Revue De Medecine Interne最新文献

{"title":"Des douleurs musculaires des membres inférieurs","authors":"A. Deroux","doi":"10.1016/j.revmed.2026.05.015","DOIUrl":"10.1016/j.revmed.2026.05.015","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 461-462"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort study of 23 patients with seropositive immune-mediated necrotizing myopathy","authors":"Romain Batton,&nbsp;Léopold Roullée,&nbsp;Marion Carrette,&nbsp;Vincent Langlois,&nbsp;Benjamin Membrey,&nbsp;Maëlle Le Besnerais,&nbsp;Shona Perrin,&nbsp;Fabienne Jouen,&nbsp;Muriel Silva,&nbsp;Ygal Benhamou,&nbsp;Olivier Boyer,&nbsp;Mathilde Leclercq","doi":"10.1016/j.revmed.2026.07.006","DOIUrl":"10.1016/j.revmed.2026.07.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Immune-mediated necrotizing myopathy (IMNM) are rare muscular inflammatory muscle diseases that bear poor prognosis. Description of their clinical evolution remains limited in the literature. This study aimed to describe the clinical, biological, and serological features of patients with anti-HMGCR or anti-SRP IMNM presenting with muscle involvement at diagnosis and to identify factors associated with relapse during follow-up.</div></div><div><h3>Methods</h3><div>Between January 1st, 2015 and December 31st, 2023, we retrospectively identified 66 patients with anti-3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR) or anti-signal recognition particle (SRP) autoantibodies in three French immunology laboratories (Rouen, Le Havre, Dieppe). We included 23 patients with a follow-up of at least 3 months: 14 with anti-HMGCR and 9 with anti-SRP autoantibodies. Statistical analysis was performed on clinical data and focused on a score derived from the manual muscle testing score at 6 months after diagnosis and during follow-up, as well as biological data and treatment strategy.</div></div><div><h3>Results</h3><div>IMNM patients with anti-SRP were significantly younger and had more severe disease at diagnosis compared to patients with anti-HMGCR. We observed an inverse correlation between creatine kinase (CK) levels and muscular strength during follow-up. At diagnosis, women, anti-SRP patients, and patients who experienced a relapse during follow-up had more severe muscle weakness compared to male, anti-HMCGR positive patients and patients who did not experience a relapse, respectively. Relapse occurred in 65.2% of patients. Relapsing patients had higher CK level and higher anti-SRP levels at diagnosis compared to non-relapsing patients. Treatment with intravenous immunoglobulins was associated with a shorter time to response.</div></div><div><h3>Conclusion</h3><div>Our study provides valuable clinical insights into the management of seropositive IMNM in a real-world setting and highlights the need for further research in this area.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 415-423"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un frottis sanguin avec des cellules abîmées","authors":"C. Rabourdin,&nbsp;C. Grosdidier,&nbsp;E. Guenet,&nbsp;F. Dolbeault,&nbsp;G. Dejeans,&nbsp;A. Benyamine,&nbsp;B. Granel","doi":"10.1016/j.revmed.2026.07.003","DOIUrl":"10.1016/j.revmed.2026.07.003","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 468-470"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French guidelines for the diagnosis and management of primary central nervous system vasculitis","authors":"Hubert de Boysson,&nbsp;Grégoire Boulouis,&nbsp;Sonia Alamowitch,&nbsp;Caroline Arquizan,&nbsp;Raphael Darbon,&nbsp;Kumaran Deiva,&nbsp;Myriam Edjlali,&nbsp;Lisa Humbertjean,&nbsp;Sylvain Lanthier,&nbsp;Romain Marignier,&nbsp;Bertrand Mathon,&nbsp;Charles Mellerio,&nbsp;Karima Mokhtari,&nbsp;Antoine Néel,&nbsp;Christian Pagnoux,&nbsp;Thomas Papo,&nbsp;Alexis Régent,&nbsp;Christine Rodriguez-Régent,&nbsp;Jean-Louis Stéphan,&nbsp;Line Toulaimat,&nbsp;Emmanuel Touze","doi":"10.1016/j.revmed.2026.07.007","DOIUrl":"10.1016/j.revmed.2026.07.007","url":null,"abstract":"<div><div>Primary central nervous system vasculitis (PCNSV) is a rare and heterogeneous disease whose diagnosis relies on a combination of clinical, radiological, and laboratory findings, and which requires a multidisciplinary hospital-based approach involving neurologists, neuroradiologists, and internists (or rheumatologists). This protocol is based on expert consensus and registry data, and aims to optimise and harmonise the diagnostic and therapeutic approach to PCNSV. Diagnosis is challenging due to non-specific clinical and radiological features. The diagnostic process includes (1) confirming vascular involvement (via MRI and angiography), and demonstrating the inflammatory process (via lumbar puncture, contrast-enhanced MRI and vascular wall sequences), (2) excluding more common differential diagnoses (especially intracranial atherosclerosis in patients with vascular stenosis), (3) and as often as possible discussing a brain or meningeal biopsy. Histological evidence obtained from a biopsy remains the gold standard for diagnosis, especially in case of small-vessel involvement. The therapeutic strategy is divided into induction (to achieve remission) and maintenance phases (to prevent relapse). Induction therapy consists of high-dose corticosteroids combined with an immunosuppressant, most often intravenous cyclophosphamide, to achieve remission. The initial corticosteroid dose is maintained for 2–3 weeks, then gradually tapered over 12–18 months. Once remission is achieved, maintenance therapy is introduced, typically using oral or subcutaneous immunosuppressants such as azathioprine, methotrexate, or mycophenolate mofetil, for 18–24 months. Preventive measures address treatment-related complications, including osteoporosis, infections, and metabolic disturbances. Relapses occur in a significant proportion of patients, necessitating prompt reassessment and possible escalation of immunosuppression. These guidelines emphasise the importance of individualised care, regular follow-up, and treatment adjustment based on disease activity and patient tolerance.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 430-452"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un diagnostic tardif de déficit en CPT-2","authors":"Marie Gernay,&nbsp;Adrien Bigot,&nbsp;Apolline Imbard,&nbsp;Edouard Le Guillou,&nbsp;Hélène Blasco,&nbsp;Chloé Giret,&nbsp;Isabelle Benz-De Bretagne,&nbsp;François Maillot","doi":"10.1016/j.revmed.2026.02.008","DOIUrl":"10.1016/j.revmed.2026.02.008","url":null,"abstract":"<div><h3>Introduction</h3><div>CPT-2 deficiency is an autosomal recessive energy metabolism disorder that can present in three forms, the most common being the muscle form, which is characterized by recurrent episodes of rhabdomyolysis throughout life. The diagnosis is usually established during childhood or adolescence, but it may sometimes be delayed and made later in adulthood. Prompt emergency management helps prevent complications related to rhabdomyolysis.</div></div><div><h3>Case report</h3><div>We present the case of a 68-year-old patient diagnosed with CPT-2 deficiency 57 years after the initial episode, following an emergency admission for pyelonephritis associated with severe rhabdomyolysis. The medical history revealed a long-standing pattern of recurrent myalgias. Acylcarnitine profile was suggestive of CPT2 deficiency, which was confirmed genetically.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of considering the diagnosis of such inherited metabolic disease even in older patients. Indeed, subtle clinical presentation and resolution of symptoms between episodes can lead to significant diagnostic delays.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 453-456"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthrite réactionnelle induite par les inhibiteurs de points de contrôle immunitaire : à propos d’un cas","authors":"Anne Cholet,&nbsp;Kevin Bihan,&nbsp;Lucile Sous,&nbsp;Christel Gerardin,&nbsp;Jeanne Chauffier","doi":"10.1016/j.revmed.2026.05.004","DOIUrl":"10.1016/j.revmed.2026.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, but immune-related adverse events are common. Reactive arthritis-like syndromes remain rarely reported in this context.</div></div><div><h3>Case report</h3><div>We report the case of a 73-year-old man with a history of clear cell renal carcinoma who developed conjunctivitis, urethritis, and asymmetric arthritis 48<!--> <!-->hours after receiving pembrolizumab. Synovial fluid analysis was sterile, the autoimmune panel was negative, and imaging excluded axial spondyloarthritis. Symptoms recurred during glucocorticoids tapering but improved after intra-articular injections and prednisone reinitiation. A pharmacovigilance analysis using VigiBase identified eleven similar cases, including three classified as Fiessinger-Leroy-Reiter syndrome.</div></div><div><h3>Conclusion</h3><div>This case illustrates a rare presentation of pembrolizumab-associated reactive arthritis, combining articular involvement with an oculo-urethral syndrome. It underscores the importance of a thorough diagnostic workup and early multidisciplinary management.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 457-460"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Contents","authors":"","doi":"10.1016/S0248-8663(26)00684-3","DOIUrl":"10.1016/S0248-8663(26)00684-3","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages e15-e16"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148718865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blocking interleukin-1 in pericarditis: Should we move earlier and stronger?","authors":"Martin Michaud,&nbsp;Yvan Jamilloux","doi":"10.1016/j.revmed.2026.04.016","DOIUrl":"10.1016/j.revmed.2026.04.016","url":null,"abstract":"<div><div>Acute pericarditis is generally a benign condition, yet 15–30% of patients will develop recurrent pericarditis. Standard first-line therapy combines non-steroidal anti-inflammatory drugs or aspirin with colchicine, which reduces but does not eliminate the risk of recurrence. Patients presenting with a high inflammatory burden, subacute evolution or large pericardial effusion are particularly prone to recurrence, and corticosteroid exposure — still frequent in clinical practice — further increases this risk. Over the last decade, the central role of interleukin-1 (IL-1) in pericardial inflammation has been demonstrated, and IL-1 inhibitors have emerged as the most effective treatment for colchicine-resistant or corticosteroid-dependent recurrent pericarditis. Anakinra, rilonacept and other IL-1–targeting agents provide rapid symptom resolution and dramatically reduce recurrences, thereby transforming the management of difficult-to-treat forms of the disease. This review summarizes current knowledge on the IL-1 pathway in pericarditis and examines whether earlier, targeted intervention could modify disease trajectory, particularly in patients identified as having a high risk of recurrence at presentation. Drawing parallels with Still's disease, in which early IL-1 inhibition improves long-term outcomes, these data support the need for high-quality trials evaluating IL-1 blockade as a first-line strategy in selected patients with acute pericarditis.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 424-429"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Des lombalgies atypiques","authors":"Ouafaa Chahboune,&nbsp;Ola Messaoud,&nbsp;Zaynab Iraqi Houssaini,&nbsp;Laila Jroundi,&nbsp;Omar El Aoufir","doi":"10.1016/j.revmed.2026.06.006","DOIUrl":"10.1016/j.revmed.2026.06.006","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 463-464"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cybersécurité dans les hôpitaux : enjeux, vulnérabilités et bonnes pratiques pour les médecins internistes","authors":"Jean-Edouard Monnerville,&nbsp;Emilie Forestier,&nbsp;Joris Galland","doi":"10.1016/j.revmed.2026.03.437","DOIUrl":"10.1016/j.revmed.2026.03.437","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 8","pages":"Pages 411-414"},"PeriodicalIF":1.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}