Primary upper-limb lymphoedema
Identifieur interne : 000028 ( PascalFrancis/Checkpoint ); précédent : 000027; suivant : 000029Primary upper-limb lymphoedema
Auteurs : S. Vignes [France] ; M. Arrault [France] ; A. Yannoutsos [France] ; M. Blanchard [France]Source :
- British journal of dermatology : (1951) [ 0007-0963 ] ; 2013.
Descripteurs français
- Pascal (Inist)
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Abstract
Background Lymphoedema is a general term used to designate pathological, regional accumulation of protein-rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment. Objectives To analyse the clinical and lymphoscintigraphic characteristics of primary upper-limb lymphoedema (ULL). Methods All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011. Results In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38.5 (range 3- 82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower-limb lymphoedema (LLL). Forty-six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow-up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable. Conclusions Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.
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Arrault</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Yannoutsos, A" sort="Yannoutsos, A" uniqKey="Yannoutsos A" first="A." last="Yannoutsos">A. Yannoutsos</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Blanchard, M" sort="Blanchard, M" uniqKey="Blanchard M" first="M." last="Blanchard">M. 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Vignes</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arrault, M" sort="Arrault, M" uniqKey="Arrault M" first="M." last="Arrault">M. Arrault</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Yannoutsos, A" sort="Yannoutsos, A" uniqKey="Yannoutsos A" first="A." last="Yannoutsos">A. Yannoutsos</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Blanchard, M" sort="Blanchard, M" uniqKey="Blanchard M" first="M." last="Blanchard">M. Blanchard</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">British journal of dermatology : (1951)</title><title level="j" type="abbreviated">Br. j. dermatol. : (1951)</title><idno type="ISSN">0007-0963</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">British journal of dermatology : (1951)</title><title level="j" type="abbreviated">Br. j. dermatol. : (1951)</title><idno type="ISSN">0007-0963</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Dermatology</term><term>Lymphedema</term><term>Upper limb</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Membre supérieur</term><term>Dermatologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Lymphoedema is a general term used to designate pathological, regional accumulation of protein-rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment. Objectives To analyse the clinical and lymphoscintigraphic characteristics of primary upper-limb lymphoedema (ULL). Methods All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011. Results In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38.5 (range 3- 82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower-limb lymphoedema (LLL). Forty-six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow-up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable. Conclusions Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0007-0963</s0></fA01><fA02 i1="01"><s0>BJDEAZ</s0></fA02><fA03 i2="1"><s0>Br. j. dermatol. : (1951)</s0></fA03><fA05><s2>168</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Primary upper-limb lymphoedema</s1></fA08><fA11 i1="01" i2="1"><s1>VIGNES (S.)</s1></fA11><fA11 i1="02" i2="1"><s1>ARRAULT (M.)</s1></fA11><fA11 i1="03" i2="1"><s1>YANNOUTSOS (A.)</s1></fA11><fA11 i1="04" i2="1"><s1>BLANCHARD (M.)</s1></fA11><fA14 i1="01"><s1>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay</s1><s2>75015 Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA20><s1>272-276</s1></fA20><fA21><s1>2013</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>1043</s2><s5>354000503706190100</s5></fA43><fA44><s0>0000</s0><s1>© 2013 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>17 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>13-0114766</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>British journal of dermatology : (1951)</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background Lymphoedema is a general term used to designate pathological, regional accumulation of protein-rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment. Objectives To analyse the clinical and lymphoscintigraphic characteristics of primary upper-limb lymphoedema (ULL). Methods All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011. Results In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38.5 (range 3- 82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower-limb lymphoedema (LLL). Forty-six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow-up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable. Conclusions Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.</s0></fC01><fC02 i1="01" i2="X"><s0>002B08</s0></fC02><fC02 i1="02" i2="X"><s0>002B12B04</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Membre supérieur</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Upper limb</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Miembro superior</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Dermatologie</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Dermatology</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Dermatología</s0><s5>08</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Linfático patología</s0><s5>38</s5></fC07><fN21><s1>091</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Vignes, S" sort="Vignes, S" uniqKey="Vignes S" first="S." last="Vignes">S. Vignes</name></region><name sortKey="Arrault, M" sort="Arrault, M" uniqKey="Arrault M" first="M." last="Arrault">M. Arrault</name><name sortKey="Blanchard, M" sort="Blanchard, M" uniqKey="Blanchard M" first="M." last="Blanchard">M. Blanchard</name><name sortKey="Yannoutsos, A" sort="Yannoutsos, A" uniqKey="Yannoutsos A" first="A." last="Yannoutsos">A. Yannoutsos</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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