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Martinez L.,Nancy University Hospital Center | Lamaze R.,Center hospitalier Emile Durkheim | Clement-Duchene C.,Nancy University Hospital Center
Revue des Maladies Respiratoires | Year: 2013

Introduction. - Lung cancer is frequently associated with paraneoplastic syndromes, sometimes uncommon, among which motor neurone disease is sometimes described, including primary lateral sclerosis, a disorder characterized by slowly progressive cortico-spinal dysfunction due to the degeneration of the upper motor neurone. Case report. - We report a case of primary lateral sclerosis developing in a young woman 9 months after the diagnosis of metastatic adenocarcinoma of the lung. Our patient showed a spastic quadriparesis, dysarthria and bulbar symptoms without amyotrophy nor fasciculation. The electromyogram showed isolated upper motor neurone involvement. Cerebral and medullary imaging and CSF analysis showed no abnormality and onconeuronal antibodies were negative. The neurological symptoms and the cancer deteriorated simultaneously and our patient died 6 months after the onset of neurological symptoms. Conclusion. - Motor neurone involvement is rare but some case reports describe an association with neoplasia without formal confirmation of a paraneoplastic syndrome. Our case is the first report of primary lateral sclerosis in a young woman diagnosed during the treatment of lung adenocarcinoma. © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Objectives To describe the French routine use of G-CSF in patients treated for breast cancer as per the EORTC recommendations. Patients and methods A prospective multicenter observational study conducted between February 2008 and September 2009 in 869 breast cancer patients treated by chemotherapy (CT) and for whom G-CSF treatment will be delivered in primary (PP) or secondary prophylaxis. Results The mean age was 55 years. A total of 80.3% of CT was in neoadjuvant/adjuvant setting (NAS). PP was delivered in 78.9% of the NAS patients and 67.5% in metastatic situation. Of the 702 evaluable patients, incidences of severe (SN) and febrile neutropenias (FN) in patients who received PP were 9.3% and 4.2%, respectively. In patients who did not received G-CSF at first cycle, SN and FN were 12.4% and 7.3%, respectively. The use of PP was mainly driven by the type of CT for patients treated in the NAS and by patient or disease related risk factors in the locally advanced/metastatic setting. Conclusion This study has shown that the use of G-CSF was in accordance with the 2010 updates of the EORTC recommendations. However, G-CSF appears more widely used in the routine practice. © 2015 Société Française du Cancer.

Moneret-Vautrin D.A.,University of Lorraine | Moneret-Vautrin D.A.,Center hospitalier Emile Durkheim | Beaudouin E.,Center hospitalier Emile Durkheim | Renaudin J.-M.,Center hospitalier Emile Durkheim | And 6 more authors.
Revue Francaise d'Allergologie | Year: 2014

Specific oral immunotherapy (OIT) has been described for allergy to milk and to egg and is now being considered as treatment for peanut allergy. The authors describe the initiation of a course of peanut-specific OIT in a hospital allergy department using a procedure designed to ensure maximum safety and which includes the laboratory assays necessary for decision-making and monitoring of the evolution of the therapy. The material used in this OIT is grilled peanut. The practice of OIT we use is based on taking increasing doses of the allergen at home. Based on the severity of the cases, three protocols of different durations (17, 36, 60. weeks) are available. This review details the conditions of the purchase, the preparation and storage of the powdered allergen, packaging of the doses and of sending them through the mail; it includes texts explaining peanut allergy and OIT, the expected benefits and risks, written informed consent forms for skin and laboratory tests, for the oral provocation test and for OIT, as well as the conditions for conducting the protocol at home, changes when necessary due to intercurrent events, the 12-weekly hospital consultations for prick-tests with the same material and assays for peanut-specific IgE and IgG4using the three major recombinant peanut allergens; and the choice and the daily quantity of the industrial foodstuffs chosen for the patient's maintenance diet. The responsibilities of the allergists and paramedical personnel are described in detail. This review of some important questions, which may need further discussion, ends by recommending that hospital-based allergy departments set up peanut-specific OIT, with regular progression of doses at home and with regular evaluation at the hospital at 12-week intervals. © 2014 Elsevier Masson SAS.

Nguyen V.-M.,Center hospitalier Emile Durkheim | Beaudouin E.,Center hospitalier Emile Durkheim | Renaudin J.-M.,Center hospitalier Emile Durkheim | Le Loet C.,Reseau Allergovigilance | And 5 more authors.
Revue Francaise d'Allergologie | Year: 2013

Five cases of severe anaphylaxis to lychee have been registered by the Allergyvigilance network over 2006-2010. Literature is reviewed including six cases. The global analysis points to the young age, the frequency of angioedema localized at larynx, tongue, uvula, lips and face, and the frequency of an associated sensitization to mugwort pollen. Some cases have associated food allergy to Anacardiaceae (mango or pistachio), sunflower seeds, Apiaceae (celery, parsley), apple and banana. Causal allergens may be Lit c1, thermostable profilin, cross reacting with pollens and latex profilines, and a 70. KDA allergen. The authors underline a possible rising frequency of anaphylaxis to lychee since these five cases have been declared over the past 5. years and represent 0.8% of cases of food anaphylaxis registered by the Allergyvigilance network. © 2012 Elsevier Masson SAS.

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