Revue De Medecine Interne最新文献

{"title":"French protocol for the diagnosis and management of recurrent pericarditis","authors":"Yvan Jamilloux ,&nbsp;Marc André ,&nbsp;Hélène Maillard ,&nbsp;Mathilde Baudet ,&nbsp;Florence Beauvais ,&nbsp;Guilaine Boursier ,&nbsp;Antoine Buschiazzo ,&nbsp;Erwan Donal ,&nbsp;Erwan Flecher ,&nbsp;Sophie Georgin-Lavialle ,&nbsp;Mathieu Gerfaud-Valentin ,&nbsp;Isabelle Kone-Paut ,&nbsp;Fabien Labombarda ,&nbsp;Nicolas Piriou ,&nbsp;David Saadoun ,&nbsp;Achille Aouba","doi":"10.1016/j.revmed.2026.02.002","DOIUrl":"10.1016/j.revmed.2026.02.002","url":null,"abstract":"<div><div>Recurrent pericarditis is characterised by repeated episodes of pericardial inflammation separated by an asymptomatic interval of at least 4 to 6 weeks. Diagnosis relies on typical clinical features (chest pain, pericardial friction rub), imaging—primarily echocardiography, with MRI when needed—and inflammatory markers, particularly C-reactive protein (CRP). The initial assessment aims to identify an underlying cause, which is most often idiopathic (frequently presumed post-viral) but may be autoimmune, autoinflammatory, or infectious. Management requires close coordination between specialists and reference centres, with the primary goal of preventing recurrence. Colchicine is the cornerstone of therapy and should be prescribed for 3 to 6 months, and often longer. During acute flares, NSAIDs or aspirin are recommended in combination with colchicine. Corticosteroids are no longer indicated, except in highly specific situations. In severe or refractory forms, early use of interleukin-1 inhibitors—particularly anakinra or rilonacept—should be considered. Long-term follow-up includes clinical and laboratory monitoring to ensure symptom resolution and normalisation of CRP levels, as well as regular assessment of quality of life. Treatment withdrawal must be very gradual, over several months or even years, and supported by therapeutic patient education to help patients recognise early warning signs. Coordinated follow-up within structured care networks is essential to ensure optimal access to treatment and advanced therapies. This French Protocol for Diagnosis and Management aims to provide clinicians with clear, harmonised, and up-to-date guidance to improve the diagnosis, treatment, and long-term care of patients with recurrent pericarditis.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 3","pages":"Pages 127-146"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313837","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":"Mycoplasma pneumoniae pneumonia associated with severe neutropenia","authors":"Dounia Abbas ,&nbsp;Amanda Blot-Cossard ,&nbsp;Delphine Giusti ,&nbsp;Amélie Servettaz ,&nbsp;Firouze Bani-Sadr","doi":"10.1016/j.revmed.2025.12.004","DOIUrl":"10.1016/j.revmed.2025.12.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Cold agglutinin haemolytic anaemia, aplastic anaemia, immune thrombocytopaenia and hemophagocytosis are well-established complications of <em>Mycoplasma pneumoniae</em> infection. In contrast, severe neutropenia has rarely been described.</div></div><div><h3>Case report</h3><div>We report the case of a 71-year-old with systemic lupus erythematosus who presented with severe febrile neutropenia (0.2<!--> <!-->G/L) and mild thrombocytopenia (75 G/L) revealing <em>M. pneumoniae</em> pneumonia. Erythema multiforme appeared secondary. Granulocyte autoantibodies were negative. Neutropenia and thrombocytopenia resolved within three days after azithromycin initiation.</div></div><div><h3>Discussion</h3><div>Four other cases of <em>M. pneumoniae</em> pneumonia presenting with severe febrile neutropenia have been reported in the literature. They were associated with thrombocytopenia and/or anemia in all cases. Granulocyte autoantibodies were positive in 2 cases. This rare case highlights the importance of considering <em>M. pneumoniae</em> infection in the differential diagnosis of febrile neutropenia and illustrates that rapid resolution of neutropenia can be observed under antibiotic therapy alone.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 98-101"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890678","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":"Renal abnormalities","authors":"Pierre-Antoine Castan ,&nbsp;Bertrand Lioger ,&nbsp;Maxime Gouguet ,&nbsp;Abderrazak El Yamani ,&nbsp;Olivia Dolleans","doi":"10.1016/j.revmed.2025.08.014","DOIUrl":"10.1016/j.revmed.2025.08.014","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 102-103"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076907","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":"Women's knowledge concerning the impact of chronic systemic diseases and related treatments on pregnancy","authors":"Marie Rolland ,&nbsp;Odile Souchaud-Debouverie ,&nbsp;Quentin Bodard ,&nbsp;Aurélie Grados ,&nbsp;Marie Pathé ,&nbsp;Mathieu Puyade ,&nbsp;Mickaël Martin","doi":"10.1016/j.revmed.2025.08.003","DOIUrl":"10.1016/j.revmed.2025.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Many women of childbearing age are being treated for chronic conditions that require long-term medication. We assessed the knowledge of women being treated in internal medicine and clinical immunology, regarding the impact of their disease and specific treatments on a potential pregnancy.</div></div><div><h3>Methods</h3><div>Between September 1st, 2019, and November 1st, 2020, in four hospitals in the Poitou-Charentes region, a questionnaire was given to every woman aged 18 to 44 who came in for an internal medicine and clinical immunology consultation for the follow-up of a chronic systemic disease. Women who were already pregnant or breastfeeding were excluded.</div></div><div><h3>Results</h3><div>One hundred and ten women were included. Lupus was the most common condition (29%). Knowledge of follow-up was adequate for 38%, 58%, and 86% of women with vasculitis, connective tissue disease or sickle cell disease, respectively. Regarding treatments, responses were correct for 71% of contraindicated treatments and 41% of authorized treatments. Knowledge was no better among women who wanted to become pregnant (correct answers for treatments: 34%) or among women who were not using contraception and did not want to become pregnant (correct answers for treatments: 50%). Only half of the women reported having received information on the subject from a healthcare professional.</div></div><div><h3>Conclusion</h3><div>Essential information on maternal and fetal safety is not properly understood by women of childbearing age, nor is it sufficiently communicated by healthcare professionals. It seems important to strengthen the questioning process and inform patients about the risks to mothers and fetuses.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 65-69"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035018","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)00025-1","DOIUrl":"10.1016/S0248-8663(26)00025-1","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages e3-e4"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147409425","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":"Transition écologique hospitalière : présentation du guide de déprescription des examens biologiques","authors":"Nathalie Costedoat-Chalumeau ,&nbsp;Véronique Bortolotti ,&nbsp;Adrien Michon ,&nbsp;Pierre Louis Cariou ,&nbsp;Marion Casadevall ,&nbsp;Caroline Charre ,&nbsp;Agnès Ferroni ,&nbsp;Camille Chenevier-Gobeaux ,&nbsp;Claire Goulvestre ,&nbsp;Hélène Lelong ,&nbsp;Marianne Leruez-Ville ,&nbsp;Alice-Andrée Mariaggi ,&nbsp;Nicolas Pallet ,&nbsp;Perrine Parize ,&nbsp;Charlotte Laurent ,&nbsp;Yann Nguyen ,&nbsp;Benjamin de Sainte Marie ,&nbsp;Christophe Richez ,&nbsp;Pauline Richebe ,&nbsp;Juliette Pavie","doi":"10.1016/j.revmed.2026.01.010","DOIUrl":"10.1016/j.revmed.2026.01.010","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 61-64"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183975","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) : la face cachée du syndrome VEXAS","authors":"Valentin Lacombe","doi":"10.1016/j.revmed.2025.08.008","DOIUrl":"10.1016/j.revmed.2025.08.008","url":null,"abstract":"<div><div>The VEXAS syndrome, whose phenotype has been extensively described in recent years, is now beginning to unveil the secrets of its pathophysiology. For those who tend to keep a respectful distance from basic science papers, Immuno’logical offers a guided dive into two recent fascinating publications, that challenge several long-held assumptions: no, VEXAS is not merely a myeloid disorder; no, UBA1-wild-type cells are not blameless in systemic inflammation; and no, UBA1-mutated progenitors do not owe their clonal dominance to uncontrolled proliferation. To understand it all, we will decode ubiquitination, single-cell RNA-sequencing, and clonal expansion – thoroughly but without unnecessary complexity – to uncover the hidden gems within these studies. In short, let's be serious without taking ourselves too seriously, and explore the hidden side of VEXAS syndrome.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 90-93"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058829","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":"Évolution de la nomenclature des maladies hépatiques stéatosiques : vers un changement de paradigme","authors":"Philippe Halfon","doi":"10.1016/j.revmed.2025.12.003","DOIUrl":"10.1016/j.revmed.2025.12.003","url":null,"abstract":"<div><div>Metabolic steatotic diseases affect 16.7% of the French population, i.e. approximately 8 million individuals. Approximately 60% of type 2 diabetes patients have hepatic steatosis, 30% of whom also have fibrosis. The progression of fibrosis, linked to systemic inflammation, is associated with a significant increase in cardiovascular and cancer mortality (particularly hepatocellular carcinoma and colorectal adenocarcinoma). In 2023, an international reform of the nomenclature led to the replacement of the old terminology “non-alcoholic fatty liver disease (NAFLD)” and “non-alcoholic steatohepatitis (NASH)” in order to better reflect the metabolic causes. The following terms were defined: “steatotic liver disease (SLD)”, which refers to all forms of steatosis, “metabolic dysfunction-associated steatotic liver disease (MASLD)”, which explicitly includes metabolic factors, and “metabolic dysfunction-associated steatohepatitis (MASH)”, which emphasizes histologically confirmed metabolic steatohepatitis. A new entity, “metabolic alcohol-related liver disease (MetALD),” refers to MASLD with moderate but regular alcohol consumption. The definition of “alcohol-related liver disease (ALD)” remains unchanged (alcohol consumption greater than 50–60<!--> <!-->g/day). “Cryptogenic steatosis” includes cases with no known cause. This new classification allows for the continued use of previous data and aims to improve patient stratification for personalized treatments.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 84-89"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800908","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":"Poumon et sclérodermie systémique","authors":"Éric Hachulla","doi":"10.1016/j.revmed.2025.08.006","DOIUrl":"10.1016/j.revmed.2025.08.006","url":null,"abstract":"<div><div>Interstitial lung disease (ILD) is a frequent and potentially life-threatening complication of systemic sclerosis, affecting 40 to 50% of patients. Systematic screening with high-resolution computed tomography and pulmonary function tests (PFTs), including DLCO, is recommended at diagnosis. ILD may be present even in patients with normal PFTs. Prognosis depends on the initial extent of ILD, assessed by imaging and forced vital capacity (FVC). Current guidelines (PNDS, ACR/CHEST, EULAR) recommend a personalized management approach based on progression risk. Mycophenolate mofetil (MMF) is considered the first-line treatment. Rituximab (RTX), evaluated in several trials, has shown a favorable effect on FVC stabilization or improvement. Tocilizumab has also demonstrated a slowing of FVC decline in ILD subgroups in two randomized trials, although the primary endpoint based on the modified Rodnan skin score was negative. Nintedanib demonstrated efficacy in the SENSCIS trial by significantly reducing the annual rate of FVC decline, including in patients receiving MMF. In cases of disease progression despite appropriate initial treatment, hematopoietic stem cell transplantation or a combination of MMF and RTX may be considered. Lung transplantation can be an option for refractory forms. A comprehensive approach including oxygen therapy, pulmonary rehabilitation, and infection prophylaxis is essential.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 70-75"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984260","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 éruption papuleuse faussement inquiétante","authors":"Quentin Gomes de Pinho ,&nbsp;Audrey Benyamine ,&nbsp;Coline Rabourdin ,&nbsp;Samuel Martinez-Levy ,&nbsp;Zian Bouchette ,&nbsp;Françoise Dolbeault ,&nbsp;Victoire Cosialls ,&nbsp;Brigitte Granel","doi":"10.1016/j.revmed.2025.10.002","DOIUrl":"10.1016/j.revmed.2025.10.002","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"47 2","pages":"Pages 110-111"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350900","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}