Specialized consultations in a hospital-based referral center for patients suspected of having limb lymphedema: Impact on diagnosis.
Identifieur interne : 000133 ( PubMed/Curation ); précédent : 000132; suivant : 000134Specialized consultations in a hospital-based referral center for patients suspected of having limb lymphedema: Impact on diagnosis.
Auteurs : Stéphane Vignes [France] ; Florence Vidal [France] ; Maria Arrault [France]Source :
- Vascular medicine (London, England) [ 1477-0377 ] ; 2017.
Abstract
Lymphedema, a chronic debilitating disease, is not always easily diagnosed. A total of 254 new patients ((217 women, 37 men), median (Q1-Q3) age 61 (46-72) years) were referred for suspected limb lymphedema to an exclusively lymphedema-dedicated department for a first consultation (January - March 2015) were included; among 118 with upper limb involvement, 100 (84.7%) were diagnosed with post-breast cancer therapy and four with primary lymphedemas; among 136 with lower limb involvement, 31 (22.8%) were diagnosed with primary lymphedemas and 35 (25.7%) with post-cancer lymphedemas. The main alternative diagnoses were: 32 (45.7%) lipedemas/lipo-lymphedemas and 21 (30%) chronic venous insufficiencies. Age at symptom onset, body mass index, referral origins and first-symptom-to-specialized-consultation intervals differed between primary, post-cancer lymphedema and alternative diagnosis patients. Among the entire cohort, 57 (22.4%) had cellulitis. For all 135 (53.1%) upper or lower limb post-cancer lymphedemas and the 119 (46.9%) others, the median (Q1-Q3) first-symptom-to-specialized-consultation intervals were 1.4 (0.7-3.8) and 4 (1.1-18.8) years, respectively ( p < 0.0001). Specialized consultations confirmed primary and post-cancer lymphedema diagnoses and identified others, especially for patients with suspected lower limb lymphedema.
DOI: 10.1177/1358863X17714884
PubMed: 28633618
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A total of 254 new patients ((217 women, 37 men), median (Q1-Q3) age 61 (46-72) years) were referred for suspected limb lymphedema to an exclusively lymphedema-dedicated department for a first consultation (January - March 2015) were included; among 118 with upper limb involvement, 100 (84.7%) were diagnosed with post-breast cancer therapy and four with primary lymphedemas; among 136 with lower limb involvement, 31 (22.8%) were diagnosed with primary lymphedemas and 35 (25.7%) with post-cancer lymphedemas. The main alternative diagnoses were: 32 (45.7%) lipedemas/lipo-lymphedemas and 21 (30%) chronic venous insufficiencies. Age at symptom onset, body mass index, referral origins and first-symptom-to-specialized-consultation intervals differed between primary, post-cancer lymphedema and alternative diagnosis patients. Among the entire cohort, 57 (22.4%) had cellulitis. For all 135 (53.1%) upper or lower limb post-cancer lymphedemas and the 119 (46.9%) others, the median (Q1-Q3) first-symptom-to-specialized-consultation intervals were 1.4 (0.7-3.8) and 4 (1.1-18.8) years, respectively ( p < 0.0001). Specialized consultations confirmed primary and post-cancer lymphedema diagnoses and identified others, especially for patients with suspected lower limb lymphedema.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28633618</PMID><DateCreated><Year>2017</Year><Month>06</Month><Day>21</Day></DateCreated><DateRevised><Year>2017</Year><Month>08</Month><Day>04</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1477-0377</ISSN><JournalIssue CitedMedium="Internet"><Volume>22</Volume><Issue>4</Issue><PubDate><Year>2017</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Vascular medicine (London, England)</Title><ISOAbbreviation>Vasc Med</ISOAbbreviation></Journal><ArticleTitle>Specialized consultations in a hospital-based referral center for patients suspected of having limb lymphedema: Impact on diagnosis.</ArticleTitle><Pagination><MedlinePgn>331-336</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1177/1358863X17714884</ELocationID><Abstract><AbstractText>Lymphedema, a chronic debilitating disease, is not always easily diagnosed. A total of 254 new patients ((217 women, 37 men), median (Q1-Q3) age 61 (46-72) years) were referred for suspected limb lymphedema to an exclusively lymphedema-dedicated department for a first consultation (January - March 2015) were included; among 118 with upper limb involvement, 100 (84.7%) were diagnosed with post-breast cancer therapy and four with primary lymphedemas; among 136 with lower limb involvement, 31 (22.8%) were diagnosed with primary lymphedemas and 35 (25.7%) with post-cancer lymphedemas. The main alternative diagnoses were: 32 (45.7%) lipedemas/lipo-lymphedemas and 21 (30%) chronic venous insufficiencies. Age at symptom onset, body mass index, referral origins and first-symptom-to-specialized-consultation intervals differed between primary, post-cancer lymphedema and alternative diagnosis patients. Among the entire cohort, 57 (22.4%) had cellulitis. For all 135 (53.1%) upper or lower limb post-cancer lymphedemas and the 119 (46.9%) others, the median (Q1-Q3) first-symptom-to-specialized-consultation intervals were 1.4 (0.7-3.8) and 4 (1.1-18.8) years, respectively ( p < 0.0001). Specialized consultations confirmed primary and post-cancer lymphedema diagnoses and identified others, especially for patients with suspected lower limb lymphedema.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Vignes</LastName><ForeName>Stéphane</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vidal</LastName><ForeName>Florence</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arrault</LastName><ForeName>Maria</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (Lymphoedèmes Primaires), Hôpital Cognacq-Jay, Paris, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>06</Month><Day>20</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Vasc Med</MedlineTA><NlmUniqueID>9610930</NlmUniqueID><ISSNLinking>1358-863X</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">diagnosis</Keyword><Keyword MajorTopicYN="N">limb swelling</Keyword><Keyword MajorTopicYN="N">lymphedema</Keyword><Keyword MajorTopicYN="N">specialized center</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28633618</ArticleId><ArticleId IdType="doi">10.1177/1358863X17714884</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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