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Thierry Genereau

Publications and source records attributed to Thierry Genereau.

6 recordsLinked to original sources

Celiprolol-induced lupus-like syndrome.

Systemic lupus erythematosus can be idiopathic or drug-induced. Although a number of beta-blockers have been reported to induce a lupus-like syndrome, to the best of our knowledge, no such case has been described following celiprolol therapy. We diagnosed a lupus-like syndrome in a 67-year-old female patient who developed febrile polyarthritis, percarditis, antinuclear and anti-histone antibodies after taking celiprolol for 2 years. Despite drug withdrawal, prolonged corticotherapy was needed to obtain clinical and biological remission.

Aged↗

[Langerhans cell histiocytosis in an adult patient associated with sclerosing cholangitis and cerebellar atrophy].

Langerhans' cell histiocytosis is a disorder in children or young adults, characterized by clonal proliferation of histiocytic cells, staining for CD1a, with uni or multifocal organ involvement. It's a rare condition in adults. We report a case of Langerhans' cell histiocytosis in an adult with sclerosing cholangitis which rapidly progressed to fatal liver failure and progressive cerebellar atrophy. Langerhans cell histiocytosis is a rare cause of sclerosing cholangititis in adults.

Aged↗

Endocrine involvement in pediatric-onset Langerhans' cell histiocytosis: a population-based study.

OBJECTIVE: To document the frequency and outcome of endocrine involvement in pediatric-onset Langerhans' cell histiocytosis (LCH), and the association with other types of organ involvement. STUDY DESIGN: This retrospective nationwide multicenter study involved 589 patients with pediatric-onset LCH, 148 of whom had endocrine dysfunction. Median follow-up was 11.6 years. RESULTS: Pituitary dysfunction was present in 145 patients, and 141 had diabetes insipidus (DI). The estimated 10-year risks of pituitary involvement were 24.2% +/- 1.8%. GH deficiency occurred in 61 patients. Median age at onset was 2.8 years for LCH, 3.9 years for DI, and 7.7 years for GH deficiency. The risk of cranial involvement; ear, nose, and throat involvement; pneumothorax; and cholangitis was significantly higher in patients with endocrinopathy. The chronology of episodes did not support a causal link between pituitary involvement and involvement of other organs. Systemic treatment of LCH did not prevent pituitary involvement. The most severe complication was a neurodegenerative syndrome, which affected 4.3% and 10.8% of patients, respectively, 5 and 15 years after initial diagnosis, and appeared to be linked to pituitary involvement. CONCLUSION: Patients who develop endocrine LCH disorders are at a high risk of neurodegenerative LCH and require long-term follow-up.

Adolescent↗

[Scleroderma and pregnancy].

PURPOSE: - The frequency of concurrent scleroderma and pregnancy is low because scleroderma is a rare connective-tissue disease and the mean age of symptom onset is in the early 40s. The reciprocal influence of pregnancy and scleroderma and management of pregnancy are the purpose of this review. Current knowledge and key points. - There is no increase in infertility in women with scleroderma. The effect of pregnancy on scleroderma is a greater risk of renal crisis, especially when scleroderma is evolutive, diffuse and recent. Conversely, pregnancy is characterized by prematurity and small full-term infants because scleroderma induce placentar vascular abnormalities. There is no increase in miscarriages and spontaneous abortions. The pregnant scleroderma patient is a potential anaesthetic challenge because of physical difficulties and visceral involvement. Future and projects. - Planning of pregnancy and follow-up by a multidisciplinary experienced team in high risk pregnancies are guarantees for successful pregnancies. Future research will try to determine the role of microchimerism in scleroderma physiopathology and specify placental findings in order to ameliorate the obstetrical prognosis.

Acute Kidney Injury↗

Pharmacokinetics of teicoplanin during plasma exchange.

OBJECTIVE: To study the elimination of teicoplanin during plasma exchange, a procedure currently used to treat a variety of disorders involving immune complexes. Teicoplanin is a glycopeptide antibiotic that exhibits a long terminal half-life (100-150 h) and is highly bound to plasma proteins (unbound fraction (fu)=0.2). METHODS: Twelve adults with systemic polyarteritis nodosa, cryoglobulinemia-induced vasculitis or dysglobulinemic neuropathy undergoing plasma exchange were studied. Each patient received intravenous teicoplanin, 6 mg/kg body weight, immediately before plasma exchange. Plasma was assayed for teicoplanin by high pressure liquid chromatography. RESULTS: A high level of protein binding of teicoplanin was measured within this patient population (98%). The mean quantity of teicoplanin eliminated (+/-SD) was 74.6+/-34.6 mg. The mean drug fraction eliminated by plasma exchange (+/-SD) was 19.5+/-5.6%. Mean fu value as determined by ultrafiltration (+/-SD) was 2.2+/-1.7%. CONCLUSIONS: These results show that plasma exchange influences teicoplanin pharmacokinetics, with a clinically significant quantity being eliminated. If trough teicoplanin concentrations of around 10 mg/L are desired, it is recommended that teicoplanin dosage be supplemented or given after plasma exchange.

Journal Article↗