Revue De Medecine Interne最新文献

{"title":"Un liquide céphalo-rachidien atypique","authors":"Charlotte Descours, Maelle Journaud, Bertrand Lioger","doi":"10.1016/j.revmed.2026.07.011","DOIUrl":"10.1016/j.revmed.2026.07.011","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 10","pages":"Pages 563-564"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876558","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 septique à Pasteurella multocida sur articulation native : dilemmes de prise en charge chez un patient allergique à la pénicilline","authors":"Jeanne Chevalier,&nbsp;Margot Guedot,&nbsp;Camelia Frantz,&nbsp;Manon Lemée,&nbsp;Pierre-Louis Conan,&nbsp;Lisa Bialé","doi":"10.1016/j.revmed.2026.06.008","DOIUrl":"10.1016/j.revmed.2026.06.008","url":null,"abstract":"<div><h3>Background</h3><div><em>Pasteurella multocida</em> is a common zoonotic, but it can also lead to invasive forms such as septic arthritis, particularly in immunocompromised patients.</div></div><div><h3>Case presentation</h3><div>We report a 53-year-old man with well-controlled HIV, who presented with acute wrist arthritis following a cat scratch. He had a documented history of penicillin anaphylaxis, leading clinicians to avoid β-lactam antibiotics in the acute setting in the absence of immediate allergological evaluation. Synovial fluid culture grew <em>P. multocida</em> susceptible to several alternative antibiotics. After failure of doxycycline and intolerance to trimethoprim–sulfamethoxazole, treatment with levofloxacin led to a favorable outcome. The absence of a drainable collection allowed conservative management, with complete recovery after six weeks of antibiotic therapy.</div></div><div><h3>Conclusion</h3><div>This case highlights the therapeutic challenges of <em>P. multocida</em> arthritis in a penicillin-allergic patient living with well-controlled HIV infection. Despite universal susceptibility to β-lactams, sequential alternative regimens were required due to drug intolerance. The favorable outcome without surgery underscores the importance of individualized antibiotic strategies.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 10","pages":"Pages 559-562"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427760","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":"Heart involvements in systemic sclerosis beyond pulmonary hypertension: From conduction, rhythm and function defects to coronary artery disease","authors":"Raffaele Barile,&nbsp;Cinzia Rotondo,&nbsp;Giulio Giancaspro,&nbsp;Valeria Rella,&nbsp;Francesco P. Cantatore,&nbsp;Addolorata Corrado","doi":"10.1016/j.revmed.2026.06.005","DOIUrl":"10.1016/j.revmed.2026.06.005","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is a rare systemic disease characterised by progressive fibrosis, vasculopathy, and immune dysregulation, resulting in multiorgan damage. Independently of pulmonary arterial hypertension, cardiac involvement, encompassing myocardial fibrosis, coronary microvascular dysfunction, arrhythmias, conduction disorders, pericardial and valvular disease, and heart failure, represents a frequently underestimated cause of morbidity and mortality. Clinically manifest cardiac disease is observed in 15 to 35% of patients, while subclinical dysfunction is detectable in approximately 70% when advanced screening tools are employed. The annual incidence of sudden cardiac death is estimated at between 1.0% and 3.3%, exceeding the general-population risk by more than tenfold. The pathophysiological framework rests on coronary microvascular dysfunction driven by endothelial injury, ischaemia–reperfusion cycles, and TGF-β–mediated replacement fibrosis, potentiated by autonomic nervous system imbalance and activation of the renin–angiotensin–aldosterone system. Electrocardiographic abnormalities, detectable in 25 to 85% of patients, are independent predictors of mortality, while diastolic dysfunction, present in 18 to 62% of cases, constitutes a robust prognostic marker. Cardiac magnetic resonance imaging has transformed subclinical detection, revealing late gadolinium enhancement fibrosis in the majority of screened patients without a prior cardiovascular diagnosis. Management requires a multidisciplinary approach, integrating SSc-specific adaptation of guideline-directed heart failure therapies, immunosuppression targeting inflammatory and fibrotic pathways, arrhythmia management with implantable devices, and EULAR-recommended cardiovascular risk reduction. This narrative review synthesises current evidence on the epidemiology, pathogenesis, diagnostic evaluation, and therapeutic strategies of cardiac involvement in SSc, highlighting the need for early, systematic, risk-stratified screening and the establishment of dedicated multidisciplinary cardiac teams.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 500-508"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304381","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":"Une lésion péricalleuse","authors":"Meriem Boui,&nbsp;Rachida Saouab,&nbsp;Hassan En-Nouali,&nbsp;Jamal El Fenni,&nbsp;Ouijdane Zamani,&nbsp;Meryem Edderai","doi":"10.1016/j.revmed.2026.04.015","DOIUrl":"10.1016/j.revmed.2026.04.015","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 521-522"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877079","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":"Rituximab-induced hypogammaglobulinemia in autoimmune cytopenia and associated diseases","authors":"Jonathan Sormani,&nbsp;Alexandre Belot,&nbsp;David Goncalves,&nbsp;Magali Dechomet,&nbsp;Pascal Seve,&nbsp;Arnaud Hot,&nbsp;Laetitia Koppe,&nbsp;Sandrine Lemoine,&nbsp;Cyrille Confavreux,&nbsp;Hervé Ghesquieres,&nbsp;Sarah Benezech,&nbsp;Isabelle Durieu,&nbsp;Quitterie Reynaud","doi":"10.1016/j.revmed.2026.07.015","DOIUrl":"10.1016/j.revmed.2026.07.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Rituximab is used for treating autoimmune cytopenia and associated diseases including autoimmune haemolytic anaemia; immune thrombopenia, systemic lupus erythematosus and antiphospholipid syndrome. However, rituximab may induce acquired immune deficiency in some patients, particularly hypogammaglobulinemia (HG), whose risk factors remain poorly defined.</div></div><div><h3>Patients and methods</h3><div>We conducted a retrospective multicentre study including patients with autoimmune cytopenia and related diseases who received at least one rituximab infusion to validate serum protein electrophoresis (SE) as a screening tool for HG and to assess its incidence, risk factors, and clinical outcomes. Univariate and multivariate Cox analysis were performed to characterize predictor of HG.</div></div><div><h3>Results</h3><div>Among 47 patients (391.89 person-years follow-up), Gammaglobulin evaluation on SE strongly correlated with IgG (ρ = 0.97, <em>P</em> <!-->=<!--> <!-->2.2<!--> <!-->×<!--> <!-->10^–16). HG, defined as gammaglobulin levels &lt;<!--> <!-->7<!--> <!-->g/L on SE after rituximab exposure, occurred in 14.9% of patients and was associated with a higher cumulative number of rituximab injections (median 11 vs. 1.5; <em>P</em> <!-->=<!--> <!-->0.033). All immunoglobulin isotypes declined after treatment, and severe infections were more frequent in HG patients. Although cumulative rituximab dose and corticosteroid exposure were associated with HG in univariate analysis, these findings were not confirmed in multivariate models.</div></div><div><h3>Conclusion</h3><div>SE appears to be a reliable screening tool for HG, but larger studies are needed to clarify risk factors.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 474-482"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714833","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 anomalies rénales","authors":"S. Cherkaoui,&nbsp;Y. El Harras,&nbsp;I. Sarsar,&nbsp;K. Imrani,&nbsp;I. Nassar","doi":"10.1016/j.revmed.2026.05.014","DOIUrl":"10.1016/j.revmed.2026.05.014","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 519-520"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267357","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":"Immuno’logique (l’actualité scientifique que vous n’auriez pas osé lire ailleurs) : privation en méthionine, summer body et polarisation des macrophages","authors":"Valentin Lacombe","doi":"10.1016/j.revmed.2026.05.001","DOIUrl":"10.1016/j.revmed.2026.05.001","url":null,"abstract":"<div><div>As summer approaches, methionine-restricted diets might appear to be just another “summer body” promise. Yet behind the loss of fat mass observed in mice lies a genuine metabolic reprogramming: methionine deprivation alters glucose utilization, reduces mitochondrial respiration, and promotes a more glycolytic metabolic profile. This energetic shift extends beyond muscle and adipose tissue, directly influencing immune cell behavior. We will explore how such restriction can skew macrophages toward a pro-inflammatory M1 phenotype, and limit the activation and proliferation of Th1 and Th17 lymphocytes, with effects that vary according to the pathological context – metabolic syndrome, cancer, or autoimmune diseases. Through this synthesis, Immuno’logique aims to make findings from fundamental science literature more digestible while highlighting their potential clinical implications. In short, let us be serious without taking ourselves too seriously, and discover how methionine deprivation can reshape metabolism and immunity.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 515-518"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166288","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":"Issue Contents","authors":"","doi":"10.1016/S0248-8663(26)00710-1","DOIUrl":"10.1016/S0248-8663(26)00710-1","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Page e17"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148916017","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":"Sécukinumab dans l’artérite à cellules géantes : décryptage des résultats de l’essai GCAptAIN","authors":"Maxime Samson","doi":"10.1016/j.revmed.2026.06.012","DOIUrl":"10.1016/j.revmed.2026.06.012","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 471-473"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427784","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":"Sacro-iliite infectieuse de la grossesse et du post partum, description d’un cas et revue de la littérature","authors":"Neila Rahal,&nbsp;Aude Mausoléo,&nbsp;Virginie Baltes,&nbsp;Nora Brouard-Daudignon,&nbsp;Noemie Chanson,&nbsp;Nicolas Noel,&nbsp;Lucas Pacoureau","doi":"10.1016/j.revmed.2026.04.004","DOIUrl":"10.1016/j.revmed.2026.04.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Infectious sacroiliitis is a rare condition, accounting for 1–2% of septic arthritis cases. Its risk factors remain poorly defined, although several studies suggest an association with pregnancy and the postpartum period.</div></div><div><h3>Methods</h3><div>Based on a case of postpartum infectious sacroiliitis, we conducted a literature review to describe the clinical, microbiological, and therapeutic features of this entity.</div></div><div><h3>Results</h3><div>A systematic search, without date or language restrictions, identified 36 articles published between 1933 and 2024. The median age of patients was 26 years [24–32], and the median time to diagnosis was 12,5 days (extremes [3–21] days). Pain was constant, most located in the buttock (63,6%) or lower limb (42,4%) and was associated with fever (≥<!--> <!-->38.0<!--> <!-->°C) in over 75% of cases. When performed, MRI was invariably abnormal. <em>Staphylococcus aureus</em> was the most frequently isolated pathogen (33%), whereas no microbiological documentation was obtained in nearly one-quarter of cases. Beta-lactams were the most used antibiotics (82,3%), and surgical intervention was required in 25% of patients.</div></div><div><h3>Discussion</h3><div>Diagnosis, often delayed, should be considered in any patient presenting with febrile lumbar or buttock pain during pregnancy or postpartum. The absence of fever does not rule out the diagnosis. MRI is the imaging modality of choice. Treatment relies on antibiotic therapy, sometimes combined with surgery, with generally favourable outcomes.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 9","pages":"Pages 509-514"},"PeriodicalIF":1.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825256","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}