Thomas Papo's research while affiliated with Université Paris Cité and other places
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Publications (629)
Objectives
The objective of this study is to better characterize the features and outcomes of a large population of patients with mixed connective tissue disease (MCTD).
Methods
We performed an observational retrospective multicenter cohort study in France. Patients who fulfilled at least one diagnostic criterion set for MCTD and none of the crite...
Objective
Sepsis is characterized by an excessive release of inflammatory cytokines. Cytokine dysregulation is pivotal to the pathophysiology of immune‐mediated inflammatory diseases (IMIDs). We aimed to analyze the incidence of IMIDs in patients who survived sepsis.
Methods
We performed a matched‐cohort study using the National Medico‐Administrat...
Objectives
Heart involvement is one of the leading causes of death in systemic sclerosis (SSc). The prevalence of SSc-related cardiac involvement is poorly known. Our objective was to investigate the prevalence and prognosis burden of different heart diseases in a nationwide cohort of patients with SSc.
Methods
We used data from a multicentric pro...
Objective
There is limited evidence on when to obtain a central nervous system (CNS) biopsy in suspected primary angiitis of the central nervous system (PACNS). Our objective was to identify which clinical and radiological characteristics were associated with a positive biopsy in PACNS.
Methods
From the multicenter retrospective Cohort of Patients...
Women with systemic lupus erythematosus (SLE), especially when exposed to immunosuppressive drugs, are at higher risk of human papillomavirus (HPV)-related cervical cancer. ¹ A recent study has shown that cervical cancer screening (CCS) coverage is worryingly low in this population.
Background
Giant cell arteritis (GCA) is a chronic large-vessel vasculitis that affects mainly the aorta and its primary branches, and in Western countries is the most common form of vasculitis in people older than 50 years. The most severe manifestations of GCA include blindness and ischemic stroke caused by occlusion of affected arteries. GCA pre...
Background
Heart involvement is one of the leading causes of death in systemic sclerosis (SSc). Cardiac manifestations are heterogeneous. In particular, prevalence of SSc-related cardiopathy is poorly known due to a lack of consensus in its definition.
Objectives
Our objective was to investigate the prevalence and prognosis burden of the different...
Relapsing polychondritis is a rare systemic disease. It usually begins in middle-aged individuals. This diagnosis is mainly suggested in the presence of chondritis, i.e. inflammatory flares on the cartilage, in particular of the ears, nose or respiratory tract, and more rarely in the presence of other manifestations. The formal diagnosis of relapsi...
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibodies raised against nuclear antigens and whose production is promoted by autoreactive T follicular helper (TFH) cells. Basophils, by accumulating in secondary lymphoid organs (SLO), amplify autoantibody production and disease progression through mechanisms to be...
Introduction
Début août 2022, l’Organisation mondiale de la santé (OMS) recense plus de 580 millions de cas mondiaux cumulés d’infections à SARS-CoV-2 (COVID-19). Plusieurs arguments expérimentaux étayent le lien entre COVID-19 et maladies auto-immunes ou inflammatoires (MAII) : la production excessive de cytokines pro-inflammatoires a été associée...
Introduction
La tuberculose neuroméningée (TNM) est une forme rare mais sévère d’infection à Mycobacterium tuberculosis. Son traitement repose sur une antibiothérapie prolongée et une corticothérapie à haute dose de courte durée. La TNM peut se compliquer d’une réaction paradoxale (RP) sous traitement. Les RP, bien décrites chez les patients VIH ou...
Introduction
L’objectif de ce travail est de déterminer, si dans l’artérite à cellules géantes (ACG), la persistance dans le temps d’un hypermétabolisme artériel en TEP-TDM 18FDG est associée au risque de rechute.
Patients et méthodes
Dans cette étude monocentrique et rétrospective, tous les patients admis pour une ACG histologiquement prouvée et...
Introduction
Les interférons de type 1 étant impliqués dans la physiopathologie du lupus érythémateux systémique (LES) et dans la réponse immunitaire anti-COVID-19, un risque de poussée lupique COVID induite pourrait être suspecté. Nos objectifs étaient d’évaluer ce risque et de rechercher les facteurs associés à une poussée de LES après un épisode...
Introduction
Le syndrome des antiphospholipides (SAPL) est une maladie auto-immune caractérisée par la survenue d’événements thrombotiques et/ou obstétricaux en lien avec la présence d’auto-anticorps antiphospholipides (aPL). En cas d’événement thrombotique, la durée du traitement anticoagulant est indéfinie. La disparition des aPL au cours du temp...
Objective:
To evaluate the specific response of SLE patients to BNT162b2 vaccination and its impact on autoimmunity defined as in vivo production of interferon-alpha (IFNα) by plasmacytoid dendritic cells (pDCs) and autoreactive immune responses.
Methods:
Our prospective study included SLE patients and healthy volunteers (HV) who received 2 dose...
Objective:
Quality indicators (QIs) for systemic lupus erythematosus (SLE) management based on the 2019 update of European League Against Rheumatism (EULAR) recommendations have been recently proposed. We aimed to determine whether adherence to QIs was associated with patient reported outcome (PRO).
Methods:
Adherence to a set of 18 EULAR-based...
Introduction
Une série de 18 indicateurs de qualité (IQs) visant à optimiser et standardiser la prise en charge des patients lupiques, basée sur les recommandations de l’EULAR, a été récemment publiée. L’objectif de ce travail était de déterminer si le suivi de ces recommandations par les praticiens était associé à une meilleure qualité de vie des...
Introduction
Alors que la vaccination anti-SARS-CoV-2 est devenue un enjeu important de la prise en charge des patients atteints de maladies auto-immunes systémiques telles que le lupus érythémateux systémique (LES), nous manquons de données sur l’impact de la vaccination par ARN messager sur l’auto-immunité. Notre objectif était de décrire l’impac...
Introduction
La connectivite mixte (CM) est une entité définie par la positivité d’anticorps dirigés contre la ribonucléoprotéine U1 (anti-RNP) et la présence plusieurs signes cliniques et biologiques retrouvés dans d’autres connectivites différenciées (CD) [1]. Néanmoins, les critères de classification de la maladie ne sont pas consensuels et l’ex...
Introduction
Le syndrome des antiphospholipides (SAPL) obstétrical est défini par la survenue d’un évènement obstétrical tardif (mort fœtale in utero, éclampsie, retard de croissance intra-utérin par insuffisance placentaire) ou précoce (3 fausses couches consécutives avant la 10e semaine d’aménorrhée) associée à la présence durable d’auto-anticorp...
Introduction
Malgré les recommandations de la Haute Autorité de santé (HAS), le dépistage du cancer du col utérin (CCU) est insuffisant en France. Chez les patientes lupiques, les risques d’infection à papillomavirus humain (HPV) et de dysplasie de haut grade sont plus importants que dans la population générale. Le but de ce travail était de tester...
Introduction
Plusieurs travaux ont rapporté une augmentation de l’incidence de l’infection à papillomavirus humain (HPV) et des dysplasies du col utérin chez les patientes lupiques. L’objectif de ce travail était de décrire la fréquence et les facteurs de risque d’infection à HPV et des anomalies cytologiques du col utérin dans une cohorte monocent...
Purpose
Because of the involvement of type 1 interferon (IFN-1) in the pathophysiology of both systemic lupus erythematosus (SLE) and COVID-19 immune response, a risk of post COVID-19 SLE flare could be hypothesized. Our objectives were to assess this risk and to look for factors associated with a post-COVID-19 SLE flare.
Methods
We conducted a re...
Purpose
Vaccination in patients with autoimmune disease like systemic lupus erythematosus (SLE) raises a special concern because its impact on autoimmunity remains partially unknown. While clinical data from large cohort are reassuring [1], very little has been described on the post vaccination immune system reaction. Besides, long-term efficacy of...
This prospective population-based study estimated the incidence of giant cell arteritis (GCA) in northeastern Paris. GCA cases diagnosed between 2015 and 2017 were obtained from local hospital and community-based physicians and the national health insurance system database. Criteria for inclusion were living in the study area at that time and fulfi...
IFNα and anti-IFNα autoantibodies have been implicated in susceptibility both for systemic lupus erythematosus (SLE) and viral infection. We aimed to analyze the SLE disease phenotype and risk for infection associated with anti-IFN-α IgG autoantibodies in SLE patients In this multidisciplinary retrospective single referral center study, all consecu...
Introduction
L’atteinte cardiaque est une des causes principales de décès dans la sclérodermie systémique (SSc). Ses différentes manifestations sont très hétérogènes et leurs prévalences mal connues, notamment en raison d’un manque de consensus sur leurs définitions. Nous avons voulu étudier la prévalence et l’impact pronostique des différentes att...
Background
Imaging mass cytometry (IMC) is a high-plex imaging technique that incorporates flow cytometry principles while preserving the histological and architectural components of the tissue sample. Characterizing the entire cellular component of temporal artery (TA) in patients with giant cell arteritis (GCA) may provide clues towards novel dia...
Background
Prediction models based on traditional cardiovascular risk factors underestimate the risk of cardiovascular events (CVE) in systemic lupus erythematosus (SLE).
Objectives
We aimed to determine whether sCD163, a biomarker for SLE-associated atherosclerosis, may predict CVE in SLE.
Methods
All SLE patients included between 2007 and 2010...
Background
IFNα and anti-IFNα autoantibodies have been implicated in susceptibility both for systemic lupus erythematosus (SLE) and viral infection.
Objectives
We aimed to analyze the SLE disease phenotype and risk for infection associated with anti-IFN-α IgG autoantibodies in SLE patients
Methods
In this multidisciplinary retrospective single re...
Background
Data regarding interstitial lung disease (ILD) in the setting of systemic lupus erythematosus (SLE) are limited
Objectives
We used a nation-wide database to determine the incidence and the prevalence of ILD in SLE patients.
Methods
Characteristics of all SLE inpatients admitted between 2011 and 2012 in France were analyzed through the...
Background
The detection of somatic mutations in genes of myeloid cells in asymptomatic patients - defining clonal hematopoiesis of indeterminate potential (CHIP) - predisposes to cardiovascular events (CVE) in the general population.
Objectives
We aimed to determine whether CHIP was associated with CVE in SLE patients.
Methods
The study is an an...
Persistent symptoms of SARS‐CoV‐2 are prevalent weeks to months following the infection. To date, it is difficult to disentangle the direct from the indirect effects of SARS‐CoV‐2, including lockdown, social, and economic factors. The study aims to characterize the prevalence of symptoms, functional capacity, and quality of life at 12 months in out...
Susac syndrome is a rare disease characterized by an inflammatory microangiopathy limited to the brain, eye, and ear vessels. It mainly affects young women. Although the pathophysiology is not fully elucidated, recent advances favour a primitive vasculitis affecting the cerebral, retinal and cochlear small vessels. Diagnosis relies on the recogniti...
Background and objective:
Data regarding interstitial lung disease (ILD) in the setting of systemic lupus erythematosus (SLE) are limited. We used a nationwide database to determine the incidence and the prevalence of ILD in SLE.
Methods:
Characteristics of all SLE inpatients admitted between 2011 and 2012 in France were analysed through the Fre...
Background/ objective:
Skeletal tuberculosis (TB) is rare. We aimed to report on diagnosis strategy and treatment of skeletal TB.
Methods:
In this multidisciplinary single-center medical records review study, all adult patients admitted between January 2009 and December 2019 with microbiologically proven skeletal TB were included. Demographic, m...
Inhaled corticosteroids (ICS) have been associated with increased risk of pneumonia. Their impact on respiratory virus infections is unclear. We performed a post-hoc analysis of the FLUVAC cohort, a multicenter prospective cohort study of adults hospitalized with influenza-like illness (ILI) during six consecutive influenza seasons (2012–2018). All...
Objective
The detection of somatic mutations in genes of myeloid cells in asymptomatic patients - defining clonal hematopoiesis of indeterminate potential (CHIP) - predisposes to cardiovascular events (CVE) in the general population. We aimed to determine whether CHIP was associated with CVE in SLE patients.
Methods
The study is an ancillary study...
Fluorodesoxyglucose Positron Emission Tomography (PET/CT) has never been compared to Chest-Abdomen-Pelvis CT (CAPCT) in patients with a fever of unknown origin (FUO), inflammation of unknown origin (IUO) and episodic fever of unknown origin (EFUO) through a prospective and multicentre study. In this study, we investigated the diagnostic value of PE...
Introduction
Outre la pleurésie, les manifestations pulmonaires spécifiques du lupus érythémateux systémique (LES) comprennent principalement la pneumonie aiguë, l’hémorragie intra-alvéolaire, la pneumonie organisée, la pneumopathie interstitielle diffuse (PID), le shrinking lung syndrome, la bronchiolite oblitérante et l’hypertension pulmonaire. P...
Objective
We analysed the incidence of, the specific outcomes and factors associated with COVID-19-associated organ failure (AOF) in patients with systemic lupus erythematosus (SLE) in France.
Methods
We performed a cohort study using the French national medical/administrative hospital database for the January 2011–November 2020 period. Each patie...
Introduction
Depuis l’apparition du SARS-CoV2, le pronostic des formes sévères de COVID-19 chez les patients atteins de lupus érythémateux systémique (LES) reste débattu. Les objectifs de cette étude étaient l’analyse de l’incidence, du pronostic et des facteurs associés aux formes sévères de COVID-19 chez les patients atteints de LES en France.
P...
Introduction
Le purpura thrombotique thrombocytopénique acquis (PTTa) est une pathologie auto-immune rare mettant en jeu le pronostic vital, caractérisée par un syndrome de microangiopathie thrombotique consécutif à un déficit profond (< 10 %) d’activité ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13). Le...
Introduction
La mortalité chez les patients atteints de lupus systémique est deux à cinq fois plus importante que dans la population générale et est principalement liée, en France, à la survenue d’évènements cardiovasculaires (ECV). Chez les patients lupiques, le risque d’ECV n’est pas parfaitement expliqué par les seuls facteurs de risque cardiova...
Introduction
Les événements cardiovasculaires (ECV) sont en France la première cause de mortalité des patients lupiques. Les ECV en contexte lupique ne sont pas expliqués par les seuls facteurs de risque cardiovasculaire classiques. L’hématopoïèse clonale est la détection par séquençage à haut débit de mutations somatiques de gènes impliqués dans l...
Introduction
En fonction des séries, jusque 40 % des patients atteints de lupus systémique (LS) présenteraient des auto-anticorps anti-INFα. Ces auto-anticorps sont pour la plupart neutralisants et donc potentiellement protecteurs des atteintes sévères de la maladie lupique. À l’inverse, les auto-anticorps anti-INFα prédisposent aux infections et n...
Introduction
Outre la pleurésie, les manifestations pulmonaires spécifiques du lupus érythémateux systémique (LES) comprennent principalement la pneumonie aiguë, l’hémorragie intra-alvéolaire, la pneumonie organisée, la pneumopathie interstitielle diffuse (PID), le shrinking lung syndrome, la bronchiolite oblitérante et l’hypertension pulmonaire. P...
Background
Acute myocarditis (AM) may be the heralding manifestation of autoimmune and inflammatory disorders (AIID). We aimed to describe the clinical presentation and outcome of patients with AM revealing AIID.
Methods
All consecutive adult patients with AM admitted in a department of Cardiology (Bichat Hospital, Paris, France) from January 2011...
Introduction
L’artérite à cellules géantes (ACG) est une maladie inflammatoire des branches extra-crâniennes de l’aorte. La biopsie d’artère temporale (BAT) – incontournable dans la démarche diagnostique–met en évidence la présence d’un infiltrat inflammatoire responsable de la destruction de la paroi arterielle. Pour mieux caractériser les différe...
Introduction
La myocardite aiguë (MA) peut révéler certaines maladies auto-immunes ou inflammatoires (MAII). Le traitement spécifique de la MAII permet d’améliorer le pronostic. Son diagnostic précoce est donc un enjeu majeur. L’objectif de cette étude était de décrire les caractéristiques cliniques et l’évolution des patients admis pour MA révélan...
Background
Patients with COVID-19 pneumonia can have increased inflammation and elevated cytokines, including interleukin (IL)-6, which might be deleterious. Thus, sarilumab, a high-affinity anti-IL-6 receptor antibody, might improve the outcome of patients with moderate-to-severe COVID-19 pneumonia.
Methods
We did a multicentric, open-label, Baye...
In the current SARS Cov-2 pandemic context, vaccination using mRNA Covid-19 vaccine has started in France in December 2020. Based on the risk for severe COVID-19, patients suffering from autoimmune diseases (AID) and receiving -or about to receive- steroids or immunosuppressive drugs have been prioritized for vaccination (1).
Background
Susac syndrome (SuS) is an rare occlusive micro vessel disease of the brain, retina, and inner ear. We aimed to determine whether brain lesion load at the acute phase predict poor outcomes in SuS.
Methods
A prospective national cohort study was conducted from December 2012 to December 2019 in 20 centres in France. Patients included at t...
Resumen
La sequedad bucal u ocular es un síntoma frecuente, cuya demostración objetiva debe obtenerse mediante pruebas sencillas y cuyas causas son muy variadas. Entre ellos, el síndrome de Sjögren, que es una agresión autoinmunitaria del sistema glandular exocrino, ocupa un lugar esencial por sus complicaciones sistémicas y el riesgo de linfoma.
Riassunto
La secchezza della bocca o degli occhi è un disturbo comune, la cui prova oggettiva deve essere ottenuta con semplici test e le cui cause sono molto varie. Tra queste, la sindrome di Gougerot-Sjögren, che scatena un attacco autoimmune al sistema ghiandolare esocrino e che occupa un posto essenziale a causa delle sue complicanze sistemiche...
Introduction
Le syndrome de Susac (SuS) associe encéphalopathie, surdité de perception et occlusions artériolaires rétiniennes. L’objectif de l’étude est de déterminer la valeur prédictive de la charge lésionnelle cérébrale à la phase aiguë, évaluée par IRM en séquence diffusion (IRM-D), sur la présentation clinique et le pronostic.
Patients et mé...
Introduction
Depuis l’apparition du SarS-CoV-2 fin 2019, beaucoup d’inquiétudes persistent concernant le risque pour les patients atteints de maladie auto-immune, telle que le Lupus Eyrthémateux Systémique (LES), de développer une forme grave de COVID-19. Si les études réalisées jusqu’alors sur des échantillons relativement faibles, sont rassurante...
Introduction
Les thromboses veineuses profondes sont fréquentes et peuvent survenir dans des contextes cliniques très différents. L’objectif de ce travail était de tester l’intérêt de l’analyse en cluster pour l’identification de groupes homogènes de patients hospitalisés pour un premier épisode de thrombose veineuse profonde dans un service de méd...
Résumé
Le syndrome de Susac est une maladie rare touchant principalement les femmes jeunes caractérisée par une microangiopathie limitée aux vaisseaux cérébraux, rétiniens et cochléaires. Bien que la physiopathologie du syndrome de Susac ne soit pas encore complètement élucidée, des données récentes confirment l’impression clinique d’être face à un...
A young man coming from La Reunion presented with headache, backpain, progressive urinary incontinence and gait instability. Blood cells count and Cerebro-Spinal Fluid (CSF) analysis showed eosinophilia. MRI confirmed thoracic myelitis. CSF and serum serodiagnosis for Toxocara were both positive. Eosinophilic meningomyelitis secondary to a toxocari...
Susac syndrome (SuS) is a rare microvasculopathy affecting the brain, the retina, and the inner ear1 whom pathophysiology is not yet fully understood2 even if recent analysis showed vasculitis3 and the implication of CD8+ T cells. Although no familial cases have been reported, a genetic defect could be suspected when considering the rarity of the d...
Case Presentation
A 29-year-old man with no significant medical history presented to the ED with a 4-week history of chest pain. The pain was insidious, located on the right side of the chest, increased by deep breathing, and incompletely alleviated by acetaminophen. The patient had never smoked tobacco. He denied any recent fevers, chills, dyspnea...
Background
Patients with COVID-19 pneumonia have an excess of inflammation and increased concentrations of cytokines including interleukin-1 (IL-1). We aimed to determine whether anakinra, a recombinant human IL-1 receptor antagonist, could improve outcomes in patients in hospital with mild-to-moderate COVID-19 pneumonia.
Methods
In this multicent...
Acquired factor V inhibitor (AFVI) is an extremely rare disorder that may cause severe bleeding. To identify factors associated with bleeding risk in AFVI patients, a national, multicentre, retrospective study was made including all AFVI patients followed in 21 centres in France between 1988 and 2015. All patients had an isolated factor V (FV) defi...
Background
The optimal treatment for patients with severe coronavirus-19 disease (COVID-19) and
hyper-inflammation remains debated.
Material and methods
A cohort study was designed to evaluate whether a therapeutic algorithm using steroids with
or without interleukin-1 antagonist (anakinra) could prevent death/invasive ventilation.
Patients with a...
Introduction
Script concordance tests (SCTs) have been developed to assess clinical reasoning in uncertain situations. Their reliability for the evaluation of undergraduate medical students has not been evaluated.
Methods
Twenty internal medicine SCT cases were implemented in undergraduate students of two programs. The results obtained on the SCTs...