La Revue de medecine interne最新文献_第6页

[Cutaneous lesions]. 皮肤病变。

La Revue de medecine interne Pub Date : 2025-08-01 Epub Date: 2025-07-31 DOI: 10.1016/j.revmed.2025.05.006

Stéphane Vignes, Imen Rihani, Inès Moloufoukila, Amina Mihoubi

引用次数: 0

[Recurrent blood problems in a 22 year-old woman]. [22岁女性复发性血液问题]。

La Revue de medecine interne Pub Date : 2025-08-01 Epub Date: 2025-05-29 DOI: 10.1016/j.revmed.2025.05.007

Nicolas Duhamel, Matthieu Buscot, Magalie Orlowski, Nihal Martis, Anaïs Roeser

引用次数: 0

[End-of-life legislation in France: Lessons from the Oregon model]. [法国的临终立法：来自俄勒冈模式的教训]。

La Revue de medecine interne Pub Date : 2025-08-01 DOI: 10.1016/j.revmed.2025.07.009

Jean-François Alexandra, Thomas Papo

引用次数: 0

[A lung mass]. [肺肿块]。

La Revue de medecine interne Pub Date : 2025-08-01 Epub Date: 2025-05-27 DOI: 10.1016/j.revmed.2025.05.012

Chaimae Abourak, Aya Laridi, Nidal El Hassani, Asmae Guennouni, Kaoutar Imrani, Ittimade Nassar

引用次数: 0

[Hydroxychloroquine in systemic lupus erythematosus: Key updates]. 羟基氯喹治疗系统性红斑狼疮：最新进展。

La Revue de medecine interne Pub Date : 2025-08-01 Epub Date: 2025-06-06 DOI: 10.1016/j.revmed.2025.05.011

Ludovic Trefond

{"title":"[Hydroxychloroquine in systemic lupus erythematosus: Key updates].","authors":"Ludovic Trefond","doi":"10.1016/j.revmed.2025.05.011","DOIUrl":"10.1016/j.revmed.2025.05.011","url":null,"abstract":"Hydroxychloroquine (HCQ) is a cornerstone treatment for systemic lupus erythematosus (SLE). Despite its long-standing use, recent studies have refined recommendations on dosage, toxicity, adherence, and benefits. The 2023 EULAR and 2024 KDIGO guidelines recommend a dose of 5mg/kg/day, with adjustments for renal impairment. However, reducing HCQ dose to≤5mg/kg/day increases the risk of moderate-to-severe flares (OR=6.04 [1.71-21.3]) and lupus-related hospitalizations (aOR=4.2 [1.45-12.19]). The prevalence of HCQ-related retinopathy reaches 8.6-11.5% after 15 years of use. Established risk factors include high daily doses, prolonged treatment, renal impairment, tamoxifen use, and pre-existing maculopathy. Recent studies have identified additional risks, including female sex (HR=3.83 [95% CI, 1.86-7.89]), darker skin phototypes (OR=5.5 [1.4-26.5]), serotonin-norepinephrine reuptake inhibitors (OR=6.6 [1.2-40.9]), an [HCQ]/[DCQ] ratio<7.2 (OR=8.4 [2.7-30.8]), and antiphospholipid syndrome (OR=8.9 [2.2-41.4]). The 2024 PNDS recommends annual ophthalmologic screening after five years of treatment. HCQ withdrawal significantly increases relapse risk, with severe flares occurring up to six times more frequently. A study on patients discontinuing HCQ due to retinopathy found a higher relapse rate compared to adherent patients (31.3 vs. 12.5%, OR=3.1 [1.2-8.2]). An algorithm for interpreting HCQ blood levels has been proposed, identifying levels below 200ng/mL as markers of poor adherence, correlating with an 80% missed-dose rate. Moreover, several studies confirm that HCQ is safe during pregnancy and does not increase the risk of congenital malformations. Finally, HCQ has been associated with a reduced risk of cardiovascular events in SLE. A study involving 52,883 patients found that HCQ use significantly lowered the incidence of cardiovascular events (OR=0.63 [0.57-0.69]). Recent evidence reinforces HCQ's essential role in SLE. Careful dose management, adherence monitoring, and ophthalmologic screening are crucial for optimizing treatment outcomes.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":"482-485"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251658","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}

引用次数: 0

[Fibrillary glomerulonephritis]. [纤维性肾小球肾炎]。

La Revue de medecine interne Pub Date : 2024-11-01 Epub Date: 2024-05-15 DOI: 10.1016/j.revmed.2024.05.005

C Dumas De La Roque, I Brocheriou, A Mirouse, P Cacoub, A Le Joncour

{"title":"[Fibrillary glomerulonephritis].","authors":"C Dumas De La Roque, I Brocheriou, A Mirouse, P Cacoub, A Le Joncour","doi":"10.1016/j.revmed.2024.05.005","DOIUrl":"10.1016/j.revmed.2024.05.005","url":null,"abstract":"Fibrillary glomerulonephritis (FGN) is a glomerular disease described since 1977, with a prevalence in renal biopsies of less than 1%. It presents as renal failure, proteinuria, haematuria and hypertension in middle-aged adults. It is defined histologically, using light microscopy, which reveals organised deposits of fibrils measuring around 20nm, which are negative for Congo red staining. Electron microscopy, the first gold standard for diagnosis, has now been superseded by immunohistochemistry using the anti-DNAJB9 antibody. The discovery of this molecule has revolutionised the diagnosis of GNF, thanks to its excellent sensitivity and specificity (98% and 99% respectively). The association of GNF with hepatitis C virus, autoimmune diseases, neoplasia or haemopathy is debated. Renal prognosis is guarded, with 50% of patients progressing to end-stage renal failure within 2 to 4years of diagnosis. In the absence of randomised controlled trials, the recommended treatment is based on nephroprotective measures, corticosteroid therapy and possibly a second-line immunosuppressant such as rituximab. After renal transplantation, recovery or recurrence is possible. The pathophysiology of the disease is still poorly understood, and further studies are needed.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":"703-709"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961326","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}

引用次数: 0

Acute Q fever revealed by an anti-phospholipid syndrome: A case report. 由抗磷脂综合征引发的急性 Q 热：病例报告

La Revue de medecine interne Pub Date : 2024-07-01 Epub Date: 2024-05-17 DOI: 10.1016/j.revmed.2024.05.006

K Balasoupramanien, J-B Roseau, N Cazes, C Surcouf, E Le Dault

{"title":"Acute Q fever revealed by an anti-phospholipid syndrome: A case report.","authors":"K Balasoupramanien, J-B Roseau, N Cazes, C Surcouf, E Le Dault","doi":"10.1016/j.revmed.2024.05.006","DOIUrl":"10.1016/j.revmed.2024.05.006","url":null,"abstract":"Introduction: Q fever is a zoonosis caused by Coxiella burnetii. Acute infection is mainly asymptomatic. In other cases it mainly causes a flu-like illness, a pneumonia, or an hepatitis. We present an atypical case of an acute Q fever revealed by a massive pleural effusion.Case report: We report the case of a 43-year-old man referred to our hospital for an acute respiratory distress. Further analyses showed an exudative eosinophilic pleural effusion, associated with a pulmonary embolism and a deep femoral vein thrombosis. Aetiologic explorations revealed an acute Q fever (IgM and IgG against C. burnetii phase II antigens) associated with anti-phospholipids. The outcome was favorable with vitamin K antagonists, doxycycline, and hydroxychloroquine, till the negativation of the anti-phospholipid antibodies.Discussion and conclusion: During acute C. burnetii infections, anti-phospholipid antibodies are highly prevalent but thrombotic complications are rare. The 2023 ACR/EULAR APS criteria restricts the diagnosis of APS, as in our case of acute severe infection. In front of an atypical pneumonia and/or thrombotic events, screening of C. burnetii and anti-phospholipid antibodies could be useful. Given its low level of evidence, prolongated treatment by doxycycline, hydroxychloroquine ± anticoagulant for C. burnetii's associated anti-phospholipid syndrome is discussed, but succeeded in our case.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":"444-446"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961338","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}

引用次数: 0

[Portrait of Claire Le Jeunne, professor and former head of the internal medicine department at Hôpital Cochin, Paris]. [巴黎科钦医院内科教授和前主任克莱尔-勒让纳的肖像]。

La Revue de medecine interne Pub Date : 2024-05-01 DOI: 10.1016/j.revmed.2024.05.004

G. Martin de Frémont, K. Chevalier, A. Roeser

引用次数: 0

[Among patients with metabolic dysfunction associated steatohepatitis (MASH), is resmetirom 80 or 100mg superior to placebo in reversing MASH and/or fibrosis on liver biopsy, and is it safe?] [在代谢功能障碍相关性脂肪性肝炎（MASH）患者中，瑞美替罗 80 毫克或 100 毫克在逆转 MASH 和/或肝活检纤维化方面是否优于安慰剂？］

La Revue de medecine interne Pub Date : 2024-05-01 DOI: 10.1016/j.revmed.2024.05.007

L. Lanthier, D. Grbic, Marc-Émile Plourde, M. Cauchon

引用次数: 0

[Atypical alveolar echinococcosis with systemic involvement in a patient treated with dupilumab]. [一名接受杜匹单抗治疗的患者患上全身受累的非典型肺泡棘球蚴病]。

La Revue de medecine interne Pub Date : 2024-05-01 DOI: 10.1016/j.revmed.2024.04.002

L. Jacquel, B. Hoellinger, G. Marzolf, A. Stab, A. Guffroy

引用次数: 0