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Lausanne, Switzerland

Two different routes of administration exist for the immunoglobulin therapy : intravenous (Ig IV-monthly administration in medical setting) and subcutaneous (Ig SC-weekly self-administration at home). According to the literature, efficacy and safety are similar, but Ig SC could improve quality of life and treatment satisfaction. The Policlinique Médicale Universitaire of Lausanne has developed an interdisciplinary program for the long-term support of Ig SC patients. Moreover, it conducted an exploratory survey interviewing Ig IV patients about their interest for Ig SC : patients interested judged less favourably efficacy and/or tolerance of Ig IV and considered that Ig SC would improve their motivation for treatment and its impact on their private and professional life.


Aubert C.,University of Lausanne | Vaudaux B.,Service de pediatrie | Bart P.-A.,Service dImmunologie et dAllergie
Revue Medicale Suisse | Year: 2010

Some chronic diseases - like renal failure, liver insufficiency, chronic lung disease, cardiac involvement, diabetes mellitus, asplenia - present limited defects of the immune system and/or a higher risk of infection; therefore, patients with such pathologies should get selective vaccinations. The efficacy of immunization decreases with disease progression; for this reason, these patients should be immunized as soon as possible. At the beginning of their disease, these patients do not need a specialized treatment and are followed by the general practitioner alone who is in charge of immunizing them as well as contact people of any immunocompromised patient. OFSP's regular vaccinations programme is recommended, as well as selective vaccinations against influenza, pneumococci and viral hepatitis, depending on the underlying chronic disease.


Stalder G.,Service dImmunologie et dAllergie | Ribi C.,Service dImmunologie et dAllergie | Alberio L.,Service Dhematologie et Laboratoire
Revue Medicale Suisse | Year: 2015

Myelodysplastic syndromes (MDS) are characterized by inefficient hematopoiesis and result in peripheral cytopenia. This heterogenous disease group arises from clonal disorders of hematopoietic stem cells. Several cohort studies and numerous case reports have highlighted a link between MDS and auto-immune disorders. Patients with MDS are more prone to develop particular systemic inflammatory diseases. On the other hand, patients suffering from auto-immune diseases are at higher risk to develop MDS. The scope of this article is to review the association between myelodysplasia and autoimmunity. It gives practical clues when to look for MDS in a patient suffering from auto-immunity and lists the main auto-immune diseases which may complicate the course of a MDS.


Vionnet J.,Service dImmunologie et dAllergie | Hart K.,Center dImmunotherapie et Vaccinologie | Spertini F.,Service dImmunologie et dAllergie
Revue Medicale Suisse | Year: 2014

Zostavax, a live attenuated vaccine against shingles (herpes zoster) has been available in Switzerland since 2008. In a population aged 60 and over, evidence suggests the vaccine effectively reduces the incidence of shingles and some of its corresponding complications. More importantly, in terms of public health, vaccination appears to reduce the burden of illness and be pharmaco-economically viable. Despite being part of the vaccination programmes in the United States and several European countries, the vaccine is not yet part of the Swiss vaccination programme. Should Switzerland follow suit by incorporating Zostavax into their vaccination policy?


Langner-Viviani F.,Service dImmunologie et dAllergie | Chappuis S.,Service dImmunologie et dAllergie | Bergmann M.M.,Unite dAllergologie Pediatrique | Ribi C.,Service dImmunologie et dAllergie
Revue Medicale Suisse | Year: 2014

In medicine, vital blue dyes are mainly used for the evaluation of sentinel lymph nodes in oncologic surgery. Perioperative anaphylaxis to blue dyes is a rare but significant complication. Allergic reactions to blue dyes are supposedly IgE-mediated and mainly caused by triarylmethanes (patent blue and isosulfane blue) and less frequently by methylene blue. These substances usually do not feature on the anesthesia record and should not be omitted from the list of suspects having caused the perioperative reaction, in the same manner as latex and chlorhexidine. The diagnosis of hypersensitivity to vital blue dyes can be established by skin test. We illustrate this topic with three clinical cases.

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