{"title":"À bout de souffle","authors":"Clément Rhoumy, Magali Dechomet, Christine Lombard","doi":"10.1016/S1773-035X(24)00309-5","DOIUrl":"10.1016/S1773-035X(24)00309-5","url":null,"abstract":"<div><h3>Résumé</h3><div>Le déficit sévère en alpha1-antitrypsine (AAT) est une maladie génétique autosomique récessive caractérisée par une faible concentration d’AAT circulante. Sa prévalence varie en Europe, touchant environ un individu sur 1 500 à 6 000. Ses manifestations cliniques sont pulmonaires avec l’apparition d’une broncho-pneumopathie chronique obstructive, et hépatiques avec des atteintes pouvant évoluer jusqu’à la cirrhose. L’AAT est le principal inhibiteur de protéases du plasma et grâce à son activité anti-élastasique, elle protège le parenchyme pulmonaire contre les enzymes protéolytiques. La prise en charge actuelle du déficit repose sur un traitement substitutif chez les patients avec une atteinte respiratoire et la mise en place de mesures hygiéno-diététiques.</div></div><div><h3>Abstract</h3><div>Severe alpha1-antitrypsin (AAT) deficiency is an autosomal recessive genetic disease characterized by low serum level. Its prevalence varies within Europe, affecting approximately one in 1500 to 6000 individuals. Its clinical manifestations are pulmonary with the development of chronic obstructive pulmonary disease, and hepatic, with damage that can progress to cirrhosis. AAT is the main plasma proteases inhibitor and its anti-elastasic activity protects lung parenchyma against proteolytic enzymes. Current management of the deficit is based on supplementation therapy in patients with respiratory disease and the implementation of health and diet measures.</div></div>","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Pages 72-75"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaccination contre le Mpox : état des lieux et perspectives","authors":"Jean-Daniel Lelièvre MD/PhD (Pr)","doi":"10.1016/S1773-035X(24)00300-9","DOIUrl":"10.1016/S1773-035X(24)00300-9","url":null,"abstract":"","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Pages 24-32"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Brève : Libéralisation de la vente en ligne des médicaments : attention danger !","authors":"Jean-Marie Manus","doi":"10.1016/S1773-035X(24)00271-5","DOIUrl":"10.1016/S1773-035X(24)00271-5","url":null,"abstract":"","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Page 5"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Traitement thermique contre le virus H5N1 bovin dans le lait cru américain","authors":"Jean-Marie Manus","doi":"10.1016/S1773-035X(24)00287-9","DOIUrl":"10.1016/S1773-035X(24)00287-9","url":null,"abstract":"","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Page 15"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ce que le périnée dit de notre vécu","authors":"Jean-Marie Manus","doi":"10.1016/S1773-035X(24)00289-2","DOIUrl":"10.1016/S1773-035X(24)00289-2","url":null,"abstract":"","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Page 16"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Brève : Du bon usage du préservatif féminin lubrifié et remboursable","authors":"Jean-Marie Manus","doi":"10.1016/S1773-035X(24)00292-2","DOIUrl":"10.1016/S1773-035X(24)00292-2","url":null,"abstract":"","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Page 17"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean Guibourdenche , Marie-Clémence Leguy , Fidéline Bonnet-Serrano
{"title":"Hypothyroïdie : diagnostic et suivi chez l’adulte","authors":"Jean Guibourdenche , Marie-Clémence Leguy , Fidéline Bonnet-Serrano","doi":"10.1016/S1773-035X(24)00304-6","DOIUrl":"10.1016/S1773-035X(24)00304-6","url":null,"abstract":"<div><h3>Résumé</h3><div>L’hypothyroïdie résulte d’une carence en hormones thyroïdiennes de manifestations cliniques variables, avec parfois un goitre pouvant nécessiter une échographie. Il s’agit le plus souvent d’un hypofonctionnement primaire de la thyroïde consécutif à une thyroïdite auto-immune ou médicamenteuse, voire à une carence en iode. Plus rarement, l’hypothyroïdie peut être centrale dans le cadre d’une insuffisance hypophysaire. Le diagnostic biologique de l’hypothyroïdie périphérique repose sur une TSH sérique élevée (normes : 0,4-4 mUI/L hors grossesse et personnes âgées). Une TSH comprise entre 4 et 10 mUI/L sera contrôlée à six semaines. À toute TSH d’emblée supérieure à 10 mUI/L ou toute TSH confirmée entre 4-10 mUI/L, on ajoutera un dosage en cascade de T4L pour établir le caractère avéré (T4L diminuée) ou fruste (T4L normale) de l’hypothyroïdie. Le diagnostic étiologique commence par le dosage des anticorps anti-thyroperoxydase (ATPO) complété du dosage des anticorps anti-thyroglobuline (ATG) si les ATPO sont négatifs, voire de la iodurie des 24 heures. Le traitement par L-thyroxine est systématique seulement en cas d’hypothyroïdie avérée, et évalué en suivant la TSH sérique à six semaines, puis en espaçant le suivi dès que la TSH sera normalisée de façon stable. Dans les autres situations, un simple suivi de la TSH est recommandé à un an. On associera un dosage de T4L en cas de TSH instable.</div></div><div><h3>Abstract</h3><div>Hypothyroïdism is a deficiency of thyroid hormones with variable clinical manifestations, sometimes with a goiter that may require an ultrasound scanning. It results mainly from primary thyroid dysfunction secondary to autoimmune or drug-induced thyroiditis, and sometimes to iodine deficiency. Less frequently, hypothyroidism can be central in the context of pituitary insufficiency. Biological diagnosis of peripheral hypothyroidism is based on an elevated serum TSH (norms: 0.4-4 mIU/L excluding pregnancy and the elderly). A TSH of between 4-10 mIU/L will be checked at six weeks. To any TSH above 10 mIU/L or any TSH confirmed between 4-10 mIU/L, fT4 assay allows the distinction between proven hypothyroidism (decreased fT4) and sub-clinical hypothyroidism (normal T4L). The etiological diagnosis relies on anti-thyroperoxidase antibodies (ATPO) assay completed by anti-thyroglobulin antibodies (ATG) assay if negative, and 24-hours ioduria if necessary. L-thyroxine supplementation is systematic only in cases of proven hypothyroidism and assessed by monitoring the TSH at six weeks, then spacing the monitoring as soon as the TSH has stabilized. In all the other situations, a simple control of TSH assay is recommended at one year. A T4L dosage will be added in case of unstable TSH.</div></div>","PeriodicalId":74728,"journal":{"name":"Revue francophone des laboratoires : RFL","volume":"2024 565","pages":"Pages 45-50"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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