P Le Goff

Centre Hospitalier Universitaire de Brest, Brest, Brittany, France

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Publications (246)357.59 Total impact

  • Paul Le Goff
    Revue du Rhumatisme 10/2009; 76(9):933-934. DOI:10.1016/j.rhum.2009.05.006
  • Paul Le Goff
    Joint, bone, spine: revue du rhumatisme 09/2009; 76(5):578; author reply 1578-9. DOI:10.1016/j.jbspin.2009.05.008 · 3.22 Impact Factor
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    ABSTRACT: We have examined serum antibodies to Epstein-Barr virus Nuclear Antigen (EBNA)-1,-2A and-2B, in addition to antibodies to viral capsid antigen and early antigen in 100 rheumatoid arthritis patients and 50 of their relatives. Using indirect immunofluorescence on transfected cells and Western-blot technique, we have found increased frequency and litres of antibodies to EBNA-2B in patients and, to a lesser degree, in their family members, whereas other anti-Epstein-Barr virus antibodies appeared to be similar to controls. Cross-inhibition experiments were carried out and show that antibodies to EBNA-2A are distinct from those to-2B, and vice verse.
    Autoimmunity 07/2009; 13(3). · 2.75 Impact Factor
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    ABSTRACT: Sera from patients with giant cell arteritis and/or polymyalgia rheumatica were tested for the presence of IgG, IgM and IgA antibody to endothelial cells (AEC), cardiolipin (ACL) and phosphatidylethanolamine (APE) using enzyme-linked immunosorbent assays. There were strong correlations between ACL and APE, but also between AEC and ACL IgM (p < 0.02) and between AEC and APE IgA (p < 0.003). Inhibition of AEC binding was achieved by absorption onto EC, but ACL and APE binding was also significantly reduced. In contrast, the binding of AEC antibody could not be inhibited by incubation with CL. Our data suggest that AEC constitute a heterogeneous population of autoantibodies.
    Autoimmunity 07/2009; 20(1):59-66. DOI:10.3109/08916939508993340 · 2.75 Impact Factor
  • D. Baron, P. Le Goff
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    ABSTRACT: Los quistes sinoviales son muy variados. De forma esquemática, se clasifican en el grupo de distrofias y tumores benignos de la membrana sinovial. Constituyen un grupo de lesiones dispares que se desarrollan desde el punto de vista histológico a expensas del tejido sinovial. Su origen es motivo de controversia, pues en la evolución del quiste pueden desaparecer los sinoviocitos, que son su signo patognomónico. Por tanto, en los quistes yuxtaarticulares es difícil diferenciar entre los quistes sinoviales puros y los otros sin sinoviocitos, de los que los principales son los quistes mucoides. La sintomatología suele ser mínima, pero puede agravarse en algunas zonas, por compresión vascular (en especial venosa en el hueco poplíteo) o neurológica (en la columna vertebral, causante de una compresión radicular). La compresión de nervios periféricos es otra posibilidad (nervio tibial posterior frente a la articulación tibioperonea superior). Para el diagnóstico, que en la mayoría de los casos se sospecha por la clínica, se utilizan las pruebas de imagen modernas que permiten un diagnóstico más precoz, con el descubrimiento de formaciones quísticas que antes no eran visibles, e incluso asintomáticas, lo que plantea la cuestión de su tratamiento.
    01/2009; 42(1):1–14. DOI:10.1016/S1286-935X(09)70911-6
  • D. Baron, P. Le Goff
    01/2008; 3(3):1-13. DOI:10.1016/S0246-0521(08)44922-7
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    ABSTRACT: To evaluate the ability of baseline hand radiographs to predict the diagnosis 2 years later in a cohort of patients with early arthritis. A total of 258 patients with arthritis onset within the previous year were evaluated. At baseline, all patients underwent a standardized evaluation including laboratory tests and radiographs. Hand radiographs were read by a blinded observer who used a standardized procedure for detecting features of crystal deposition diseases and rheumatoid arthritis (RA). After 30 +/- 11.3 months, the final diagnosis was established by a panel of rheumatologists. All radiographs were evaluated. Significant associations were found between radiographic features and a clinical diagnosis of RA, calcium pyrophosphate dihydrate (CPPD) arthritis, and hydroxyapatite arthritis. No radiographic abnormalities suggesting psoriatic arthritis or gout were seen. The sensitivities of hand radiographs for diagnosing CPPD or hydroxyapatite arthritis ranged from 80% to 100%. Baseline hand radiographs suggested the final diagnosis in 31/258 patients, including 21 (22.5%) of the 93 patients with RA, 10 of the 11 (91%) patients with CPPD or hydroxyapatite deposition disease, and none of the patients with other disorders. Sensitivity was 29%, specificity 86.5%, positive predictive value 61%, and negative predictive value 63%. In our cohort of patients with recent arthritis, the overall performance of hand radiographs in predicting a diagnosis 2 years later was modest. However, they had an excellent diagnostic value for calcium deposition diseases.
    The Journal of Rheumatology 09/2006; 33(8):1511-5. · 3.17 Impact Factor
  • Paul Le Goff
    The Journal of Rheumatology 02/2006; 33(1):198-9; author reply 199. · 3.17 Impact Factor
  • D. Baron, P. Le Goff
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    ABSTRACT: Esta revisión sobre las infiltraciones intraarticulares de corticoides analiza lo que en la actualidad se debe saber sobre el tema. Después de una reseña histórica, se abordan el modo de acción, las características farmacológicas y la acción de los corticoides sobre el tejido sinovial normal y patológico. También se dedica un epígrafe a la higiene e información del paciente, datos nuevos estos últimos que habrá que incorporar a la práctica. A continuación, se describen las complicaciones, los efectos secundarios y las contraindicaciones. El apartado más significativo es el que se refiere a las indicaciones: artrosis, artritis reumáticas y otras como la capsulitis retráctil, la sinovitis villonodular y los reumatismos microcristalinos. En la artrosis, y en menor grado en los reumatismos inflamatorios, las distintas articulaciones se tratan por separado cuando los datos son suficientes. Un último epígrafe recapitula los factores predictivos de respuesta a una infiltración de corticoide. En resumen, lo más importante de este artículo es saber que las infiltraciones desempeñan un papel en el tratamiento de las artritis reumáticas, así como en el de las artrosis, pero su acción es de duración limitada y son pocos los factores predictivos de respuesta.
    01/2006; 10(3):1–11. DOI:10.1016/S1636-5410(06)70393-2
  • D. Baron, P. Le Goff
    01/2006; 1(2):1-12. DOI:10.1016/S1634-6939(06)39673-1
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    ABSTRACT: Post-fracture osteolysis of the pubic bone is rare. We report a case of a 70-year-old woman with osteoporosis and a history of radiation therapy 2 years earlier. At presentation, she was found to have a bilateral sacral fracture and fractures of both pubic rami on one side. The pain persisted, and follow-up radiographs showed osteolysis of the pubic rami suggestive of metastatic disease. The development of a bony callus within 8 months established the diagnosis of benign osteolysis. About 50 cases of osteolysis at fracture sites have been reported to date, of which about a dozen occurred after radiation therapy. All the patients were elderly women with post-menopausal osteoporosis. Radiation therapy probably further increases the risk in this setting. The possibility of osteolysis at fracture sites in patients with osteoporosis should be borne in mind to avoid unnecessary and burdensome investigations that are costly and cause undue anxiety to the patients. Rest is the only effective treatment.
    Joint Bone Spine 06/2004; 71(3):230-3. DOI:10.1016/S1297-319X(03)00091-5 · 3.22 Impact Factor
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    ABSTRACT: Postfracture osteolysis of the pubic bone is rare. We report a case in a 70-years-old woman with osteoporosis and a history of radiation therapy 2 years earlier. At presentation, she was found to have a bilateral sacral fracture and fractures of both pubic rami on one side. The pain persisted, and follow-up radiographs showed osteolysis of the pubic rami suggestive of metastatic disease. The development of a bony callus within 8 months established the diagnosis of benign osteolysis. About 50 cases of osteolysis at fracture sites have been reported to date, of which about a dozen occurred after radiation therapy. All the patients were elderly women with postmenopausal osteoporosis. Radiation therapy probably further increases the risk in this setting. The possibility of osteolysis at fracture sites in patients with osteoporosis should be borne in mind to avoid unnecessary and burdensome investigations that are costly and cause undue anxiety to the patients. Rest is the only effective treatment.
    Revue du Rhumatisme 05/2004; 71(5):397-401. DOI:10.1016/S1169-8330(03)00259-X
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    ABSTRACT: In a cohort of patients with early arthritis, to evaluate how well foot radiographs at study inclusion predicted a diagnosis of rheumatoid arthritis (RA) 2 years later. A cohort of patients with arthritis of less than one year duration was evaluated in a multicenter study and followed for 30 +/- 11 months. An observer blinded to patient data read all 149 hand and foot radiographs done at study inclusion, using item 7 of the 1987 American College of Rheumatology (ACR) criteria for RA and Sharp's method to score erosions and joint space narrowing. The kappa coefficient for the 1987 ACR item 7 was 0.52 for bony decalcification and 0.87 for erosions. Intra and interobserver correlation coefficients for Sharp's scores ranged from 0.90 to 0.98. Erosions at the feet were significantly associated with RA. The item 7 erosion component at the feet was more specific than the full item 7 (97.5% vs 94%; p = 0.01). Sharp's erosion score at the feet was not better than the erosion component of item 7 (sensitivity 18%; specificity 97.5%). Combined use of radiographs of the hands and feet improved the diagnostic performance of the item 7 erosion component; (sensitivity and specificity of item 7 erosions at the hands combined with the feet were 32.5% and 94.5%, respectively). The "erosion" criterion at the feet had the best diagnostic performance and was significantly associated with a diagnosis of RA. Combining hand and foot radiographs improved diagnostic performance.
    The Journal of Rheumatology 02/2004; 31(1):66-70. · 3.17 Impact Factor
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    ABSTRACT: To compare the diagnostic values of antiperinuclear factor (APF), antikeratin antibody (AKA), and anti-cyclic citrullinated peptides (anti-CCP) to discriminate between patients with and without rheumatoid arthritis (RA) and to determine the diagnostic value of anti-CCP used alone or with other tests. Two hundred and seventy patients with early arthritis underwent standardized investigations in 1995-1997. The clinical utility of APF, AKA, and anti-CCP in first-visit sera was evaluated using receiver-operating characteristic curves. Combinations of anti-CCP with other laboratory tests were assessed by multiple logistic regression. Anti-CCP, APF, and AKA were not perfectly correlated with one another. Anti-CCP with 53 UI as the cutoff was 47% sensitive and 93% specific, versus 52% and 79%, and 47% and 94%, for APF and AKA, respectively. Multiple logistic regression selected anti-CCP, AKA, IgM-rheumatoid factor (RF) ELISA, and the latex test. Rheumatologists can routinely use 2 or 3 tests for diagnosing RA (latex and/or IgM RF ELISA, and either AKA or anti-CCP ELISA) and can add a third or fourth test when the diagnosis remains in doubt.
    The Journal of Rheumatology 01/2004; 30(12):2535-9. · 3.17 Impact Factor
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    Y Ollivier, A Saraux, P Le Goff
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    ABSTRACT: To evaluate the influence of lifestyle factors on the prevalence of rheumatoid arthritis (RA) by comparing Roman Catholic nuns and the general female population. RA prevalence in the general population was evaluated using a standardized telephone survey in 1857 homes taken at random. Individuals who reported an inflammatory joint disease were contacted by a rheumatologist of our unit, missing data were collected from the general practitioner or rheumatologist with the patient's permission, and if necessary a physical examination was done by a rheumatologist. The 9 largest Roman Catholic nun communities in Brittany were screened using the same standardized questionnaire administered face-to-face; nuns who reported an inflammatory joint disease were interviewed and examined by rheumatologists. In both populations, RA was diagnosed when (1) the rheumatologist of our unit who interviewed the patient considered the RA classification criteria positive and (2) the rheumatologist who examined the patient gave a diagnosis of RA independently from RA classification criteria. Data were available for 1706 adult females in the general population and 721 nuns. Of the 20 nuns who reported RA or polyarthritis, 11 received a diagnosis of RA (prevalence 1.52%). The prevalences adjustedfor the French population after 40 years were 1.66% (95% confidence interval, 0.84-2.44) and 1.33 (0.27-2.40) among the nuns and the general female population, respectively. Although our nun population was too small for definite conclusions, we found no evidence of a difference in RA prevalence among nuns and the general female population in Brittany.
    Clinical and experimental rheumatology 01/2004; 22(6):759-62. · 2.97 Impact Factor
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    ABSTRACT: Although bone and joint manifestations are common in children with cystic fibrosis (CF), they have received little attention in adults. As compared to healthy individuals, bone mineral density is low, even with calcium intakes greater than 1500 mg/d. Nevertheless, calcium and phosphate levels in blood and urine are often normal, and vitamin D levels vary. Short stature with a low body mass index and central hypogonadism are the rule in these patients. Fractures and kyphosis are often reported. CF arthropathy occurs in 2-8.5% of patients. Arthritis develops, and there may be skin eruptions. Non-steroidal antiinflammatory drug therapy is effective. Hypertrophic osteoarthropathy associated with respiratory failure is present in 2-7% of patients. Rheumatoid arthritis, spondyloarthropathies, sarcoidosis, and amyloidosis have been reported in association with CF. Knee pain due to patellofemoral syndrome, quinolone-induced arthropathy, and mechanical back pain have been described. Rheumatoid factor titers are higher than in healthy controls, particularly in patients with episodic arthritis. No data are available on antiperinuclear factor or antikeratin antibody titers. Tests for antinuclear antibody are usually negative. Circulating immune complex levels and antibodies to heat shock proteins may be elevated. Antineutrophil cytoplasmic antibody of the bactericidal/permeability-increasing protein (BPI) or azurocidin (AZ) type has been reported, often in high titers (up to 40%).
    Joint Bone Spine 10/2003; 70(5):327-35. DOI:10.1016/S1297-319X(03)00063-0 · 3.22 Impact Factor
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    ABSTRACT: Although bone and joint manifestations are common in children with cystic fibrosis, they have received little attention in adults. As compared to healthy individuals, bone mineral density is low, even with calcium intakes greater than 1500 mg/d. Nevertheless, calcium and phosphate levels in blood and urine are often normal, and vitamin D levels vary. Short stature with a low body mass index and central hy-pogonadism are the rule in these patients. Fractures and kyphosis are often reported. Cystic fibrosis arthropathy occurs in 2 to 8,5% of patients. Arthritis develops, and there may be skin eruptions. Nonsteroidal anti-inflammatory drug therapy is effective. Hypertrophic osteo-arthropathy associated with respiratory failure is present in 2 to 7% of patients. Rheumatoid arthritis, spondylo-arthropathies, sarcoido-sis, and amyloidosis have been reported in association with cystic fibrosis. Knee pain due to patellofemoral syndrome, quinolone-induced arthropathy, and mechanical back pain have been described. Rheumatoid factor titers are higher than in healthy controls, particularly in patients with episodic arthritis. No data are available on anti-perinuclear factor or antikeratin antibody titers. Tests for antinuclear antibody are usually negative. Circulating immune complex levels and antibodies to heat shock proteins may be elevated. Antineutrophil cytoplasmic antibody of the BPI or AZ type has been reported, often in high titers (up to 40%).
    Revue du Rhumatisme 10/2003; 70(9):703-712. DOI:10.1016/S1169-8330(03)00147-9
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    Arthritis Research & Therapy 02/2003; 5(Suppl 1). DOI:10.1186/ar654 · 4.12 Impact Factor
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    Arthritis Research & Therapy 02/2003; 5(Suppl 1). DOI:10.1186/ar738 · 4.12 Impact Factor
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    ABSTRACT: The extent to which radiographs of the hands and feet can contribute to the diagnosis of early rheumatoid arthritis (RA) has received little research attention. Yet, the workup for recent-onset inflammatory joint disease usually includes radiographs of the hands and feet. We reviewed the literature for data on the value of these radiographs for diagnosing early RA. We sought to determine whether radiographic changes in the hands and feet constitute a valid diagnostic criterion, i.e., show good discrimination, good reproducibility, and an ability to detect early disease. Furthermore, we evaluated whether the sensitivity, specificity, and positive and negative predictive values of these changes could be calculated from published data. Few cohort studies of early inflammatory joint disease have been published, and the data come mainly from studies in early RA. Among radiographic alterations described to date, erosions seem associated with the best reliability and discriminating power. Radiographic alterations are of limited sensitivity for early rheumatoid arthritis because they occur only after some time. Radiographs of the hands and feet are far easier to obtain than magnetic resonance imaging and ultrasonography, which seem promising but are still undergoing validation.
    Joint Bone Spine 11/2002; 69(5):434-41. DOI:10.1016/S1297-319X(02)00427-X · 3.22 Impact Factor

Publication Stats

1k Citations
357.59 Total Impact Points

Institutions

  • 1980–2004
    • Centre Hospitalier Universitaire de Brest
      Brest, Brittany, France
  • 2001–2002
    • Centre Hospitalier Universitaire de Nantes
      • Service de rhumatologie
      Naoned, Pays de la Loire, France
    • Université de Bretagne Occidentale
      Brest, Brittany, France
  • 2000
    • Hospital Centre University of Fort de France
      Fort Royal, Martinique, Martinique
  • 1996
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France
  • 1995
    • University College London
      • Division of Medicine
      Londinium, England, United Kingdom
  • 1990–1995
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 1994
    • University of Grenoble
      Grenoble, Rhône-Alpes, France