediatricians Association: Laying the Foundations for Collaboration, Integration, and Networking among Pediatricians of the Future. J Pediatr 2016; 171:324-5.e1. [PMID: 27017465 DOI: 10.1016/j.jpeds.2015.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sebastian Gray
- Royal College of Pediatrics and Child Health Trainee Committee, United Kingdom.
| | | | | | | | - Salvatore Aversa
- National Observatory for Trainees and Young Pediatricians, Italy
| | - Gizem Pamuk
- Turkish Young Pediatricians Association, Turkey
| | - Mine Ozdil
- Turkish Young Pediatricians Association, Turkey
| | - Paola Berlese
- National Observatory for Trainees and Young Pediatricians, Italy
| | | | - Martin Magner
- Residents Committee, Czech Pediatric Society, Czech Republic
| | | | | | | | | | | | | | | | - Norbi Varga
- Armenian Young Pediatric Association, Armenia
| | - David James
- Royal College of Pediatrics and Child Health Trainee Committee, United Kingdom
| | - Andrea Bon
- National Observatory for Trainees and Young Pediatricians, Italy
| | - Davide Vecchio
- National Observatory for Trainees and Young Pediatricians, Italy
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13
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Alison M, Biran V, Tanase A, Bendavid M, Blouet M, Demené C, Sebag G, Tanter M, Baud O. Quantitative Shear-Wave Elastography of the Liver in Preterm Neonates with Intra-Uterine Growth Restriction. PLoS One 2015; 10:e0143220. [PMID: 26580807 PMCID: PMC4651533 DOI: 10.1371/journal.pone.0143220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/01/2015] [Indexed: 12/17/2022] Open
Abstract
The feasibility and reproducibility of liver stiffness measurements using Supersonic Shear-wave Imaging (SSI) in preterm neonate have not been reported. Our aim was to determine if liver stiffness differs between intra-uterine growth restriction (IUGR) and appropriate for gestational age (AGA) preterm infants with/without cholestasis. We measured liver stiffness (in kPa) in 45 AGA and 18 IUGR preterm infants, and assessed reproducibility in 26 preterms using Intraclass Correlation Coefficients (ICC) and Bland-Altman tests. Liver stiffness values were compared between AGA and IUGR with and without cholestasis and correlated with birth weight. Measurements showed high reproducibility (ICC = 0.94–0.98 for intra-operator, 0.86 for inter-operator) with good agreement (95% limits: -1.24 to 1.24 kPa). During the first postnatal week, liver stiffness was higher in IUGR (7.50 ±1.53 kPa) than in AGA infants (5.11 ±0.80 kPa, p<0.001). After day 8, liver stiffness remained unchanged in AGA but increased progressively in IUGR infants (15.57 ±6.49 kPa after day 21). Liver stiffness was higher in IUGR neonates with cholestasis (19.35 ± 9.80 kPa) than without cholestasis (7.72 ± 1.27 kPa, p<0.001). In conclusion, quantitative liver SSI in preterms is feasible and reproducible. IUGR preterms who will develop cholestasis present high liver stiffness even at birth, before biological cholestasis occurs.
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Affiliation(s)
- Marianne Alison
- Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
- PremUP foundation, 75014 Paris, France
| | - Valérie Biran
- PremUP foundation, 75014 Paris, France
- Neonatal Intensive Care Unit and INSERM U1141, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
| | - Anca Tanase
- Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
- PremUP foundation, 75014 Paris, France
| | - Matthieu Bendavid
- Neonatal Intensive Care Unit and INSERM U1141, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
| | - Marie Blouet
- Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
| | - Charlie Demené
- PremUP foundation, 75014 Paris, France
- Institut Langevin, CNRS UMR 7587, INSERM U979, ESPCI ParisTech, 75005 Paris, France
| | - Guy Sebag
- Department of Pediatric Radiology, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
- PremUP foundation, 75014 Paris, France
| | - Mickael Tanter
- PremUP foundation, 75014 Paris, France
- Institut Langevin, CNRS UMR 7587, INSERM U979, ESPCI ParisTech, 75005 Paris, France
| | - Olivier Baud
- PremUP foundation, 75014 Paris, France
- Neonatal Intensive Care Unit and INSERM U1141, Robert Debré Children University Hospital and Denis Diderot Paris University, APHP, 75019 Paris, France
- * E-mail:
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