Service de pneumologie et dallergologie pediatriques

Paris, France

Service de pneumologie et dallergologie pediatriques

Paris, France
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PubMed | University of Bordeaux 1, Center Intercommunal Of Creteil, University Pierre and Marie Curie, Service de Pneumologie et dAllergologie Pediatriques and 2 more.
Type: Journal Article | Journal: Pediatric pulmonology | Year: 2016

There is a lack of evidence concerning the effectiveness of immunoprophylaxis with palivizumab in children with childhood interstitial lung disease (chILD). In this retrospective study, we evaluated the effectiveness of palivizumab for decreasing the rate of RSV-related hospitalizations in children under the age of 24 months with chILD treated with corticosteroids.A retrospective national study was conducted in France. Patients born between 2007 and 2013, diagnosed with chILD and on corticosteroid treatment were identified through the French online database for pediatric interstitial lung disease (Respirare() ). Data were collected for the etiology and severity of chILD, risk factors and preventive measures for bronchiolitis, palivizumab immunoprophylaxis, and hospitalizations for bronchiolitis and RSV-bronchiolitis.We included and evaluated 24 children during their first two RSV seasons, corresponding to 36 patient-seasons. The observed rate of RSV-related hospitalization (305/1000 patient-seasons), and the median length of stay (7 days), were higher than those for the general population. RSV-related hospitalization rates did not differ significantly between children with and without palivizumab prophylaxis (5/16 vs. 4/18, respectively, P=0.70).Children with chILD on corticosteroid treatment are at high risk of hospitalization for RSV-bronchiolitis, which tends to be more severe in these children than in the general population. The effectiveness of palivizumab prophylaxis in this population remains to be demonstrated. Pediatr Pulmonol. 2016;51:688-695. 2015 Wiley Periodicals, Inc.


Odievre M.-H.,Service de pediatrie | Odievre M.-H.,French Institute of Health and Medical Research | Danekova N.,Service de pediatrie | Picard C.,Center detude des deficits immunitaires | And 7 more authors.
Archives de Pediatrie | Year: 2011

A 15-month-old boy treated with amoxicillin and clavulanic acid therapy for 8 days was admitted for persistent gastroenteritis and fever. He received ceftriaxone for pneumonia modified on day 4 for cefotaxime and josamycin due to extension of alveolar lesions. On day 7, persistent fever and worsened respiratory distress led to addition of rifampicin. The child was then admitted to an intensive care unit. A hemophagocytic syndrome was suspected based on clinical signs and laboratory findings and confirmed by cytological examination of bone marrow. Adenovirus type 7 was identified by polymerase chain reaction and culture of bronchoalveolar fluid. Prognosis was good within 3 weeks. B and T immunologic evaluations were normal 5 months after the infection. This case of severe adenovirus pneumonia was associated with hemophagocytic syndrome in a child without identified primary immunodeficiency. Adenovirus type 3 and 7 are most frequently responsible for severe or fatal respiratory infections. © 2011 Elsevier Masson SAS.


Pham Thi T.N.,Service de pneumologie et dallergologie pediatriques | Scheinmann P.,Service de pneumologie et dallergologie pediatriques | Karila C.,Service de pneumologie et dallergologie pediatriques | Karila C.,Institute Pasteur Paris | And 3 more authors.
Revue Francaise d'Allergologie | Year: 2011

Atopic dermatitis is frequently the first step of the atopic march. Frequency and severity of subsequent asthma are higher in children with severe cutaneous lesions and with IgE-dependent multiple sensitisations. Filaggrin null mutations and food allergy are associated with increased severity of asthma. It remains to be demonstrated that treatment of atopic dermatitis will reduce the risk of subsequent allergic asthma and rhinitis. © 2011 Elsevier Masson SAS.


Hadchouel A.,Service de Pneumologie et dAllergologie Pediatriques | Hadchouel A.,University of Paris Descartes | Hadchouel A.,French Institute of Health and Medical Research | Wieland T.,Helmholtz Center Munich | And 22 more authors.
American Journal of Human Genetics | Year: 2015

Methionyl-tRNA synthetase (MARS) catalyzes the ligation of methionine to tRNA and is critical for protein biosynthesis. We identified biallelic missense mutations in MARS in a specific form of pediatric pulmonary alveolar proteinosis (PAP), a severe lung disorder that is prevalent on the island of Réunion and the molecular basis of which is unresolved. Mutations were found in 26 individuals from Réunion and nearby islands and in two families from other countries. Functional consequences of the mutated alleles were assessed by growth of wild-type and mutant strains and methionine-incorporation assays in yeast. Enzyme activity was attenuated in a liquid medium without methionine but could be restored by methionine supplementation. In summary, identification of a founder mutation in MARS led to the molecular definition of a specific type of PAP and will enable carrier screening in the affected community and possibly open new treatment opportunities. © 2015 The American Society of Human Genetics.


PubMed | Institute Pasteur in Cambodia, Pham Ngoc Thach Hospital, Unite dImmunologie Hematologie Rhumatologie Pediatrique., Montpellier University Hospital Center and 6 more.
Type: Journal Article | Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America | Year: 2016

The diagnosis of tuberculosis in human immunodeficiency virus (HIV)-infected children is challenging. We assessed the performance of alternative specimen collection methods for tuberculosis diagnosis in HIV-infected children using Xpert MTB/RIF (Xpert).HIV-infected children aged 13 years with suspected intrathoracic tuberculosis were enrolled in 8 hospitals in Burkina Faso, Cambodia, Cameroon, and Vietnam. Gastric aspirates were taken for children aged <10 years and expectorated sputum samples were taken for children aged 10 years (standard samples); nasopharyngeal aspirate and stool were taken for all children, and a string test was performed if the child was aged 4 years (alternative samples). All samples were tested with Xpert. The diagnostic accuracy of Xpert for culture-confirmed tuberculosis was analyzed in intention-to-diagnose and per-protocol approaches.Of 281 children enrolled, 272 (96.8%) had 1 specimen tested with Xpert (intention-to-diagnose population), and 179 (63.5%) had all samples tested with Xpert (per-protocol population). Tuberculosis was culture-confirmed in 29/272 (10.7%) children. Intention-to-diagnose sensitivities of Xpert performed on all, standard, and alternative samples were 79.3% (95% confidence interval [CI], 60.3-92.0), 72.4% (95% CI, 52.8-87.3), and 75.9% (95% CI, 56.5-89.7), respectively. Specificities were 97.5%. Xpert combined on nasopharyngeal aspirate and stool had intention-to-diagnose and per-protocol sensitivities of 75.9% (95% CI, 56.5-89.7) and 75.0% (95% CI, 47.6-92.7), respectively.The combination of nasopharyngeal aspirate and stool sample is a promising alternative to methods usually recommended by national programs. Xpert performed on respiratory and stools samples enables rapid confirmation of tuberculosis diagnosis in HIV-infected children.The ANRS (Agence Nationale de Recherche sur le Sida) 12229 PAANTHER (Pediatric Asian African Network for Tuberculosis and HIV Research) 01 study is registered at ClinicalTrials.gov (NCT01331811).


Lezmi G.,Service de pneumologie et dallergologie pediatriques | Karila C.,Service de pneumologie et dallergologie pediatriques | De Blic J.,Service de pneumologie et dallergologie pediatriques | Scheinmann P.,Service de pneumologie et dallergologie pediatriques
Revue Francaise d'Allergologie | Year: 2013

Allergic rhinitis is a common chronic disease in children and adults, responsible for important changes in their quality of life. The results of several recent cohort studies have provided a better description of its risk factors and its association with asthma. Allergic rhinitis often begins during childhood and persists into adulthood; it is more frequent in females. Exposure to tobacco smoke during pregnancy and early childhood, a parental history of allergy, and sensitization may be risk factors for the development of allergic rhinitis. The presence of allergic rhinitis in non-asthmatic individuals may predict the subsequent development of asthma, while its presence in asthmatics predicts persistence of their asthma. Allergic rhinitis and asthma might be two distinct diseases, but they seem more likely to represent two different expressions of a unique airway disease. © 2013 Elsevier Masson SAS.


Pham-Thi N.,Service de pneumologie et dallergologie pediatriques | Pham-Thi N.,University of Paris Descartes | Leite-de-Moraes M.-C.,University of Paris Descartes
Revue Francaise d'Allergologie | Year: 2010

The term "Natural Killer T (NKT) cells" was first used in the 1990s to designate T lymphocytes expressing the NK marker NK1.1 (NKR-P1A or CD161). Subsequently, this population turned out to be quite heterogeneous and it is now well-established that it includes several subsets with distinct functional capacities. Among them, the invariant NKT (iNKT) cells are at present the most abundant and best characterized subset. They express the invariant Vα14J αφ{symbol}0α18 chain in mice and the Vα14J α18 chain in humans, preferentially paired with limited TCR Vβ chains. This particular T cell population, which recognizes glycolipids instead of peptides, is implicated in the severity of experimental allergic asthma. The influence of iNKT cells in the human pathology is still a matter of discussion. Here, we will briefly address these points in the following paragraphs. © 2010 Elsevier Masson SAS. All rights reserved.


Hadchouel-Duverge A.,Service de Pneumologie et Dallergologie Pediatriques | Hadchouel-Duverge A.,French Institute of Health and Medical Research | Hadchouel-Duverge A.,University of Paris Descartes | Lezmi G.,French Institute of Health and Medical Research | And 5 more authors.
Revue des Maladies Respiratoires | Year: 2012

Introduction. - Congenital lung lesions comprise a broad spectrum of various malformations including congenital cystic adenomatoid malformation (CCAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema, bronchial atresia and bronchogenic cyst. This review aims at the description of their natural history, and of the underlying pathophysiological mechanisms. State of the art. - Congenital lung lesions are frequently diagnosed antenatally and many remain asymptomatic after birth. In the absence of antenatal identification, they are usually revealed by the occurrence of infection. In some cases, spontaneous resolution of the malformation can occur. Different pathogenic hypotheses are discussed for the origin of these abnormalities, and common processes appear likely to all of these malformations. Factors involved in the process of branching seem to play a particularly important role. Perspectives. - Prospective follow-up of operated and unoperated children would complete our knowledge about the natural history of these lesions. The contribution of experimental models has led to advances in the understanding of pathogenic mechanisms. Further studies are needed to identify the factors initiating the malformative process. © 2012 SPLF.


PubMed | University of Lille Nord de France, Service de Pneumologie et dAllergologie Pediatriques and University of Paris Descartes
Type: Journal Article | Journal: The European respiratory journal | Year: 2016

The role of mast cells in the pathogenesis of childhood asthma is poorly understood. We aimed to estimate the implication of airway mucosal mast cells in severe asthma and their relationship with clinical, functional, inflammatory and remodelling parameters.Bronchial biopsies were performed in 36 children (5-18years) with severe asthma: 24 had frequent severe exacerbations and/or daily symptoms in the previous year (symptomatic group), and 12 had few symptoms and a persistent obstructive pattern (paucisymptomatic group). Nine children without asthma were included as control subjects. We assessed mast cells in the submucosa and airway smooth muscle using c-kit antibodies and in the entire biopsy area using Giemsa.The number of submucosal mast cells was higher in the symptomatic group than in the paucisymptomatic group (p=0.02). The number of submucosal mast cells correlated with the number of severe exacerbations (p=0.02, r=0.37). There were positive correlations between the number of submucosal mast cells (p<0.01, r=0.44), airway smooth muscle mast cells (p=0.02, r= 0.40), mast cells stained by Giemsa (p<0.01, r=0.44) and submucosal eosinophils.Mast cells are associated with severe exacerbations and submucosal eosinophilic inflammation in children with severe asthma.


PubMed | Service de pneumologie et dallergologie pediatriques
Type: Journal Article | Journal: Revue des maladies respiratoires | Year: 2012

Congenital lung lesions comprise a broad spectrum of various malformations including congenital cystic adenomatoid malformation (CCAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema, bronchial atresia and bronchogenic cyst. This review aims at the description of their natural history, and of the underlying pathophysiological mechanisms.Congenital lung lesions are frequently diagnosed antenatally and many remain asymptomatic after birth. In the absence of antenatal identification, they are usually revealed by the occurrence of infection. In some cases, spontaneous resolution of the malformation can occur. Different pathogenic hypotheses are discussed for the origin of these abnormalities, and common processes appear likely to all of these malformations. Factors involved in the process of branching seem to play a particularly important role.Prospective follow-up of operated and unoperated children would complete our knowledge about the natural history of these lesions. The contribution of experimental models has led to advances in the understanding of pathogenic mechanisms. Further studies are needed to identify the factors initiating the malformative process.

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