Publications by authors named "Juliette Abeillon-du Payrat"

6 Publications

  • Page 1 of 1

Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus 2019 guidelines. Short version.

Ann Endocrinol (Paris) 2020 10 21;81(5):511-515. Epub 2020 May 21.

Service d'endocrinologie et maladies métaboliques, CHU de Larrey, 31059 Toulouse, France. Electronic address:

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http://dx.doi.org/10.1016/j.ando.2020.05.002DOI Listing
October 2020

[Checkpoint inhibitors-induced hypophysitis].

Bull Cancer 2020 Apr 19;107(4):490-498. Epub 2020 Mar 19.

Hospices civils de Lyon, fédération d'endocrinologie, 28, avenue Doyen-Lépine, 69677 Bron cedex, France; ImmuCare, institut de cancérologie des hospices civils de Lyon (IDCRC-HCL), Lyon, France; Université de Lyon, université Claude-Bernard-Lyon-1, Lyon, France.

Checkpoint inhibitors immunotherapy is more and more prescribed in oncology, causing new immune related endocrine adverse events. Hypophysitis occurs in approximately 10 % of patients treated with anti-CTLA4. It occurs two to three months after initiation of the immunotherapy. The initial presentation is characterized, in typical forms, by the association of headache, asthenia and hyponatremia. Hormonal exploration usually shows ACTH, gonadotropic and thyrotropic deficiencies. ACTH deficiency may be life-threatening and requires urgent supplementation, without awaiting for biological results. MRI is warranted in order to exclude differential diagnoses, such as pituitary metastases. Hypophysitis induced by anti-PD1/PDL1 seems to be a different nosologic entity characterized by a later onset and a less symptomatic presentation. Biologically ACTH deficiency seems to be constant and permanent, and often isolated. Treatment requires high-dose steroids only in case of severe tumor syndrome (resistant headache, visual disturbance) or acute decompensation of ACTH deficiency. Patients always need lifelong hormonal supplementation of pituitary deficits and must be followed and educated specifically. Immunotherapy can be delayed during the acute phase, but can be secondarily continued if there is an oncological benefit. As it is a pauci-symptomatic but potentially life-threatening complication, biological screening must be systematic in patients treated with checkpoint inhibitors.
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http://dx.doi.org/10.1016/j.bulcan.2020.01.012DOI Listing
April 2020

Age- and Sex-Specific TSH Upper-Limit Reference Intervals in the General French Population: There Is a Need to Adjust Our Actual Practices.

J Clin Med 2020 Mar 14;9(3). Epub 2020 Mar 14.

Hospices Civils de Lyon, Fédération d'Endocrinologie, Groupement Hospitalier Est, F-69677 Bron cedex, France.

It is well known that thyroid dysfunction increases with age. This study is aimed to determine reference intervals, in males and females, suitable for thyroid disease exploration during adult life using routinely collected serum thyrotropin (TSH) data in a tertiary center from 2007 to 2018. Over 11 years, 295,775 TSH levels were measured in a single lab. Among the 156,025 TSH results available for analysis, 90,538 values were from female subjects, 82,019 were from patients aged >60 years and 26,825 were from patients aged >80 years. By using an indirect approach, we determined reference values of TSH adapted to age and sex, and we then evaluated the proportion of patients who would have been reclassified with these reference values. The median TSH ranged from 1.2-1.4 mUI/L during the study period. The upper limit of reference range of TSH increased with age; in females the median to 97.5th percentile values increased continuously from the age of 30 years to the oldest age group. Using new calculated reference values in patients with TSH above the conventional upper-limit reference value (4 mUI/L), the proportion of results reclassified as within the reference interval among patients aged >60 years ranged, according to age group, from 50.5% to 65.1% of females and from 33.0% to 37.7% of males. The use of TSH age-specific and sex-specific upper-limit reference values led to the reclassification of a great number of samples, notably among women. This suggests that age-specific TSH upper-limit reference intervals in daily practice should be used in order to avoid misclassification.
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http://dx.doi.org/10.3390/jcm9030792DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141356PMC
March 2020

Minimal-Access Endoscopic Endonasal Management of Dysthyroid Optic Neuropathy: The Dysthone Study.

Neurosurgery 2019 12;85(6):E1059-E1067

Department of Neurosurgery, Pierre Wertheimer Neurological and Neurosurgical Hospital, Hospices Civils de Lyon, Lyon, France.

Background: Dysthyroid optic neuropathy (DON) is a devastating complication of thyroid eye disease. Corticosteroids are the primary medical treatment for DON, but some refractory patients may require surgical management.

Objective: To evaluate the efficacy of endoscopic endonasal decompression of the orbital apex in refractory DON.

Methods: This study included patients with refractory DON who underwent endoscopic endonasal decompression of the orbital apex from February 2015 to October 2016. A total of 23 orbital apices were decompressed across 17 patients. Visual acuity, ophthalmometry, tonometry, and visual field were evaluated at the preoperative, early and delayed postoperative stages. Statistical analyses were performed using RStudio software. A Wilcoxon test for matched data was performed to determine if there was a statistically significant difference between pre- and postsurgical treatment for the following items: visual acuity, proptosis, visual field, and intraocular pressure.

Results: Visual acuity improved in 69.5% of the cases with a mean gain of 2.5 points ± 1.6 (P < .05). Additionally, there was an 18.3% reduction in mean proptosis across all cases (P < .05) and a 13.7% decrease in intraocular pressure (P < .05) for all patients. Finally, visual field improved in 82.6% (P < .05) of the cases. The mean time for follow-up was of 6.28 ± 3.7 mo. There were 3 cases of transient postoperative rhinitis and 2 cases of transient diplopia. Two patients experienced recurrence at 4 and 8 mo, respectively.

Conclusion: Endoscopic endonasal decompression of the orbital apex significantly improves visual parameters. As a result, multidisciplinary screening for patients is crucial to ensure prompt surgical decompression.
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http://dx.doi.org/10.1093/neuros/nyz268DOI Listing
December 2019

Predictive value of maternal second-generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism.

Eur J Endocrinol 2014 Oct;171(4):451-60

Hospices Civils de LyonLyon, FranceFédération d'EndocrinologieService d'Endocrinologie PédiatriqueService de Médecine NucléaireService de Gynécologie-ObstétriqueService de NéonatalogieService de BiochimieGroupement Hospitalier Est, F-69003 Lyon, FranceService de BiochimieService d'EndocrinologieCentre Hospitalier Lyon Sud, 69310 Lyon, FranceFaculté de Médecine Lyon-EstUniversité Lyon 1, Lyon, FranceFaculté de PharmacieLyon, FranceFaculté de Médecine et de Maïeutique Lyon Sud - Charles MérieuxLyon, FranceCARMEN INSERM U1060Lyon, FranceINSERM U1052Lyon, FranceService de Biostatistiques162 Avenue Lacassagne, 69003 Lyon, France Hospices Civils de LyonLyon, FranceFédération d'EndocrinologieService d'Endocrinologie PédiatriqueService de Médecine NucléaireService de Gynécologie-ObstétriqueService de NéonatalogieService de BiochimieGroupement Hospitalier Est, F-69003 Lyon, FranceService de BiochimieService d'EndocrinologieCentre Hospitalier Lyon Sud, 69310 Lyon, FranceFaculté de Médecine Lyon-EstUniversité Lyon 1, Lyon, FranceFaculté de PharmacieLyon, FranceFaculté de Médecine et de Maïeutique Lyon Sud - Charles MérieuxLyon, FranceCARMEN INSERM U1060Lyon, FranceINSERM U1052Lyon, FranceService de Biostatistiques162 Avenue Lacassagne, 69003 Lyon, France Hospices Civils de LyonLyon, FranceFédération d'EndocrinologieService d'Endocrinologie PédiatriqueService de Médecine NucléaireService de Gynécologie-ObstétriqueService de NéonatalogieService de BiochimieGroupement Hospitalier Est, F-69003 Lyon, FranceService de BiochimieService d'EndocrinologieCentre Hospitalier Lyon Sud, 69310 Lyon, FranceFaculté de Médecine Lyon-EstUniversité Lyon 1, Lyon, FranceFaculté de PharmacieLyon, FranceFaculté de Médecine et de Maïeutique Lyon Sud - Charles MérieuxLyon, FranceCARMEN INSERM U1060Lyon, FranceINSERM U1052Lyon, FranceService de Biostatistiques162 Avenue Lacassagne, 69003 Lyon, France Hospices Civils de LyonLyon, FranceFédération d'Endocr

Context: Hyperthyroidism occurs in 1% of neonates born to mothers with active or past Graves' disease (GD). Current guidelines for the management of GD during pregnancy were based on studies conducted with first-generation thyroid-binding inhibitory immunoglobulin (TBII) assays.

Objective: This retrospective study was conducted in order to specify the second-generation TBII threshold predictive of fetal and neonatal hyperthyroidism, and to identify other factors that may be helpful in predicting neonatal hyperthyroidism.

Methods: We included 47 neonates born in the Lyon area to 42 mothers harboring measurable levels of TBII during pregnancy. TBII measurements were carried out in all mothers; bioassays were carried out in 20 cases.

Results: Nine neonates were born with hyperthyroidism, including five with severe hyperthyroidism requiring treatment. Three neonates were born with hypothyroidism. All hyperthyroid neonates were born to mothers with TBII levels >5 IU/l in the second trimester (sensitivity, 100% and specificity, 43%). No mother with TSH receptor-stimulating antibodies (TSAb measured by bioassay) below 400% gave birth to a hyperthyroid neonate. Among mothers of hyperthyroid neonates, who required antithyroid drugs during pregnancy, none could stop treatment before delivery. Analysis of TBII evolution showed six unexpected cases of increasing TBII values during pregnancy.

Conclusion: Maternal TBII value over 5 IU/l indicates a risk of neonatal hyperthyroidism. Among these mothers, a TSAb measurement contributes to identify more specifically those who require a close fetal thyroid ultrasound follow-up. These results should be confirmed in a larger series.
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http://dx.doi.org/10.1530/EJE-14-0254DOI Listing
October 2014