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Publications (124)
Objectives
(1) To assess the clinical utility of the adjusted global antiphospholipid syndrome score (aGAPSS) to predict new obstetric events during follow-up in primary obstetric antiphospholipid syndrome (POAPS) patients under standard-of-care treatment (SC) based on the use of low-dose aspirin (LDA) + heparin and (2) to study the risk of a first...
Objective
Patients with inflammatory myopathies (IM) are known to have an increased risk of developing malignancies. Autoimmune and inflammatory diseases occur in up to 25% of patients with myelodysplastic syndrome (MDS). This study aimed to describe the rare association between IM and MDS.
Methods
We report here the main characteristics, treatmen...
Objective
Interleukin-26 (IL-26) has a unique ability to activate innate immune cells due to its binding to circulating double-stranded DNA. High levels of IL-26 have been reported in patients with chronic inflammation. We aimed to investigate IL-26 levels in patients with systemic lupus erythematosus (SLE).
Methods
IL-26 serum levels were quantif...
Background:
The combination of low-dose aspirin (LDA) and low-molecular-weight heparin (LMWH) until the end of gestation are the currently the accepted standard of care for the treatment of antiphospholipid-related obstetric disorders. In refractory cases, hydroxychloroquine (HCQ) can be added to this standard of care.
Objective:
To evaluate the...
The most common peripheral nervous system manifestations in Sjogren’s syndrome are small fiber sensory neuropathies (SFPN) and axonal sensorimotor polyneuropathies. Currently, treatment in small fiber neuropathy is mainly symptomatic and based on anti-depressors and anti-epileptics. The benefit of treatment with polyvalent immunoglobulins for SFPN...
Objective
The first aim was to retrospectively identify risk factors for the development of early severe preeclampsia (sPE) in patients with obstetric antiphospholipid syndrome (OAPS) who received conventional treatment (CT). The second aim was to evaluate the impact of hydroxychloroquine (HCQ) in preventing early sPE among a subgroup of patients c...
The PI3K/AKT/mTOR signaling pathway is significantly activated in rheumatoid arthritis. In addition, somatic activating mutations of the PI3K/AKT/mTOR pathway may result in PIK3CA-related overgrowth spectrum diseases, including CLOVES (Congenital Lipomatous Overgrowth, Vascular malformation, Epidermal nevi, Skeletal abnormalities/Scoliosis) syndrom...
Background
Although guidelines do not recommend antiphospholipid antibodies testing after 60 yo, recent data reported late onset antiphospholipid syndrome (APS).
Objectives
To comparatively analyse the clinical, laboratory features and outcomes in 695 cases with primary APS between patients older and younger than 70 yo.
Methods
we have performed...
Severe Acute Respiratory Syndrome related to Coronavirus-2 (SARS-CoV-2), coronavirus disease-2019 (COVID-19) may cause severe illness in 20% of patients. This may be in part due to an uncontrolled immune-response to SARS-CoV-2 infection triggering a systemic hyperinflammatory response, the so-called “cytokine storm”. The reduction of this inflammat...
Azathioprine (AZA), an oral immunosuppressant, is safe during pregnancy. Some reports suggested different impairments in the offspring of mothers with autoimmune diseases (AI) exposed in utero to AZA. These observations are available from retrospective studies or case reports. However, data with respect to the long-term safety in the antenatally ex...
Extra-criteria manifestations such as thrombocytopenia and livedo are described associated with antiphospholipid syndrome (APS) but are not included in the current classification criteria. Their clinical expression might be important, as they may be associated with a high-risk profile of antiphospholipid antibodies (aPL) and thrombosis. We evaluate...
Objective: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB).
Method: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a French multicentre database. They all met at least th...
Objectives:
To compare clinical features, laboratory data and fetal-maternal outcomes between 1000 women with obstetric APS (OAPS) and 640 with aPL-related obstetric complications not fulfilling Sydney criteria (non-criteria OAPS, NC-OAPS).
Methods:
This was a retrospective and prospective multicentre study from the European Registry on Obstetri...
Background
The obstetric antiphospholipid syndrome is an autoimmune systemic disorder related to antiphospholipid antibodies and pregnancy morbidity. There exist many patients that do not fulfill the Sydney classification criteria. Those cases may be defined as Obstetric Morbidity related with antiphospholipid antibodies (OMAPS).
Objectives
To com...
Background
The relapse rate in antiphospholipid syndrome (APS) remains high, 20% at 5 years in thrombotic APS and 28% in obstetrical APS (1). Hydroxychloroquine (HCQ) appears as an additional therapy, with immunomodulatory and antithrombotic effects (2-5).
Objectives
The main aim
of this trial is to assess the efficacy of treatment with Hydroxych...
Background
Optimal standard therapy in obstetrical antiphospholipid syndrome (APS) (aspirin and LMWH) is effective in 72- 80% of pregnancies (1). Intravenous immunoglobulins (IVIG) are not more efficient than standard therapy (2, 3) and seems to be reserved to high risk pregnant APS patients (4) and/or refractory cases (5).
Objectives
The main aim...
Background
The obstetric antiphospholipid syndrome (OAPS) is an autoimmune disease defined by the presence of obstetric complications related to antiphospholipid antibodies. EUROAPS project is the biggest published European registry on obstetric antiphospholipid syndrome and it is ongoing.
Objectives
To analyse the clinical features, laboratory da...
Background
The mollecular pathogenesis of antiphospholipid syndrome is complex (environmental triggers, predisposed individuals). Previous studies suggested that infection may lead to the development of transiently elevated non-thrombogenic aPL antibodies. However, there are increasing case reports of patients with viral infections who develop anti...
Background
Antiphospholipid syndrome is associated with endothelial dysfunction, which leads to thrombosis and early atheroma. Given that hydroxychloroquine has anti-thrombotic properties in lupus, we hypothesized that it could reduce endothelial dysfunction in an animal model of antiphospholipid syndrome. We evaluated the effect of hydroxychloroqu...
The relapse rate in antiphospholipid syndrome (APS) remains high, i.e. around 20%–21% at 5 years in thrombotic APS and 20–28% in obstetrical APS [2, 3]. Hydroxychloroquine (HCQ) appears as an additional therapy, as it possesses immunomodulatory and anti-thrombotic various effects [4–16]. Our group recently obtained the orphan designation of HCQ in...
Primary antiphospholipid syndrome (PAPS) and antiphospholipid syndrome associated to lupus (SAPS) have several overlapping characteristics. As systemic manifestations are also reported in patients with PAPS, and as a subgroup of PAPS patients could evaluate to a SAPS, the differentiation between the two types of APS could be performed based on the...
Introduction
L’artérite à cellule géante (ACG) est associée à une aortite dans 45 à 65 % des cas. Au diagnostic, environ 80 % des aortites sont asymptomatiques. Cependant, au cours de l’évolution de l’ACG, le risque de développer un anévrisme de l’aorte thoracique est augmenté (risque relatif jusqu’à 17,3). Ces anévrismes se compliquent dans un tie...
Introduction
L’aortite au cours de l’arterite a cellules geantes est un facteur associe a un pronostic plus severe avec un risque accru de developper un anevrysme aortique. Les aortites isolees sont meconnues, elles ont principalement fait l’objet de travaux descriptifs anatomopathologiques leur risque evolutif reste a preciser.
Patients et methode...
Introduction
Selon le critère classique avec un seuil sérique de vitamine B12 (B12) de 200 ng/L, la prévalence de sa carence est estimée à 1 à 2 % de la population générale, jusqu’à 10 % chez les plus de 65 ans. Néanmoins, ce seuil apparaît insuffisamment sensible pour détecter précocement la carence. Les experts ont donc proposé un dépistage de la...
Purpose:
To develop French recommendations about the management of vaccinations, the screening of cervical cancer and the prevention of pneumocystis pneumonia in systemic lupus erythematosus (SLE).
Methods:
Thirty-seven experts qualified in internal medicine, rheumatology, dermatology, nephrology and pediatrics have selected recommendations from...
Introduction
Des modifications microvasculaires ont été observés chez des patients avec un syndrome antiphospholipides.
Une étude a rapporté en capillaroscopie des microhémorragies symétriques, qui ont été trouvées particulièrement significatives chez des patients avec des IgG et IgM ACL. Des altérations microcirculatoires marquées ont été retrouvé...
Introduction
La prévalence de la carence en vitamine B12 (B12) est estimée à 1 à 2 % de la population générale, jusqu’à 10 % chez les plus de 65 ans. Le seuil sérique de 200 ng/L, longtemps retenu pour le diagnostic, apparaît insuffisamment sensible. Plusieurs auteurs ont retenu l’homocystéïne et l’acide méthylmalonique, substrats des réactions imp...
Introduction
L’existence d’une hypogammaglobulinémie et d’une lymphopénie chez l’adulte doit faire discuter un déficit immunitaire secondaire. Dans ce cadre, l’association à une hypoalbuminémie évoque des pertes excessives et fait rechercher un syndrome néphrotique, une dermatose étendue mais aussi une entéropathie exsudative. Nous rapportons un ca...
Several studies assess an important risk of thrombosis relapse in antiphospholipid syndrome (APS) (1-2), and the need for a secondary prophylaxis (3). Hydroxychloroquine (HCQ) is such a treatment, revealing a positive balance benefits/risks and a low economic cost. The goals of this first prospective study in primary APS patients were to assess the...
Systemic and immune manifestations have been reported in patients with MDS. The correlation between immunological abnormalities and prognosis in myelodysplastic syndrome patients remains controversial. Most of the authors agree that the median survival in myelodysplastic syndrome is not related to the presence of systemic and immune manifestations,...
Large vessels are also affected in sickle cell disease. The aim of this study was to assess several parameters in adult patients with sickle cell disease compared with control subjects and in patients with sickle cell disease with stroke.
Carotid arterial stiffness, intima-media thickness, and transcranial Doppler ultrasonography were measured.
Art...
The presence of systemic and/or immune manifestations in myelodysplasia has been currently reported. The influence of these manifestations on the natural outcome of myelodysplastic syndrome has to be considered. We present a multicenter retrospective study (2002-2009) of patients with myelodysplastic syndrome disclosing systemic and/or immune manif...
Cryofibrinogenemia may be essential, or secondary to diseases such as neoplasia, infection, thrombosis, and collagen vascular diseases. In a previous study, we reported the occurrence of neoplasia in some essential cryofibrinogenemia patients after a short period of follow-up.
We performed a prospective multi-center 5-year follow-up study in essent...
Anti-Ku antibodies are reported in various connective tissue diseases and the Ku complex can be responsible for a very strong autoimmune answer in autoimmune disease. Nowadays, anti-Ku antibodies are detected by ELISA, counterimmunoelectrophoresis (CIE), immunoblot (IB) and new highly performant techniques. Although the prevalence of anti-Ku antibo...
Vasculitis may be associated with infection, immunization or anti-microbial drugs. Infections are responsible for a number
of different types of vasculitis. Conversely, patients with vasculitis may develop infections, which sometimes mimic relapse.
The aim of this review is to summarize the various aspects of the inter-relationship between vasculit...
Several disturbances of the coagulation system are associated with malignancies of the hematopoietic system. The primary mechanisms of these are disseminated intravascular coagulation and hyperviscosity. As such, bleeding or thrombotic events are often encountered and, occasionally, they may even be the inaugural symptom of leukaemia. The lack of a...
The relationship between atherosclerosis and the antiphospholipid syndrome (APS) is unclear. This study compared intima-media thickness (IMT), arterial stiffness, and presence of plaques in APS patients and controls to evaluate the risk of atherosclerosis in this patient population. The study also explored the relationship between these parameters...
The present study assessed the outcome of several cases of cryofibrinogenaemia detected in our hospitals during a 10-yr period (December 1996-April 2007), and also attempted to evaluate the clinical manifestations and associated diseases.
We performed a retrospective study in a series of 61 consecutive cryofibrinogenemia patients detected in our ho...
A premature atherosclerosis has been presumed in patients with antiphospholipid syndrome. The potential role of antiphospholipid antibodies in the development of atheroma is rather controversial. In this study, we tested the hypothesis that antiphospholipid antibodies could induce atherosclerosis via vascular functional changes. CD1 mice received o...
Sir,
Tonsillar tuberculosis is a rare presentation of extrapulmonary tuberculosis. Although tuberculosis of the tonsils is nowadays an uncommon finding, tonsillar granulomas are occasionally seen by histopathologists, and can sometimes contain tuberculous organisms. Occasionally, tonsillar tuberculosis may precede the diagnosis of pulmonary tuberc...
The presence of early atheroma in antiphospholipid syndrome (APS) underscores the necessity of new therapies for this disorder. Inflammation plays an essential role in the pathogenesis of both APS secondary to systemic lupus erythematosus and atheroma. Several drugs currently used in APS have also anti-atherogenic properties via their anti-inflamma...