Unusual neurologic presentation of aseptic abscesses syndrome

Nicolas, Philippe; Guerrier, Olivier; Benoit, A; Durand‐Dubief, Françoise; Raverot, Gérald; Debarbieux, S.; Delteil, Clémence; Vasiljevic, Alexandre; Jouanneau, Emmanuel; Cotton, François; Marignier, Romain; Vukusic, Sandra

doi:10.1212/nxi.0000000000000469

Cited by 1 publication

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“…Palpable splenomegaly was present in nine patients (12.6%). The median PMN count was 15,100 per mm 3 (12,(0)(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)750). The median CRP was 120 mg/L (67-234).…”

Section: Manifestations On Diagnosismentioning

confidence: 99%

“…In 2007, 30 cases were described, 70% of which were associated with inflammatory bowel disease (IBD), with relapses in 60% [3]. Since then, isolated cases have been reported describing rare locations and the effect of new treatments [4][5][6][7][8][9] including biologics, notably anti-interleukin 1 (IL-1) [10,11]. The use of positron emission tomography (PET) has also changed the management of the disease [12].…”

Section: Introductionmentioning

confidence: 99%

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Aseptic Abscess Syndrome: Clinical Characteristics, Associated Diseases, and up to 30 Years’ Evolution Data on a 71-Patient Series

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Costédoat-Chalumeau

et al. 2022

JCM

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Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22,5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28,1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; CI 95 [0.28–0.97]; p = 0.042), associated IBD (HR 0.57; CI 95 [0.32–0.99]; p = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; CI 95 [1.35–3.40]; p = 0.001 and HR 1.78; CI 95 [1.07–2.93]; p = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse.

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