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<title lang=en>Cryptococcosis in sarcoidosis: cryptOsarc, a comparative study of 18 cases.</title>
<creator>Bernard, C.</creator>
<creator>Maucort-Boulch, D.</creator>
<creator>Varron, L.</creator>
<creator>Charlier, C.</creator>
<creator>Sitbon, K.</creator>
<creator>Freymond, N.</creator>
<creator>Bouhour, D.</creator>
<creator>Hot, A.</creator>
<creator>Masquelet, A. C.</creator>
<creator>Valeyre, D.</creator>
<creator>Costedoat-Chalumeau, N.</creator>
<creator>Etienne, M.</creator>
<creator>Gueit, I.</creator>
<creator>Jouneau, Stephane</creator>
<creator>Delaval, Philippe</creator>
<creator>Mouthon, L.</creator>
<creator>Pouget, J.</creator>
<creator>Serratrice, J.</creator>
<creator>Brion, J.-P.</creator>
<creator>Vaylet, F.</creator>
<creator>Bremont, C.</creator>
<creator>Chennebault, J. M.</creator>
<creator>Jaffuel, S.</creator>
<creator>Broussolle, C.</creator>
<creator>Lortholary, O.</creator>
<creator>Sève, P.</creator>
<contributor>Contaminants Chimiques, immunité et Inflammation ; Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) - Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) - Service de pneumologie ; Université de Rennes 1 (UR1) - CHU Pontchaillou [Rennes] - CHU Pontchaillou [Rennes]</contributor>
<contributor>Service des Maladies Infectieuses ; CHU Grenoble</contributor>
<contributor>Centre d’Infectiologie Necker Pasteur ; Assistance publique - Hôpitaux de Paris (AP-HP) - Université Paris Descartes - Paris 5 (UPD5) - CHU Necker - Enfants Malades [AP-HP]</contributor>
<description>International audience</description>
<source>ISSN: 1460-2725</source>
<source>EISSN: 1460-2393</source>
<source>QJM: An International Journal of Medicine</source>
<publisher>Oxford University Press (OUP)</publisher>
<identifier>hal-00873410</identifier>
<identifier>https://hal.archives-ouvertes.fr/hal-00873410</identifier>
<source>https://hal.archives-ouvertes.fr/hal-00873410</source>
<source>QJM: An International Journal of Medicine, Oxford University Press (OUP), 2013, 106 (6), pp.523-39. 〈10.1093/qjmed/hct052〉</source>
<identifier>DOI : 10.1093/qjmed/hct052</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1093/qjmed/hct052</relation>
<identifier>PUBMED : 23515400</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/23515400</relation>
<language>en</language>
<subject>[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>AIM: To describe the main characteristics and the treatment of cryptococcosis in patients with sarcoidosis. DESIGN: Multicenter study including all patients notified at the French National Reference Center for Invasive Mycoses and Antifungals. METHODS: Retrospective chart review. Each case was compared with two controls without opportunistic infections. RESULTS: Eighteen cases of cryptococcosis complicating sarcoidosis were analyzed (13 men and 5 women). With 2749 cases of cryptococcosis registered in France during the inclusion period of this study, sarcoidosis accounted for 0.6% of all the cryptococcosis patients and for 2.9% of the cryptococcosis HIV-seronegative patients. Cryptococcosis and sarcoidosis were diagnosed concomitantly in four cases; while sarcoidosis was previously known in 14/18 patients, including 12 patients (67%) treated with steroids. The median rate of CD4 T cells was 145 per mm(3) (range: 55-1300) and not related to steroid treatment. Thirteen patients had cryptococcal meningitis (72%), three osteoarticular (17%) and four disseminated infections (22%). Sixteen patients (89%) presented a complete response to antifungal therapy. After a mean follow-up of 6 years, no death was attributable to cryptococcosis. Extra-thoracic sarcoidosis and steroids were independent risk factors of cryptococcosis in a logistic regression model adjusted with the sex of the patients. CONCLUSIONS: Cryptococcosis is a significant opportunistic infection during extra-thoracic sarcoidosis, which occurs in one-third of the cases in patients without any treatment; it is not associated to severe CD4 lymphocytopenia and has a good prognosis.</description>
<date>2013-06</date>
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