Publications (29)94.53 Total impact
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Article: Limited sampling strategy using Bayesian estimation for estimating individual exposure of the once-daily prolonged-release formulation of tacrolimus in kidney transplant children.
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ABSTRACT: BACKGROUND: A limited sampling strategy (LSS) for estimating the area under the curve (AUC) of the prolonged-release formulation of tacrolimus (tacrolimus(PR)) is not available in pediatric patients, although the method is of real benefit to children. The objective of this study was to develop and validate a reliable and clinically applicable LSS using Bayesian estimation for estimating tacrolimus(PR) AUC in pediatric kidney transplant patients METHODS: The original tacrolimus pharmacokinetic dataset consisted of 22 full profiles from 22 pediatric kidney transplant patients. The Bayesian estimation method was used to develop the LSS. External validation was performed in an independent validation group which consisted of 20 full pharmacokinetic profiles from 12 pediatric kidney transplant patients. RESULTS: Bayesian estimator using C(0h) C(2h) and C(3h) gave the best predictive performance with a mean prediction error of 2.2 % in the external validation dataset. There was no correlation between the prediction error and age. The Bland-Altman analysis showed that the mean difference between the reference and Bayesian-estimated AUC(0-24) was 3.5 (95 % confidence interval -3.5-10.5) ng h/mL CONCLUSIONS: A reliable and clinically applicable LSS for estimating AUC(0-24) of tacrolimus(PR) was determined and validated in children. The prediction was unbiased and precise. It can be used as a routine procedure to perform AUC-based tacrolimus(PR) dosage optimization in pediatric renal transplant patients.European Journal of Clinical Pharmacology 12/2012; · 2.85 Impact Factor -
Article: Pharmacogenetic Determinant of the Drug Interaction Between Tacrolimus and Omeprazole.
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ABSTRACT: A 17-year-old adolescent with acute nephrotoxicity had CYP3A4-5, CYP2C19, and ABCB1 genotyping performed to understand a suspected drug interaction between tacrolimus and omeprazole. The determinant role of individual pharmacogenetic profile in the occurrence of tacrolimus nephrotoxicity is presented and discussed.Therapeutic drug monitoring 10/2012; · 2.43 Impact Factor -
Article: Population pharmacokinetics and pharmacogenetics of once daily prolonged-release formulation of tacrolimus in pediatric and adolescent kidney transplant recipients.
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ABSTRACT: BACKGROUND AND OBJECTIVES: Tacrolimus(PR) is a new prolonged-release once-daily formulation of the calcineurin inhibitor tacrolimus, currently used in adult transplant patients. As there are no pharmacokinetic data available in pediatric kidney transplant recipients, the aims of this study were to develop a population pharmacokinetic model of tacrolimus(PR) in pediatric and adolescent kidney transplant recipients and to identify covariates that have a significant impacts on tacrolimus(PR) pharmacokinetics, including CYP3A5 polymorphism. METHODS: Pharmacokinetic samples were collected from 22 pediatric kidney transplant patients. Population pharmacokinetic analysis was performed using NONMEM. Pharmacogenetic analysis was performed on the CYP3A5 gene. RESULTS: The pharmacokinetic data were best described by a one-compartment model with first order absorption and lag-time. The weight normalized oral clearance CL/F [CL/F/ (weight/70)(0.75)] was lower in patients with CYP3A5*3/*3 as compared to patients with the CYP3A5*1/*3 (32.2 ± 10.1 vs. 53.5 ± 20.2 L/h, p = 0.01). CONCLUSIONS: The population pharmacokinetic model of tacrolimus(PR) was developed and validated in pediatric and adolescent kidney transplant patients. Body weight and CYP3A5 polymorphism were identified as significant factors influencing pharmacokinetics. The developed model could be useful to optimize individual pediatric tacrolimus (PR) dosing regimen in routine clinical practice.European Journal of Clinical Pharmacology 06/2012; · 2.85 Impact Factor -
Article: Pharmacokinetic interaction between tacrolimus and amlodipine in a renal transplant child.
Transplantation 04/2012; 93(7):e29-30. · 4.00 Impact Factor -
Article: Individualization of valganciclovir prophylaxis for cytomegalovirus infection in pediatric kidney transplant patients.
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ABSTRACT: Valganciclovir is used for the prophylaxis of cytomegalovirus infection in pediatric solid transplant patients. The current pediatric dose regimen resulted in large variability in drug exposure. A posterior dosage adaptation was required in children to achieve the daily target area under the curve (AUC) of 40-50 μg·h·mL(-1). However, a clinically feasible tool for valganciclovir dosage adjustment based on individual AUC is not available. The objective of this study was to develop and validate a reliable and clinically applicable limited sampling strategy using Bayesian estimation for individualizing valganciclovir dose in pediatric kidney transplant patients. The Bayesian estimator to calculate ganciclovir AUC was developed using the original pharmacokinetic dataset consisting of 28 full profiles from 22 pediatric kidney transplant patients. External validation was prospectively performed in an independent validation group consisting of 14 full pharmacokinetic profiles from 14 pediatric kidney transplant patients. The Bayesian estimator of exposure using T0-T2-T4 gave the best predictive performance. The mean prediction error was of 3.1% and Bland-Altman analysis shows that the average difference between referenced and estimated AUCs was 0.4 μg·h·mL(-1). Valganciclovir dosage adaptation was required in children to achieve target AUC. The Bayesian estimator of valganciclovir, using 3 concentrations measured at T0-T2-T4 after drug intake, was validated and could be used to accurately estimate individual AUC. This approach will be useful for individualizing valganciclovir prophylaxis in pediatric kidney transplant patients.Therapeutic drug monitoring 04/2012; 34(3):326-30. · 2.43 Impact Factor -
Article: Limited sampling strategy for estimating individual exposure of tacrolimus in pediatric kidney transplant patients.
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ABSTRACT: Limited sampling strategies (LSS) for estimating the area under the curve (AUC(0-12h)) of tacrolimus and optimizing dosage adjustment are not currently used or fully validated in pediatric patients, although the method is of real benefit to children. The objective of the present study was to develop and validate reliable and clinically applicable LSS using Bayesian estimation and the multiple regression analysis for estimating tacrolimus AUC in pediatric kidney transplant patients. The original tacrolimus pharmacokinetic dataset consists of 50 full profiles from 50 pediatric kidney transplant patients. Two LSS based on Bayesian estimator or multiple regression analysis to calculate tacrolimus AUC were developed and then compared. External validation was prospectively performed in an independent validation group, which consisted of 42 full pharmacokinetic profiles from 20 pediatric kidney transplant patients. Bayesian estimators using C(0h), C(1h) or C(2h), and C(3h) gave the best predictive performance, the external validation having a mean prediction bias of 1% and mean imprecision of 5.5%. The multiple regression analysis using C(0h), C(1h), and C(3h) gave the best correlation (r² = 0.953) between estimated and referenced AUCs with a mean prediction bias of 4.2% and mean precision of 8.3% in external validation dataset. The prediction of AUC using developed LSS was unbiased and precise. The age and time after transplantation did not influence the predictive performance. Such LSS approach will help guiding tacrolimus therapeutic drug monitoring based on AUC in pediatric kidney transplant patients.Therapeutic drug monitoring 12/2011; 33(6):681-7. · 2.43 Impact Factor -
Article: Mycophenolate mofetil for steroid-dependent nephrotic syndrome: a phase II Bayesian trial.
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ABSTRACT: Mycophenolate mofetil (MMF) has emerged as a new therapeutic option in steroid-dependent nephrotic syndrome (SDNS). We conducted a phase II Bayesian trial of MMF in children with SDNS. Phase II trials, usually single-arm studies, investigate the effect of new treatments. Standard Fleming's procedure relies on observed results (relapse rate during the trial), whereas Bayesian approach combines observed results with prior information (expected relapse rate according to prior studies and clinical experience). All patients were required to have received prior alkylating-agent treatment. Sixty-seven percent of them had also received levamisole. Patients received MMF (1,200 mg/m(2)/day) and prednisone according to a defined schedule [reduction of alternate-day (e.o.d) dose to 50% of pre-MMF dose at 3 months, 25% at 6 months]. Twenty-four children (median age 6.0 years, 2.8-14.4) entered the study and 23 completed it. Bayesian analysis showed that adding four patients would not change significance of results, allowing stopping inclusions. Four patients relapsed during the first 6 months (estimated probability 17.6%, 95% credibility interval: 5.4-35.0%) and two at months 8 and 11.5. In the 19 patients free of relapse during the first 6 months, median (Q1-Q3) prednisone maintenance dose decreased from 25 (10-44) to 9 (7.5-11.2) mg/m(2) e.o.d (p < 0.001) and cumulative dose from 459 (382-689) to 264 (196-306) mg/m(2)/month (p < 0.001) before and on MMF respectively. Pre-MMF patient characteristics and MMF pharmacokinetics did not differ between patients with or without relapse. MMF reduces relapse rate and steroid dose in children with SDNS and should be proposed before cyclosporine and cyclophosphamide.Pediatric Nephrology 09/2011; 27(3):389-96. · 2.52 Impact Factor -
Article: Rituximab in steroid-dependent idiopathic nephrotic syndrome in childhood--follow-up after CD19 recovery.
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ABSTRACT: Rituximab (RTX) is a new treatment strategy in high-degree steroid-dependent idiopathic nephrotic syndrome (SDNS) in childhood. Thirty patients (nine girls) with SDNS with steroid side effects and previously treated with immunosuppressive drugs, mostly calcineurin inhibitors, were treated with RTX and included in this non-controlled single-centre study. Patient age at first RTX infusion was 12.9 ± 0.7 years. Our aim was to evaluate disease outcome after a minimum CD19 depletion period of 15 months obtained by repeated RTX infusion. Minimum follow-up after initial CD19 depletion was 24 months. During the RTX treatment period, seven patients had nephrotic syndrome relapses, six among them at the time of an intermittent CD19 recovery and one patient relapsed under CD19 depletion. The risk for these patients to relapse after the RTX treatment period was higher than in those without intermittent relapses. After definitive CD19 recovery over a follow-up of 17.4 ± 1.9 months, 19 patients (63%) did not relapse and 11 (37%) relapsed 4.3 ± 1 months after defininitive CD19 recovery. Among these 11 patients, 6 already had intermittent relapses during the RTX treatment period. Steroid and immunosuppressive treatment could be discontinued in all patients during CD19 depletion and was re-introduced in two after CD19 recovery. Fourteen patients had mostly benign and transitory side effects, which did not require RTX discontinuation. In conclusion, RTX treatment with a 15-month CD19 depletion period induced long-term remission after definitive CD 19 recovery in almost two-thirds the of patients without oral immunosuppressive drugs.Nephrology Dialysis Transplantation 08/2011; 27(3):1083-9. · 3.40 Impact Factor -
Article: Cyclophosphamide in steroid-dependent nephrotic syndrome.
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ABSTRACT: In order to determine the long-term effects of cyclophosphamide (CPO) and to identify parameters associated with sustained remission, we retrospectively studied the data from 90 patients with steroid-dependent nephrotic syndrome (SDNS) who received a single course of oral cyclophosphamide (2 mg/kg/day for 10 to 12 weeks). The median follow-up period after CPO was 5.5 years (interquartile range 3.2-8.5). Sustained remission reached the cumulative rate of 57% at 1 year, 42% at 2 years, and 31% at 5 years. For the patients who relapsed, the median threshold dose of prednisone between CPO initiation and first relapse has significantly decreased (22.1 mg/kg/day versus 4.9 mg/kg/day, p < 0.001). No further immunosuppressive agent was required in 60% of all patients. Young age at CPO initiation was associated with a lower rate of sustained remission (p < 0.001). Age at diagnosis of nephrotic syndrome, gender, cumulative dose of CPO (in mg/kg), and level of steroid dependence at CPO initiation did not influence the outcome. The incidence of side effects was low. These findings suggest that despite the wide use of new immunosuppressive agents, a short course of CPO remains an effective second-line therapy in SDNS patients. Optimal efficiency was observed in children over 7.5 years.Pediatric Nephrology 03/2011; 26(6):927-32. · 2.52 Impact Factor -
Article: Membranoproliferative glomerulonephritis with C3NeF and genetic complement dysregulation.
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ABSTRACT: The development of membranoproliferative glomerulonephritis (MPGN) is associated with uncontrolled activation of the complement alternative pathway. This dysregulation is related either to C3 nephritic factor (C3NeF), an auto-antibody directed against the alternative C3 convertase, or to homozygous loss-of-function mutation of the complement regulatory protein factor H. Heterozygous mutations in the genes coding for factor H, or for the other alternative pathway inhibitory proteins factor I and membrane cofactor protein, have recently been identified in a small number of patients with MPGN with exclusive C3 deposits. We report three hypocomplementemic children with dense deposit disease (n=1) or immune-complex-mediated MPGN type I (n=2), associated with both C3NeF activity and heterozygous mutation of factor H or factor I. These observations highlight the possible combination of genetic and acquired defect in complement control in various subtypes of MPGN, a finding that may influence the treatment strategy in some patients.Pediatric Nephrology 12/2010; 26(3):419-24. · 2.52 Impact Factor -
Article: Population pharmacokinetics and Bayesian estimator of mycophenolic acid in children with idiopathic nephrotic syndrome.
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ABSTRACT: To develop a population pharmacokinetic model for mycophenolic acid (MPA) in children with idiopathic nephrotic syndrome (INS) treated with mycophenolate mofetil (MMF), identify covariates that explain variability and determine the Bayesian estimator of the area under the concentration-time curve over 12 h (AUC(0-12)). The pharmacokinetic model of MMF was described from 23 patients aged 7.4 +/- 3.9 years (range 2.9-14.9) using nonlinear mixed-effects modelling (NONMEM) software. A two-compartment model with lag-time and first-order absorption and elimination was developed. The final model was validated using visual predictive check. Bayesian estimator was validated using circular permutation method. The population pharmacokinetic parameters were apparent oral clearance 9.7 l h(-1), apparent central volume of distribution 22.3 l, apparent peripheral volume of distribution 250 l, inter-compartment clearance 18.8 l h(-1), absorption rate constant 5.16 h(-1), lag time 0.215 h. The covariate analysis identified body weight and serum albumin as individual factors influencing the apparent oral clearance. Accurate Bayesian estimation of AUC(0-12) was obtained using the combination of three MPA concentrations measured just before (T(0)), 1 and 4 h (T(1) and T(4)) after drug intake with a small error of 0.298 microg h(-1) ml(-1) between estimated and reference AUC(0-12). The population pharmacokinetic model of MPA was developed in children with INS. A three-point (T(0), T(1) and T(4)h) Bayesian estimator of AUC(0-12) was developed and might be used to investigate the relation between MPA pharmacokinetic and pharmacodynamics in children with INS and determine if there is any indication to monitor MPA exposure in order to improve patient outcome based on individual AUC-controlled MMF dosing.British Journal of Clinical Pharmacology 04/2010; 69(4):358-66. · 2.96 Impact Factor -
Article: Rituximab efficiency in children with steroid-dependent nephrotic syndrome.
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ABSTRACT: Although most patients with idiopathic nephrotic syndrome (NS) respond to steroid treatment, development of steroid dependency may require a long-term multidrug therapy including steroid and calcineurin inhibitor. Rituximab was shown to allow a reduction of the doses of steroid and immunosuppressive drugs in those patients. In the present series, 22 patients with steroid-sensitive, but steroid-dependent nephrotic syndrome were treated with rituximab. Rituximab reduced B cell count down to an undetectable level in all patients. A second treatment was necessary in 18 patients in order to maintain B cell depletion for up to 18 months. B cell depletion lasted 4.9 to 26 months (mean 17.2 months). At last follow-up, 9 patients were in remission without oral steroid or calcineurin inhibitor, although B cell count had recovered for 2.9 to 17 months (mean 9.5 months). A remission under ongoing B cell depletion was observed in 10 other patients in the absence of oral steroid or calcineurin inhibitor. Rituximab failed in 2 patients and 1 refused any additional treatment, despite B cell recovery and relapse. Toxicity of rituximab was limited to reversible cytokine shock in 2 patients and reversible neutropenia in 1 patient. No severe infection was observed.Pediatric Nephrology 03/2010; 25(6):1109-15. · 2.52 Impact Factor -
Article: Growth in boys with idiopathic nephrotic syndrome on long-term cyclosporin and steroid treatment.
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ABSTRACT: Although steroid-free remission can usually be achieved with cyclosporin A (CsA) in patients with steroid-dependent nephrotic syndrome (SDNS), some CsA-treated patients require long-term steroid therapy. Data on growth in these patients are scarce. Sixty-four boys with SDNS receiving long-term CsA and steroid therapy were retrospectively analyzed. During the 10-year follow-up period, height standard deviation score (HSDS) remained in the normal range in 47 patients but was below -2 SD in 17 patients. The occurrence of growth retardation was influenced by height at diagnosis and the number of relapses. Thirty patients were followed for at least 3 years before and after age 12. The decrease in HSDS per year of disease in patients older than 12 years was twice that observed in children younger than 12. However, adult height was < or = -2 SD in only two of the 14 patients reaching adult height, reflecting potential catch-up growth during late puberty. Careful monitoring of growth is recommended, given than up to 25% of patients experienced severe growth retardation during the course of their disease.Pediatric Nephrology 09/2009; 24(12):2393-400. · 2.52 Impact Factor -
Article: Varicella as a trigger of atypical haemolytic uraemic syndrome associated with complement dysfunction: two cases.
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ABSTRACT: We report two cases of children who presented with haemolytic uraemic syndrome following varicella infection. One of them had a membrane cofactor protein mutation, and the other had anti-factor H antibodies. These observations show that infectious agents such as varicella-zoster virus may be the trigger of haemolytic uraemic syndrome in patients with complement dysregulation.Nephrology Dialysis Transplantation 05/2009; 24(9):2752-4. · 3.40 Impact Factor -
Article: Population pharmacokinetics of ganciclovir following administration of valganciclovir in paediatric renal transplant patients.
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ABSTRACT: To develop a population pharmacokinetic model for valganciclovir in paediatric renal transplant recipients, identify covariates that explain variability, and determine valganciclovir dosage regimens for cytomegalovirus (CMV) prophylaxis in children. The pharmacokinetics of valganciclovir were described with plasma concentrations from 22 patients (age range 3-17 years) using nonlinear mixed-effects modelling (NONMEM) software. A two-compartment model with lag-time and first-order absorption and elimination was developed. The final model was validated using a bootstrap and visual predictive check. The dosage regimens of valganciclovir for CMV prophylaxis in children were simulated using the final model. The mean population pharmacokinetic parameters were apparent systemic clearance (CL) 10.1L/h, apparent central volume of distribution 5.2 L, apparent peripheral volume of distribution 30.7 L, inter-tissue clearance 3.97 L/h, absorption rate constant 0.369 h-1 and lag-time 0.743 h. The covariate analysis identified creatinine clearance (CL(CR)) and bodyweight (WT) as individual factors influencing the apparent oral clearance: CL= 8.04 x (CL(CR)/89)(2.93) + 3.62 x (WT/28) L/h. The results of the simulation showed that for a typical patient (WT 28 kg and CL(CR) 89 mL/min), an area under the plasma concentration-time curve of 43 +/- 10.6 mg x h/mL will be achieved with valganciclovir 500 mg once daily. The dosage regimens of valganciclovir for CMV prophylaxis have been defined using the final population pharmacokinetic model based on WT and CLCR for paediatric renal transplantation patients.Clinical Pharmacokinetics 02/2009; 48(5):321-8. · 5.40 Impact Factor -
Article: Acute renal cortical necrosis due to acquired antiprotein S antibodies.
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ABSTRACT: Although varicella is a common disease of childhood, renal complications are quite rare. We report here the interesting case of a-22 month-old boy exhibiting renal cortical necrosis related to an acquired protein S deficiency following varicella. Ten days after the vesicle eruption appearance, he presented with ecchymosed heels, oligoanuric kidney failure, anemia [hemoglobin (Hb) 78 g/L], schizocytosis (2.5%), but normal platelet count. Kidney sonography and magnetic resonance imaging evoked renal cortical necrosis. All together, these features suggested acquired protein S deficiency secondary to varicella. Strikingly, it was confirmed by a dramatic decrease in protein S plasma activity and a huge increase in immunoglobulin (Ig)G antibodies against protein S in the plasma. Anticoagulation therapy in addition with plasmapheresis and steroid pulses allowed a dramatic decrease in the antibodies against protein S and recovery of normal protein S activity. Undelayed diagnosis and treatment did not avoid kidney insufficiency but prevented life-threatening complications. In the light of this case report, protein S deficiency due to antibody inhibition should be carefully monitored anytime in the context of varicella when kidney insufficiency or necrosis occurs.Pediatric Nephrology 10/2008; 24(1):207-9. · 2.52 Impact Factor -
Article: Rituximab treatment for severe steroid- or cyclosporine-dependent nephrotic syndrome: a multicentric series of 22 cases.
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ABSTRACT: Several case reports suggest that rituximab (RTX) could be effective in steroid-dependent nephrotic syndrome, but RTX efficacy has not yet been studied in a series of patients. Safety and efficacy of RTX were assessed in a multicenter series of 22 patients aged 6.3-22 years with severe steroid-dependent nephrotic syndrome or steroid-resistant but cyclosporin-sensitive idiopathic nephrotic syndrome. Patients were treated with two to four infusions of RTX. Seven patients were nephrotic at the time of RTX treatment. Peripheral B cells were depleted in all subjects. Remission was induced in three of the seven proteinuric patients. One or more immunosuppressive (IS) treatments could be withdrawn in 19 patients (85%), with no relapse of proteinuria and without increasing other IS drugs. RTX was effective in all patients when administered during a proteinuria-free period in association with other IS agents. When relapses occurred, they were always associated with an increase in CD19 cell count. Adverse effects were observed in 45% of cases, but most of them were mild and transient. This study suggests that RTX could be an effective treatment for severe steroid-dependent nephrotic syndrome.Pediatric Nephrology 09/2008; 23(8):1269-79. · 2.52 Impact Factor -
Article: Comparison of high-performance liquid chromatography and enzyme-multiplied immunoassay technique to monitor mycophenolic acid in paediatric renal recipients.
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ABSTRACT: Therapeutic drug monitoring (TDM) of mycophenolate mofetil (MMF) is recommended to guide immunosuppression. High-performance liquid chromatography with ultraviolet (HPLC-UV) or the enzyme-multiplied immunoassay technique (EMIT), used to measure mycophenolic acid (MPA) were compared in an exclusive paediatric renal transplant population. Twenty patients were included as part of the pharmacokinetics study of MMF, and 88 additional samples were drawn for TDM. Agreement between HPLC-UV and EMIT was assessed by the Bland-Altman method. With the two methods, pre-dose concentrations were not normally distributed. After logarithmic transformation, their mean was 0.79 +/- 1.16 microg ml(-1) and their mean difference was 0.34 +/- 0.16 microg ml(-1) [95% confidence interval (95%CI 0.30-0.38 microg ml(-1), with antilogarithmic values of these limits of 1.34-1.46 microg ml(-1)). Area under the curve (AUC)(HPLC) and AUC(EMIT) were normally distributed. Their mean was 52.42 +/- 25.91 mg x h/l and their mean difference was 15.22 +/- 8 mg x h/l (95%CI 11.99-18.45 mg x h/l), the Bland-Altman plot showing a bias proportional to the mean. Our data showed the absence of agreement between the HPLC and EMIT methods, with an average positive bias of 15% with the EMIT. Further studies are required to determine which method is best appropriate for TDM of MMF in children.Pediatric Nephrology 08/2008; 23(10):1859-65. · 2.52 Impact Factor -
Article: Acute renal failure in a 3-year-old child as part of the drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome following hepatitis A.
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ABSTRACT: We report on a 3-year-old Melanesian girl admitted for acute renal failure following subfulminant hepatitis A virus infection. While the child was slowly recovering from severe cytolytic hepatitis, she presented 8 weeks of protracted fever and major eosinophilia (30,000/microl); thereafter, acute renal failure (serum creatinine 295 micromol/l) occurred. Renal histology displayed diffuse eosinophilic infiltrate, with severe acute tubulointerstitial lesions associated with mild glomerular endocapillary proliferation and eosinophilic infiltrate, suggesting an immunoallergic mechanism. The child had received cefixime and cotrimoxazole 3 weeks prior to hospitalisation for the hepatitis A virus infection. The final diagnosis was of the syndrome drug reaction with eosinophilia and systemic symptoms or DRESS, induced by cefixime or cotrimoxazole and possibly triggered by the hepatitis A virus infection.Pediatric Nephrology 05/2008; 23(4):667-9. · 2.52 Impact Factor -
Article: Literature review and case histories of Histoplasma capsulatum var. duboisii infections in HIV-infected patients.
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ABSTRACT: African histoplasmosis caused by Histoplasma capsulatum var. duboisii is an invasive fungal infection endemic in central and west Africa. Most of its ecology and pathogenesis remain unknown. H. capsulatum var. capsulatum is an AIDS-defining opportunistic infection in HIV-infected patients who are living in or have traveled to histoplasmosis-endemic areas. In contrast, reports concerning African histoplasmosis during HIV infection are rare, although both pathogens coexist in those regions. We report 3 cases of imported African histoplasmosis diagnosed in France in HIV-infected patients and a literature review on similar cases.Emerging infectious diseases 12/2007; 13(11):1647-52. · 6.17 Impact Factor
Top co-authors
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Institutions
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2004–2012
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Université Paris Diderot - Paris 7
Paris, Ile-de-France, France
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2002–2012
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Hôpital universitaire Robert-Debré
Paris, Ile-de-France, France
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2008
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Assistance Publique – Hôpitaux de Paris
Paris, Ile-de-France, France
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