Lausanne, Switzerland
Lausanne, Switzerland

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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.


Chappuis S.,Service dImmunologie et dAllergie | Ribi C.,Service dImmunologie et dAllergie | Greub G.,Institute Of Microbiologie | Spertini F.,Service dImmunologie et dAllergie
Revue Medicale Suisse | Year: 2013

Although not specific, an increased in peripheral blood eosinophils may contribute substantially to the diagnosis of numerous infectious, allergic and inflammatory diseases. The scope of this article is to detail pathologies associated with peripheral eosinophilia by order of frequency and to guide further investigations.


Vionnet J.,Service dImmunologie et dAllergie | Petitpierre S.,Service dImmunologie et dAllergie | Fumeaux A.,CHUV | Meuli R.,CHUV | And 2 more authors.
Revue Medicale Suisse | Year: 2013

Hypersensitivity reactions to radio-contrast media are common in the daily practice. These products are responsible for immediate (≤ 1 hour after administration) and non immediate (> 1 hour after administration) hypersensitivity reactions. A diagnostic work-up by an allergologist with skin tests and in some cases provocation tests is of value in reducing the risk of recurrent hypersensitivity reactions to iodinated contrast media. A careful selection of the patients is required because the incidence of break through reactions is still concerning, even with proper premedication. Practical recommendations are presented in this article. For gadolinium-based contrast agents, data in the literature is not sufficient for suggesting guidelines.


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.


Maitre S.,Service dImmunologie et dAllergie | Maniu C.-M.,Service dImmunologie et dAllergie | Buss G.,Service dImmunologie et dAllergie | Maillard M.H.,Service de Gastroenterologie et dHepatologie | And 2 more authors.
Revue Medicale Suisse | Year: 2014

Adverse food reactions can be classified into two main categories depending on wether an immune mechanism is involved or not. The first category includes immune mediated reactions like IgE mediated food allergy, eosinophilic oesophagitis, food protein-induced enterocolitis syndrome and celiac disease. The second category implies non-immune mediated adverse food reactions, also called food intolerances. Intoxications, pharmacologic reactions, metabolic reactions, physiologic, psychologic or reactions with an unknown mechanism belong to this category. We present a classification of adverse food reactions based on the pathophysiologic mechanism that can be useful for both diagnostic approach and management.


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.


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.


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?


PubMed | Service dimmunologie et dallergie
Type: Journal Article | Journal: Revue medicale suisse | Year: 2011

Hereditary angioedema is a disease which develops as a result of a deficiency or dysfonction of C1-inhibitor, a key regulator of the complement, coagulation and contact cascades, resulting among others in excessive release of bradykinin. This disease mortality rate is high in absence of immediate and effective treatment, in particular in presence of acute attacks of the upper respiratory tract (laryngeal edema). Until now only administration of a purified C1-inhibitor extract was effective against these symptoms. This paper aims to synthesise essentials knowledge concerning news drugs, in particular icatibant, a selective bradykinin B2- receptor antagonist whose use should be widened to the treatment of angioedema with ACE-inhibitors intolerance.


Gambillara E.,Service dImmunologie et dAllergie | Spertini F.,Service dImmunologie et dAllergie | Leimgruber A.,Service dImmunologie et dAllergie
Revue Medicale Suisse | Year: 2010

Numerous professional or leisure activities expose individuals to plants susceptible to provoke contact allergies. The immunological mechanisms that are responsible for these ailments (delayed cellular reaction linked to allergic dermatitis or immediate IgE mediated reaction of the allergic urticaria) differ according to the plant families involved. A differential diagnosis must be made in the case of the even more frequent non-allergic reactions implying either a simple mechanical irritation, or a contact with toxic substances. The role of UV (phytophotodermatosis), as well as the contact allergy to wood is also evoked in this paper.

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