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What are red blood cell diseases? Red blood cells are the main components of blood and transport oxygen throughout the body. They consist of a membrane and mainly contain haemoglobin, as well as other components required for their proper functioning (enzymes, proteins, etc.). All of these components may be affected by a genetic (or hereditary) disease or an acquired disease (which develops during a person’s lifetime), such as an autoimmune disease.These conditions include:Thalassaemia and other haemoglobin disorders.Hereditary spherocytosis and other membrane disorders (elliptocytosis, stomatocytosis).Enzyme deficiencies, such as G6PD deficiency or pyruvate kinase deficiency.Autoimmune haemolytic anaemia.Other rarer diseases, such as congenital dyserythropoietic anaemia, are also treated in our department. These diseases result in anaemia of varying severity, which may require regular transfusions. Chronic destruction also affects the liver and iron metabolism. Management of red blood cell diseases As these various diseases have specific consequences and require specific management, the first step is to establish an accurate diagnosis.To this end, our Haematology Department works closely with the Hospital’s Erythrocyte Chemistry, Genetics, Immunohaematology/Transfusion Laboratory.Management consists of improving chronic anaemia and its consequences. This may require regular transfusions or medication aimed at increasing red blood cell production (erythropoietin) or reducing their destruction (immunosuppressants, targeted treatments).Chronic destruction of red blood cells and the resulting anaemia, as well as transfusions, regularly lead to iron overload.This overload causes liver damage, as well as damage to the organs responsible for hormonal regulation. It therefore requires specific monitoring and treatment (iron chelator). Advice As these diseases are most often transmitted genetically/inherited, it is important that patients and their families have access to a specific consultation known as genetic counselling. USEFUL LINK – Healthcare pathway for rare constitutional diseases of red blood … Our specialists Dr Martin ColardHaematologistAssociate Professor at Brussels University Hospital.  Make an appointment Dr Aude TheunissenHaematologist Make an appointment Haematology Department Haematology is the medical specialty that manages diseases of the blood and immune system. Our department provides comprehensive and specialised care for patients with these diseases. Our mission is to provide specialised and personalised care to each patient. If you do not yet have a specific diagnosis, you can make an appointment in general haematology and you will then be referred to one of our experts. Discover our Haematology Department Red Blood Cell Day 2025 On Thursday 20 February 2025, the “Globule Rouge” group of the Belgian Society of Hematology and the H.U.B. are organising the next Red Blood Cell Day. An event open to healthcare professionals and patients. Discover the programme and speakers. Learn more

What is Premature Ovarian Insufficiency? Premature ovarian insufficiency (POI) is defined as the premature cessation of ovarian function before the age of 40. This leads to a decrease in the production of sex hormones, particularly oestrogen and progesterone, which can cause symptoms similar to those of menopause, such as hot flushes, menstrual irregularities and infertility. POI can have a significant impact on the quality of life of affected women, affecting not only their physical health but also their emotional and psychological well-being. Causes and risk factors Genetic factors : certain chromosomal abnormalities, such as Turner syndrome, or mutations in specific genes, may predispose individuals to POI.Medical treatments : gonadotoxic treatments (i.e. toxic to the reproductive organs), such as chemotherapy or radiotherapy used to treat cancers, may damage the ovaries.Ovarian surgery : repeated surgical procedures on the ovaries, for example to treat endometriosis or ovarian cysts, may reduce the ovarian reserve.Infections : certain viral or bacterial infections may also affect ovarian function.Autoimmune diseases: conditions such as Hashimoto’s thyroiditis or lupus may be associated with ovarian damage.Prevalence of premature ovarian insufficiencyPremature ovarian insufficiency affects 1 to 3.7% of women worldwide. A significant proportion of women may be affected by this condition, often without being aware of it. Precise data on the prevalence of POI are limited, but studies suggest that young patients receiving cancer treatment should be particularly closely monitored for this condition.  Medical management of POI DiagnosisThe diagnosis of premature ovarian insufficiency involves several steps:Clinical assessment: a thorough medical examination and a history of symptoms, including menstrual cycles and medical history, are necessary.Hormonal tests: blood tests to measure hormone levels, particularly oestrogen and follicle-stimulating hormone (FSH), may indicate impaired ovarian function.Ultrasound: an ultrasound examination may be performed to assess the presence of follicles, the anatomy of the ovaries and uterus, and to detect abnormalities such as cysts or lesions.Treatment optionsOocyte retrieval and freezing: before starting gonadotoxic treatment, patients may consider having their oocytes retrieved and frozen to preserve their fertility.Hormone replacement therapy (HRT): this therapy may help relieve symptoms associated with early menopause, such as hot flushes and mood disturbances. Non-hormonal therapies are also available in the event of contraindications.Psychological support: psychological support is often necessary to help women cope with the emotional aspects of POI.Required medical follow-upRegular medical follow-up is essential for patients with POI. This may include endocrinology consultations to monitor hormone levels and assess whether hormone therapy needs to be adjusted. Fertility consultations may also be recommended to discuss conception options and assisted reproductive techniques. Services involved in the management of POI at Brussels University Hospital:Gynaecology: gynaecologists are often the first healthcare professionals involved in the diagnosis and management of POI.Endocrinology: endocrinologists may be involved in overall management.Oncology: oncologists play a crucial role in monitoring patients who have undergone cancer treatment and are at risk of developing POI.Psychology: psychologists or psychiatrists can provide emotional and psychological support to women facing the challenges of POI.Fertility Clinic: fertility specialists are involved in managing fertility preservation options and assisted reproductive techniques.Endometriosis Clinic: gynaecologists specialising in endometriosis can refer young patients at risk to discuss fertility preservation strategies with specialists.  Make an appointment with the Gynaecology Department

What is a bicatricial uterus? A scarred uterus is a uterus with one or more scars. A uterus with two scars refers to a uterus that has undergone two previous procedures resulting in scars.In the case of a uterus with two scars, if there are no obstetric contraindications to vaginal delivery and the previous caesarean sections went well, vaginal delivery may be considered, with a low risk of complications. However, caesarean section is an option if that is your preference. Care management Obstetricians specialising in high-risk pregnancies at Erasme Hospital’s Obstetrics Clinic see patients for consultations in this context.During this consultation, your medical file will be reviewed to ensure favourable conditions for considering an attempt at vaginal birth. If vaginal birth is not possible, a gentle caesarean section protocol (Gentle C-section) is offered in most cases. Learn more about our Gynaecology - Obstetrics Department Our specialists Advice If you have any concerns, unusual symptoms or abnormal pain around the scar, do not hesitate to call or go to the hospital’s Emergency Department or delivery room for an assessment of the situation.

What is haemochromatosis? Iron is essential for the body to function, and its quantity is therefore carefully regulated. Iron absorption increases in cases of iron deficiency or anaemia. Elimination, however, cannot be modulated and cannot be increased in the event of iron overload. In certain genetic conditions, the body abnormally accumulates iron, which is deposited in various organs. This accumulation causes chronic oxidation, leading to lesions that may sometimes be irreversible in the affected organs. These include, in particular, the liver (with damage that may lead to cirrhosis) and the organs that regulate hormones (potentially resulting in diabetes, for example). Management of haemochromatosis This iron overload causes very non-specific symptoms such as fatigue, joint pain, erectile dysfunction, and so on. As these different diseases have specific consequences and require specific management, the first step is to establish an accurate diagnosis. To this end, the department works closely with the Chemistry and Genetics Laboratory. Management is based on correcting the iron overload. This may involve regular venesection or treatment with specific medicines known as chelators.  Advice As these diseases are most often transmitted genetically or inherited, it is important that patients and their families have access to a specific consultation known as genetic counselling. Our specialists Dr Martin ColardHaematologistAssociate Professor at Brussels University Hospital. Make an appointment Dr Aude TheunissenHaematologist Make an appointment Haematology Department Haematology is the medical specialty that treats diseases of the blood and immune system. Our department provides comprehensive, specialised care for patients with these diseases. Our mission is to provide specialised and personalised care to each patient. If you do not yet have a specific diagnosis, you can make an appointment in general haematology and you will then be referred to one of our experts. Discover our Haematology Department

What is malnutrition? Malnutrition is a condition in which the body does not function properly because it lacks essential nutrients. These nutrients are carbohydrates, fats and proteins, also known as macronutrients. Image There are several reasons why someone might be deficient in these nutrients:They do not eat enough.Their body cannot digest or absorb the food they have eaten.They have a serious illness that changes their nutritional needs. In this case, we refer to disease-associated malnutrition.In addition to macronutrients, our body needs micronutrients such as vitamins, trace elements and minerals. The reasons for a micronutrient deficiency may differ from those for a macronutrient deficiency. Care management Managing malnutrition requires several steps:Early screening of patients at risk: It is important to identify patients at risk of malnutrition as soon as possible, during the first contact with the patient, in consultation or on admission to hospital.Diagnosis of malnutrition: This is made when a combination of a cause and a visible consequence is present (unintentional weight loss, a body mass index (BMI) below normal, or a decrease in muscle mass or strength).Setting nutritional goals: Healthcare professionals set energy and protein intake goals to enrich the patient’s diet.Checking food intake: We check whether the patient is meeting these goals. If not, oral nutritional supplements may be offered to be taken between meals.Enteral nutrition: If nutritional supplements are not sufficient, enteral nutrition may be considered. This means that the patient receives food through a tube that reaches the stomach.Parenteral nutrition: As a last resort, if enteral nutrition is insufficient, parenteral nutrition may be considered. This means that the patient receives nutrition directly into the veins.Managing malnutrition requires close collaboration between different healthcare professionals, such as doctors, dietitians, nurses, speech therapists and pharmacists. Concrete cases There are several situations in which people can become malnourished and need special assistance with eating. For example:People with upper gastrointestinal cancer may have difficulty eating enough. They may need a tube inserted into their stomach or small intestine to help them eat.People with an eating disorder such as anorexia may also become malnourished. They may temporarily require enteral nutrition, meaning special food adapted to what their body can use.After bariatric surgery, patients may absorb insufficient amounts of certain nutrients. They need nutritional supplements to help prevent this.After a cerebrovascular accident, patients may have difficulty swallowing. They may need food with a modified texture or, sometimes, enteral tube feeding if their level of consciousness is reduced. Focus Home enteral or parenteral nutrition is managed by an experienced multidisciplinary team (doctors, dietitians and nurses). They assist with the placement of feeding tubes, educate patients and their relatives, and organise consultations for close follow-up. Several hundred patients at Erasme benefit from this type of follow-up. We have all the necessary facilities to identify, manage and monitor patients through a multidisciplinary team with extensive expertise and genuine know-how.  We have developed particular expertise in monitoring the nutritional problems of patients with pancreatic disease and oesophageal disease, for whom Erasme Hospital is an expert centre, thanks to our dedicated team and cutting-edge technologies.  The approved centre for parenteral nutrition has a multidisciplinary team that works closely together to ensure optimal care for patients requiring long-term parenteral nutrition following benign or malignant intestinal diseases. Erasme Hospital is an excellent choice for patients seeking high-quality care and long-term follow-up for diseases requiring specialised nutritional management.  Our specialists Associated services Publications Practical ESPEN guideline on clinical nutrition in acute and chronic pancreatitis. Arvanitakis M, Ockenga J, Bezmarevic M, Gianotti L, Krznarić Ž, Lobo DN, Löser C, Madl C, Meier R, Phillips M, Rasmussen HH, Van Hooft JE, Bischoff SC.Clin Nutr. February 2024;43(2):395–412.  Dietary strategies in patients with non-alcoholic fatty liver disease: from evidence to daily clinical practice—a systematic review. Hadefi A, Arvanitakis M, Trépo E, Zelber-Sagi S.United European Gastroenterol J. 2023 Sep;11(7):663-689. Percutaneous endoscopic jejunostomy: when, how, and when to avoid it. Gkolfakis P, Arvanitakis M.Curr Opin Gastroenterol. 2022 May 1;38(3):285-291.  Lien vers https://www.amub-ulb.be/revue-medicale-bruxelles/article/risque-de-denutrition-… Risk of malnutrition and confirmed malnutrition: updated diagnostic criteria. Preiser JC, Farine S.Rev Med Brux 2022;43(1):7-11. 

Presentation The Palliative Care – Continuous Care Unit is a mobile, multidisciplinary team made up of healthcare professionals from different disciplines. Its aim is to ensure continuity of care for patients approaching the end of life. Image Care pathway This multidisciplinary team, made up of healthcare professionals from different professions, aims to ensure continuity of care at Erasme Hospital and outside it when patients are approaching the end of life or require symptomatic treatment, particularly for pain management.The team consists of psychiatrists or internists, nurses, psychologists, physiotherapists, dietitians, pharmacists and social workers. Their role is to provide occasional and/or repeated medical advice without directly managing the patient’s care, offer support to relatives and care teams, and prepare discharge, a return home, or a transfer to another institution or nursing home, in close collaboration with the family doctor and the required outpatient care and support services. Each team member will ensure that they provide a listening ear, any necessary advice, and raise awareness among each of their contacts, while respecting their individual philosophical and religious beliefs.The shared approach to patients with a serious, progressive, incurable condition must focus on respecting their autonomy, with the aim of ensuring the best possible quality of their remaining life and their comfort. Useful links Brussels Federation for Palliative Care (FBSP)Website: www.fbsp-bfpz.orgPluralist Association for Palliative Care in the Brussels Region (Palliabru)Website: www.palliabru.be Our specialists Associated Services

Our role The Royal Decree defining the Care Programme for the geriatric patient stipulates that frail patients aged 75 and over must be assessed by a multidisciplinary mobile geriatric team, or internal liaison team. The care units screen their patients for frailty upon admission and then contact the internal liaison team if necessary. The latter assesses the patient and provides recommendations so that care can be adapted to each patient’s medical and psychosocial situation. Throughout the hospitalisation of the older person, the liaison team also provides geriatric expertise to the hospital’s medical and surgical departments. A report is also sent to the attending physician. Image Our specialties The care pathway followed by the geriatric older patient begins at home. The hospital is only one stage, and coordination of care, whether at home or in an institution, is essential. The geriatric team maintains strong contacts with general practitioners, home care services, rehabilitation centres, day centres, and nursing and care homes to coordinate the care provided as effectively as possible. It also arranges transport and provides continuing education for nursing and care home staff. Good communication is essential. The purpose of inpatient care is to assess the potential and resources of frail older patients who cannot be assessed in the Day Hospital, with a view to proposing a care and discharge plan aimed at maintaining the older patient’s independence. The department offers the expertise of a multidisciplinary team that assesses the patient’s functional, cognitive, nutritional and social potential, among other aspects, while treating diseases in accordance with current recommendations. The main geriatric syndromes treated by the team include falls, memory disorders, confusion, loss of independence, malnutrition and dysphagia, urinary incontinence, etc. Acute inpatient ward The purpose of inpatient care is to assess the potential and resources of frail older patients who cannot be assessed in the Day Hospital, with a view to proposing a care and discharge plan aimed at maintaining the older patient’s independence. The department offers the expertise of a multidisciplinary team that assesses the patient’s functional, cognitive, nutritional and social potential, among other aspects, while treating diseases in accordance with current recommendations. “Liaison” geriatric care The Royal Decree defining the Care Programme for the geriatric patient stipulates that frail patients aged 75 and over must be assessed by a multidisciplinary mobile geriatric team. The care units screen their patients for frailty upon admission and then contact the liaison team, which provides care recommendations tailored to each patient’s medical and psychosocial situation. The liaison team provides geriatric expertise to the hospital’s medical and surgical departments. Geriatric syndromes The geriatrician therefore has multiple conditions to treat, including geriatric syndromes such as: Polypharmacy and inappropriate prescribing sensory deficits, such as hearing loss or visual impairment falls and trauma, which may have more serious consequences at an advanced age (for example, a fracture of the neck of the femur) osteoporosis and osteoarthritis neurological diseases, such as dementia depressive disorders cardiovascular and respiratory diseases nutritional disorders sleep disorders complex social issues. The involvement of a geriatrician in a care pathway The health problems frequently encountered by older people may sometimes require planned surgery, chemotherapy or radiotherapy in the event of cancer, minimally invasive interventional techniques such as TAVI (treatment of aortic valve stenosis), or dialysis in cases of severe kidney failure. The decision to intervene may depend on numerous factors, relating both to the disease itself and to other conditions the person may have, or to the combination of specific issues affecting older people, such as malnutrition, memory or mood disorders, loss of mobility, and so on. The specialist physician, surgeon or other healthcare professional therefore seeks the opinion of the geriatrician and their team in order to prepare the patient as effectively as possible before the procedure or treatment, by addressing the geriatric issues. This assessment takes place either during an inpatient stay or in a geriatric day hospital. Focus Inappropriate prescribing of medicines in older people   The number of conditions affecting older people can lead to an accumulation of medicines that cause side effects, interact negatively with one another and sometimes result in hospital admissions that could have been avoided. The geriatrician and clinical pharmacist can make treatment recommendations to prevent complications associated with inappropriate prescribing. Our specialists Associated services

What is systemic amyotrophy? under construction A service recognised as an expert centre ERN-RND ERN-RND – Expert Centres

The Outpatient Neurological Functional Rehabilitation Centre (CRFNA) is a treatment facility for people with cerebral and neurological disorders. Rehabilitation aims to achieve the greatest possible independence and seeks to facilitate reintegration into family, social and, where applicable, professional life.   The Outpatient Neurological Functional Rehabilitation Centre is a multidisciplinary rehabilitation centre. All disciplines involved in the consequences of neurological disorders are represented: physiotherapy, occupational therapy, speech therapy, neuropsychology, psychology and the Social Work Department. Each discipline, with its specific objectives and methods, contributes to the collective effort to achieve the best possible outcome in rehabilitation and reintegration. This teamwork, which is intended to be interdisciplinary, is characterised by a commitment to information sharing, collaboration and continuous critical review. Objectives People who have suffered a cerebrovascular accident (thrombosis or haemorrhage), a head injury (following a road traffic accident, a fall, etc.) or any other neurological disorder can contact the CRFNA. These disorders often impair motor function (hemiplegia), manual dexterity and coordination, balance and walking. Higher functions, known as “cognitive” functions (such as concentration, memory, reasoning and language), are often affected. The CRFNA team attaches particular importance to people with cognitive disorders, as these are often unrecognised and limit daily activities and independence. However, for care to be optimal, it must begin as early as possible.   Making an appointment Tel.: 02 555 6855 Tel.: 02 555 3394   It is advisable to bring a referral letter from your doctor and a brief summary of your medical record. The therapies take place over several half-days per week (from 9 a.m. to 12 p.m. and from 1:30 p.m. to 4:30 p.m.), and you will be offered an individual schedule. Medical secretariat Tel.: 02 555 6855 Fax: 02 555 6860

The Cerebral Palsy Centre provides patients with cerebral palsy with individualised and regular support, as well as assessment by a specialised multidisciplinary team. Since 2006, Erasme Hospital has been one of the sites of the Interuniversity Reference Centre for Cerebral Palsy (ULB-VUB-Ulg): CIRICU. This centre has established an agreement with INAMI enabling patients with cerebral palsy to undergo assessments by a specialised multidisciplinary team. It therefore provides patients and their families with individualised and regular support. In practice, patients with cerebral palsy are assessed in the unit once or twice a year. The first assessment consists of a multidisciplinary evaluation carried out by all the professionals involved (psychologist, physiotherapist, occupational therapist, speech therapist, social worker, orthopaedic surgeon and neurologist), which takes place over one day in the unit. At the end of this day, therapeutic objectives and treatment plans are proposed and discussed with the patient or their family. The patient’s usual treating physician and physiotherapist are invited to this discussion, and a report is always sent to them if the patient gives their consent. Collaboration with the various services already involved in the patient’s care is essential. Subsequent assessments involve the physician and at least two paramedical professionals and are also always followed by a report summarising the points discussed during the consultation. Patients registered with the reference centre may also benefit at the hospital from specialised examination and treatment techniques, such as the gait laboratory or botulinum toxin injections. The team consists of: Paediatric neurologists and rehabilitation physicians, who coordinate the assessments and reports Orthopaedic surgeons Physiotherapists Occupational therapist Speech therapist Social worker Psychologists Coordinating nurse Making an appointment Tel.: 02 555 6851 Email: secmed [dot] CRFNI [dot] erasme [at] hubruxelles [dot] be (secmed[dot]CRFNI[dot]erasme[at]hubruxelles[dot]be) Medical secretariat Tel.: 02 555 6978 Email: secmed [dot] CRFNI [dot] erasme [at] hubruxelles [dot] be (secmed[dot]CRFNI[dot]erasme[at]hubruxelles[dot]be)

The Infectious and Tropical Diseases Clinic focuses on infectious diseases, which involves studying the pathophysiology, prevention, diagnosis and treatment of infectious diseases, both community-acquired and hospital-acquired (nosocomial). The Infectious and Tropical Diseases Department at Erasme Hospital is a centre accredited by the Ministry of Health and is therefore referred to as the “Travel Clinic”.

Obesity, too common in Belgium In Belgium, it is estimated that: 34% of the adult population is overweight (BMI between 25.0 and 29.9) 14% of the adult population is obese (BMI ≥30). These figures increase with age. Indeed, between the ages of 45 and 54, more than half of the adult population is already overweight. Overweight and obesity are chronic health conditions associated with the development of other diseases such as hypertension, diabetes, etc. Bariatric surgery, medical intervention, intensive coaching Solutions for weight problems of all sizes! Are you concerned about your health? Would you like to make a change and feel better about yourself? The Integrated Obesity Centre (CIO) at Erasme Hospital can help you! We form a multidisciplinary team with each patient, of which you will be the key member. Each patient requires an individual treatment plan, which is why the CIO offers three types of personalised care: Intensive programme and coaching Medical intervention Surgical intervention. At every stage, you will be supported by our multidisciplinary team, comprising dietitians, psychologists, endocrinologists, gastroenterologists, gastrointestinal surgeons and physiotherapists. Would you like more information? Contact the CIO secretariat on 02 555 70 89.