Recherche

An international study to which the H.U.B contributed sheds new light on a severe complication of decompensated cirrhosis: kidney impairment. The researchers discovered that a variation in our genetic make-up could help explain the pathophysiological mechanisms underlying its occurrence. Image The liver and kidneys have very different functions. However, when the liver is severely affected, the kidneys may also become compromised. This is particularly the case in decompensated cirrhosis, meaning that the liver disease has reached a stage at which complications develop. At this advanced stage of liver disease, the kidneys remain particularly vulnerable to functional impairment. This kidney injury is a serious complication that can sometimes develop rapidly and worsen the prognosis.But one question remains difficult to explain: why do some patients develop kidney injury while others, despite having comparable liver disease, do not? A new international study, published in The Lancet Gastroenterology & Hepatology, provides an initial answer: our genetic make-up may play a role.Searching for a difference in our DNATo conduct this research, the scientists studied the genetic make-up of thousands of people with cirrhosis. The main study included 3,220 South American and European patients with decompensated cirrhosis. The researchers then validated their observations in 1,728 additional patients from several independent cohorts. They also compared their results with those of people with compensated cirrhosis and with those of more than 400,000 people from the general population without cirrhosis. The aim was to identify variations in DNA that might be associated with blood creatinine, a marker used to assess kidney function.The researchers identified a common genetic variation located in a region of the genome containing the SUSD1 gene. This variation was associated with higher creatinine levels and a higher frequency of kidney failure in people with decompensated cirrhosis. In patients carrying two copies of the variant considered to be at risk, the risk of kidney failure was approximately 60% higher than in those carrying two copies of the other version of the variant.This result does not mean that a gene “condemns” the kidneysIt is important to understand clearly that this common genetic variation does not mean that a patient will necessarily develop kidney injury. An individual’s susceptibility to kidney injury depends on many factors, such as the severity of the liver disease, any other medical conditions, infections and medications. Genetics is one factor among many.Another important observation is that the association between this genetic variation and kidney function was not observed in patients with compensated cirrhosis or in the general population. This therefore suggests that the effect of this genetic variation manifests itself in the context of an already severely diseased liverWhat happens between the liver and the kidney?The study also provides a lead for understanding this phenomenon. The researchers studied cells present in different tissues in order to assess the pathophysiological mechanisms linking SUSD1 to impaired kidney function. In particular, they identified the potential contribution of immune-system cells known as plasmacytoid dendritic cells. In patients whose kidneys were affected, these cells were more numerous, and certain communication pathways involving type I interferons—molecules produced notably during immune responses—were more active in the liver and kidneys. These results suggest that an immune-system reaction may contribute to the link between liver failure and kidney injury.However, precisely how this reaction is triggered and the exact role played by the SUSD1 gene remain to be understood. The researchers therefore describe this as a biological lead that still requires further study.“Our aim is to better understand why the kidneys become particularly vulnerable in some patients with decompensated cirrhosis. This study highlights a genetic component and an immune pathway that deserve further investigation. At this stage, it mainly provides insight into the possible mechanisms of the disease; it does not yet make it possible to predict a patient’s course or select their treatment,” explains Professor Éric Trépo, hepatologist at H.U.B. and F.R.S.-FNRS Research Associate.Why is this discovery important for patients?Because it helps improve our understanding of the biological mechanisms that may contribute to kidney injury, a complication that can be particularly difficult to manage.This study suggests that part of this difference could be linked to patients’ own biology, including their genetic make-up. In the long term, better identification of particularly vulnerable patients could make it possible to further tailor their monitoring and care. The longer-term aim would be to identify situations at risk earlier and, if new therapeutic targets are confirmed, to develop treatments that act more precisely on the mechanisms responsible for kidney injury.A pathway towards more personalised medicineHowever, we are still at the beginning of this journey. This discovery does not mean that a genetic test capable of predicting kidney injury will soon be offered to all patients with cirrhosis. The predictive value of this association and its clinical usefulness still need to be assessed in prospective studies. But these results open up a new avenue of research: gaining a better understanding of the individual susceptibility of the patients concerned.For people living with decompensated cirrhosis, this research could therefore ultimately contribute to more personalised care, if its clinical usefulness is demonstrated. This is one of the current challenges in hepatology research: gradually moving from medicine that treats complications when they occur to medicine capable of better anticipating each patient’s individual course.This research project is supported by the Erasme Fund. Read the scientific publication Read the EF CLIF press release Our researchers Dr Eric Trépo, Hepatologist at H.U.B and Research Associate of the F.R.S.-FNRS.Dr Lukas Otero Sanchez, Resident in Gastroenterology at H.U.B, Candidate Specialist Trainee – Erasmus Fund Researcher Learn more about our researchers’ projects Projects supported by the Erasmus Fund. Research projects of Dr Eric Trépo Research projects of Dr Otero Sanchez  Learn more about our Gastroenterology and Hepato-pancreatology DepartmentFor comprehensive care of digestive disordersThe Gastroenterology and Hepato-pancreatology Department at H.U.B-Erasmus provides comprehensive care for digestive disorders within a leading university hospital. Our mission is based on three fundamental pillars: the highest quality of care, the transmission of knowledge through teaching, and continuous innovation through research. Discover our department

Department overview The Adult Endocrinology Clinic provides diagnosis and follow-up for adult patients with an endocrine problem, that is, a condition affecting the secretion of a hormone (excessive or insufficient secretion) and/or the gland that secretes it. The department therefore manages conditions affecting the thyroid, parathyroid glands, adrenal glands, gonads (ovaries and testicles), and pituitary gland. Since 2016, the Endocrinology Department of Erasme Hospital, in association with the Queen Fabiola Children’s University Hospital (HUDERF) for paediatric care, has been part of ENDO-ERN (European Reference Network for Rare Endocrine Conditions), the European Reference Network for rare endocrine diseases.This network aims to improve access to high-quality care for patients with rare endocrine disorders. It supports clinical research and contributes to the creation of registries listing patients receiving follow-up for rare conditions, in order to promote knowledge sharing and improve clinical practice. The management of rare endocrine diseases is multidisciplinary. Regular consultations are organised to discuss complex cases, with numerous specialists within our institution, as well as during virtual consultations with recognised European experts through the ENDO-ERN network or during international multidisciplinary case meetings (France).Some endocrine diseases begin at birth or during childhood and require lifelong treatment and follow-up. Transition consultations have been provided for many years with our paediatric colleagues at HUDERF to ensure the smoothest possible transition from paediatric to adult care. What are rare congenital thyroid diseases? Rare congenital thyroid diseases are conditions that are most often present from birth and affect the functioning of the thyroid gland. In most cases, they are congenital hypothyroidism, meaning insufficient production of thyroid hormones. Thyroid hormones are essential for growth, but also and above all for the normal development of the brain during fetal life and childhood. In adulthood, they are primarily involved in regulating body temperature (thermoregulation), controlling metabolism (energy expenditure), fertility, intestinal transit, heart rate and mood. Hypothyroidism occurring in adulthood is most often acquired and has various causes (autoimmunity, thyroid surgery, medication, etc.). It does not fall into the category of rare endocrine diseases, unlike congenital hypothyroidism.The latter may be caused by an absent thyroid (agenesis), an abnormally formed thyroid (dysgenesis), or a defect in the synthesis of thyroid hormones resulting from a mutation in one of the key enzymes (proteins) involved in hormone production. They are most often detected very early, during the first days of life, through neonatal screening. This enables rapid and effective management, preventing the harmful effects of thyroid hormone deficiency on the child’s brain and musculoskeletal development. During pregnancy, the mother provides the fetus with thyroid hormones, thereby compensating for the defect in the fetal thyroid’s hormone synthesis. However, once born, the affected baby no longer benefits from its mother’s thyroid hormones and must therefore promptly receive oral hormone replacement therapy.Another category of rare congenital thyroid diseases consists of disorders of the metabolism, transport and action of thyroid hormones, including syndromes of resistance to thyroid hormones. These conditions are very rare (1/19,000–1/40,000 births) and are caused by genetic abnormalities affecting one of the thyroid hormone receptors (there are two types). Thyroid hormones are produced in sufficient quantities, but are unable to act optimally in tissues containing the mutated receptor (brain, liver, heart, muscle and bone). The severity and type of symptoms vary considerably depending on the mutation. For the most common forms of these rare disorders, which are also the least severe, diagnosis is most often made following so-called “discordant” thyroid function tests (with an unusual profile) performed during routine blood tests or as part of family screening after a known familial mutation has been identified.  Diagnosis and management Congenital hypothyroidism is screened for in newborns. A drop of blood is taken from the newborn’s heel between the 2nd and 5th day of life and placed on filter paper before being analysed. Parents are recalled for an endocrinology consultation if the screening test result is abnormal. Additional tests are performed to confirm the diagnosis (a follow-up blood test) and determine its cause (thyroid ultrasound and scintigraphy). Treatment consists of early replacement therapy with thyroid hormones, started in the first days of life. This treatment is simple, well tolerated and enables the child to develop normally. As with acquired hypothyroidism, the aims of continued follow-up into adulthood are to ensure proper metabolic function, fertility and an optimal quality of life in all areas (physical, psychosocial and professional).Regular clinical and biological follow-up is essential in order to adjust the doses as the child grows, as well as in response to changing needs in certain situations (weight fluctuations, interactions with other medicines, digestive absorption problems, fertility, pregnancy, etc.).Medical follow-up must continue throughout life. Providing patients and families with information and support is essential to ensure treatment adherence and long-term quality of life.In the most common cases of resistance to thyroid hormones, symptoms are mild and patients generally do not require specific treatment. However, this is a difficult diagnosis to make and requires the exclusion of other conditions through specific tests (including genetic analysis for confirmation), with a risk of diagnostic error that may lead to unnecessary thyroid surgery or drug treatment. Follow-up is also essential, as symptoms may evolve and require drug treatment. Care pathways File hypothyroidie_congenitale_.pdf File maladies_du_metabolisme_transport_et_action_des_hormones_thyroidiennes.pdf Transition to adulthood During adolescence, a gradual preparation for the transition to adult care is organised. This stage helps strengthen the young patient’s autonomy, ensure continuity of medical follow-up, and transfer all the necessary information to the specialised adult service. The transition is planned in collaboration with the patient, their family, and the paediatric and adult care teams. Focus / Search Patients are treated by a qualified adult endocrinologist. Hormone assays and genetic tests are carried out in a specialised laboratory. Genetic counselling is offered. An on-call service is available 24 hours a day. Our centre is actively involved in improving knowledge and care for patients with rare endocrine diseases.A local registry of cases of congenital hypothyroidism and thyroid hormone resistance has been established, and the number of new cases managed is continuously reported to the European ENDO-ERN registry. The aim is to optimise follow-up practices and compare care between different specialised centres. The team receives ongoing training, participates in congresses and seminars, initiates and collaborates on single-centre and multicentre studies, and publishes in the field of thyroid disorders. It also provides training and teaching for students and doctors in training. Our specialists

Department presentation The Adult Endocrinology Clinic provides diagnosis and follow-up for adult patients with an endocrine disorder, meaning a condition affecting the secretion of a hormone (excessive or insufficient secretion) and/or the gland that secretes it. The department therefore manages conditions affecting the thyroid, parathyroid glands, adrenal glands, gonads (ovaries and testicles), and pituitary gland.Since 2016, the Endocrinology Department of Erasme Hospital, together with the Queen Fabiola Children’s University Hospital (HUDERF) for paediatric care, has been part of the ENDO-ERN network (European Reference Network for Rare Endocrine Conditions), the European Reference Network for rare endocrine diseases.This network aims to improve access to high-quality care for patients with rare endocrine disorders. It supports clinical research and contributes to the creation of registries that list patients receiving follow-up for rare conditions, in order to promote knowledge-sharing and improve clinical practices.The management of rare endocrine diseases is multidisciplinary. Regular discussions are organised for complex cases with numerous specialists within our institution, as well as during virtual consultations with recognised European experts through the ENDO-ERN network or during international multidisciplinary consultation meetings (France).Some endocrine diseases begin at birth or during childhood and require lifelong treatment and follow-up. Transition consultations have been provided for many years in collaboration with our paediatric colleagues at HUDERF, to ensure the smoothest possible transition from paediatric to adult care.  What are rare congenital thyroid diseases? Rare congenital thyroid diseases are conditions that are most often present from birth and affect the functioning of the thyroid gland. In the majority of cases, they involve congenital hypothyroidism, i.e. insufficient production of thyroid hormones. Thyroid hormones are essential for growth, but also—and above all—for the normal development of the brain during fetal life and childhood. In adulthood, they are primarily involved in regulating body temperature (thermoregulation), controlling metabolism (energy expenditure), fertility, intestinal transit, heart rate and mood. Hypothyroidism occurring in adulthood is most often acquired and has various causes (autoimmunity, thyroid surgery, medication, etc.). It does not fall into the category of rare endocrine diseases, unlike congenital hypothyroidism.The latter may be caused by an absent thyroid (agenesis), an abnormally formed thyroid (dysgenesis), or a defect in the synthesis of thyroid hormones linked to a mutation in one of the key enzymes (proteins) involved in hormone production. They are most often detected very early, during the first days of life, through newborn screening. This enables rapid and effective management, helping to prevent the harmful effects of thyroid hormone deficiency on the child’s brain and musculoskeletal development. During pregnancy, the mother provides the fetus with thyroid hormones and thus compensates for the defect in hormone synthesis by the fetal thyroid. However, once born, the affected baby no longer benefits from its mother’s thyroid hormones and must therefore receive prompt oral hormone replacement therapy.Another category of rare congenital thyroid diseases comprises disorders of the metabolism, transport and action of thyroid hormones, including thyroid hormone resistance syndromes. These very rare conditions (1/19,000–1/40,000 births) are caused by genetic abnormalities affecting one of the thyroid hormone receptors (there are two types). Thyroid hormones are produced in sufficient quantities, but cannot act optimally in tissues containing the mutated receptor (brain, liver, heart, muscle and bones). The severity and type of symptoms vary considerably depending on the mutation. In the most common forms of these rare conditions, which are also the least severe, the diagnosis is most often made following so-called “discordant” thyroid function tests (with an unusual profile) performed during routine blood tests or as part of family screening in the context of a known familial mutation.   Diagnosis and management Congenital hypothyroidism is screened for in newborns. A drop of blood is taken from the newborn’s heel between the 2nd and 5th day of life and placed on filter paper before being analysed. The parents are recalled for an endocrinology consultation if the screening test result is abnormal. Additional tests are performed to confirm the diagnosis (a follow-up blood test) and determine its cause (thyroid ultrasound and scintigraphy). Management is based on early treatment with thyroid hormone replacement therapy, started during the first days of life. This treatment is simple, well tolerated and enables the child to develop normally. As with acquired hypothyroidism, the challenges when continuing follow-up into adulthood are to ensure proper metabolic function, fertility and optimal quality of life in all areas (physical, psychosocial and professional).Regular clinical and laboratory follow-up is essential in order to adjust the doses as the child grows, as well as according to changing needs in certain situations (weight fluctuations, interactions with other medicines, digestive absorption problems, fertility, pregnancy, etc.).Medical follow-up must continue lifelong. Providing patients and families with information and support is essential to ensure treatment adherence and long-term quality of life.In the most common cases of resistance to thyroid hormones, symptoms are mild and patients generally do not require specific treatment. However, this is a difficult diagnosis to make and requires the exclusion of other conditions through specific tests (including genetic analysis for confirmation), with a risk of misdiagnosis that could lead to unnecessary thyroid surgery or drug treatment. Follow-up is also essential, as symptoms may evolve and require drug treatment.  Care pathway File trajetdesoin.pdf Transition to adulthood During adolescence, a gradual preparation for the transition to adult care is organised. This step helps strengthen the young patient’s autonomy, ensure continuity of medical follow-up, and transfer all the necessary information to the specialised adult service. The transition is planned in collaboration with the patient, their family, and the paediatric and adult care teams. Focus: expertise Patients are treated by an accredited adult endocrinologist. Hormone assays and genetic tests are performed in a specialised laboratory. Genetic counselling is offered. An on-call service is available 24 hours a day. Our centre is actively committed to improving knowledge and care for patients with rare endocrine diseases.A local registry of cases of congenital hypothyroidism and thyroid hormone resistance has been established, and the number of new cases managed is continuously reported to the European ENDO-ERN registry. The aim is to optimise follow-up practices and compare patient management between different specialised centres. The team undertakes continuing education, participates in congresses and seminars, initiates and collaborates on single-centre and multicentre studies, and publishes work in the field of thyroid disease. It also provides training and teaching for students and doctors in training. Our specialists Associated department

The must-attend event for anyone and all healthcare professionals interested in geriatric care and care pathways that support healthy ageing for older adults. Preliminary Programme 6:00 PM – Welcome and registration 6:30 PM – Keynote: Geriatrics – Helping People Continue Living What Matters MostDr Pierre Hanotier, Head of the Department of Geriatrics, H.U.B 6:40 PM – 7:00 PM | Flash Talks – One Expertise, One Message, Five Minutes 6:40 PM – Cardiogeriatrics: From Organ-Based Medicine to Person-Centred CareDr Véronique Lesage, Geriatrician specialised in cardiogeriatrics and palliative care, Erasmus Hospital, H.U.B 6:45 PM – Orthogeriatrics: The Care Model That Improves Outcomes for Older PatientsDr Laetitia Beernaert, Geriatrician specialised in orthogeriatrics, Erasmus Hospital, H.U.B 6:50 PM – Oncogeriatrics: When Age No Longer Determines TreatmentDr Julie Caillet, Geriatrician specialised in oncogeriatrics, Jules Bordet Institute, H.U.B and Dr Nathalie Compté, Geriatrician, CHU Helora 6:55 PM – Sexual Health: Pleasure Has No Expiry DateDr Nathan Franceschi, Geriatrician, Erasmus Hospital, H.U.B 7:00 PM – Geriatric Rehabilitation: Regaining Abilities, Preserving Life GoalsDr Anne Mergam, Geriatrician, Geriatric Rehabilitation Centre (GRC), Erasmus Hospital, H.U.B 7:10 PM – Healthy Aging Keynote: Supporting Health and Independence for as Long as Possible!Dr Pierre Hanotier 8:00 PM – Networking Dinner 9:30 PM – End of the Symposium Register Practical Information Date: Thursday, 12 November 2026Venue: Jules Bordet Institute, 90 Rue Meylemeersch, 1070 Brussels, Tagnon Auditorium (1st floor). DirectionsThis symposium is open to everyone: healthcare professionals, people interested in geriatric care, anyone wishing to learn more about healthy ageing, and general practitioners who would like to strengthen collaboration with geriatricians.Participation is free of charge, but registration is mandatory. Registration deadline: 6 November 2026.Participating physicians will receive accreditation points. Accreditation points will only be awarded to physicians who attend the symposium in its entirety.The symposium will be held in French. Contact With the support of Image

Interventional radiology in gynecology: minimally invasive innovations to preserve health and fertility Interventional radiology is playing an increasingly important role in the management of gynecological conditions. Thanks to image-guided minimally invasive techniques, it provides alternatives or complements to conventional treatments, with potential benefits including organ preservation, reduced complications and improved patients’ quality of life.This symposium will provide a multidisciplinary overview of the latest advances in interventional radiology applied to gynecology. Gynecologists, interventional radiologists and specialists involved in the management of pelvic pathologies will come together to discuss current indications, clinical outcomes and future perspectives of these approaches.Therapeutic innovations at the heart of gynecological careTargeted embolization: a conservative approach for uterine conditionsArterial embolization allows precise targeting of the blood supply of certain gynecological lesions, offering an alternative or complement to conventional treatments while preserving the uterus.This session will address in particular:Uterine fibroids (fibromyomas): indications, clinical outcomes and the role of embolization within today’s therapeutic options.Pelvic adenomyosis: new perspectives for managing a condition often responsible for chronic pain and menstrual disorders.Thermal ablation: new minimally invasive strategies for deep endometriosisThermal ablation opens up new perspectives in the management of certain deep endometriosis lesions through a targeted approach that limits the impact on surrounding tissues. This session will present the indications, available outcomes and the role of this technique within a personalized therapeutic strategy.Pelvic vascular conditions: diagnosing and treating differentlySome chronic pelvic pain conditions may be related to vascular abnormalities. Experts will present recent advances in:Pelvic varices embolization: a targeted approach to treating pelvic congestion syndrome in selected patients.Management of varicoceles: with particular focus on indications and outcomes.Restoring fertility: the potential of selective tubal recanalizationIn certain cases of proximal tubal obstruction, selective tubal recanalization is a minimally invasive approach that may restore tubal patency. This session will explore its role within infertility care pathways and its integration into individualized patient management.A comprehensive reflection on interventional radiology in gynecologyCross-cutting challenges: responsible practice of interventional radiology in gynecologyBeyond technical innovations, the development of these approaches raises essential questions:What ethical challenges will accompany the evolution of these practices?How can economic considerations be integrated into therapeutic decision-making?How can radiation protection for patients and healthcare professionals be optimized?A comprehensive reflection is essential to ensure innovative, responsible and patient-centered medicine.A symposium to strengthen collaboration between specialistsThis symposium is aimed at gynecologists wishing to deepen their knowledge of available interventional techniques in gynecology and better identify situations in which these approaches can be offered to their patients.It provides an opportunity to exchange with specialists in interventional radiology and gynecology through clinical cases, practical experiences and discussions on future developments.Practical informationDate: Saturday, 21 November 2026Time: 08:00 AM to 03:00 PMLocation: Museum of Medicine, Erasme Campus – Place Facultaire. Route de Lennik 808, 1070 Anderlecht. AccessTarget audience: gynecologists, interventional radiologists and specialists involved in the management of pelvic pathologiesAccredited symposium organized under the direction of Dr Salvatore Murgo and Dr Arnaud Bourguignon.Free registration required (registration deadline: 14/11/2026)Contact: Interventional Radiology Angiography Coordination, coordination [dot] RI [at] hubruxelles [dot] be Registration

The Epileptology Clinic at Erasme Hospital, H.U.B, specialises in the diagnosis, treatment and follow-up of people with epilepsy or epileptic seizures. Diagnose and treat epilepsy Epilepsy affects approximately 1% of the population and can occur at any age. In one-third of cases, anti-epileptic medicines are unable to control it. The impact on daily life, particularly the ability to work and drive a vehicle, can then be significant. Image Image Image Freeing patients from epileptic seizures The Epileptology Clinic provides care for adult patients with epilepsy of any type and severity. The goals of care are freedom from seizures and a better quality of life. Your reference centre in Brussels Neurologists, neurophysiologists, neurosurgeons, neuroradiologists, psychologists and specialist nurses work together to provide personalised care for patients. The Epilepsy Clinic of Erasme Hospital H.U.B is part of the Reference Centre for the management of refractory epilepsy, recognised by INAMI. Our healthcare services Specialised outpatient consultationsSpecialist consultations for patients admitted to the Emergency Department or hospitalised, particularly in the Intensive Care UnitProlonged video-EEG recordings (24 hours or several days) for the diagnosis of epilepsy and the pre-surgical assessment of refractory epilepsies in the specialised epilepsy monitoring unitIntracranial EEG recordings for the management of refractory epilepsies requiring surgeryProlonged inpatient EEG recordings, particularly in the Intensive Care Unit, to diagnose epileptic seizures in critically ill patients, assess neurological prognosis in comatose patients or, for example, detect delayed cerebral ischaemia Our team Dr Benjamin Legros, Director of the Adult Epilepsy Clinic Our doctorsProf. Nicolas Gaspard, Head of the Neurology DepartmentProf. Chantal DepondtProf. Lorenzo FerliniDr Romain TortuyauxDr Sarah CaroyerOur nursing staffHead nurse: Nathalie BuffeDeputy head nurse: Didier Depré The departments with which we collaborate Neuropaediatrics Lien vers Neuropaediatrics Neurosurgery Lien vers Neurosurgery Radiology and medical imaging Lien vers Radiology and medical imaging Nuclear medicine Lien vers Nuclear medicine Interventional neuroradiology Lien vers Interventional neuroradiology Neuropsychology Lien vers Neuropsychology Translational neuroimaging Lien vers Translational neuroimaging Details of the multidisciplinary collaboration of the H.U.B Epileptology ClinicNeuropaediatricsChildren with epilepsy receive care tailored to their age and development. When routine tests do not make it possible to identify the exact origin of the seizures, doctors may, in certain situations, record the brain’s electrical activity directly using small electrodes temporarily placed inside the brain (intracerebral EEG). This examination makes it possible to locate the area responsible for the seizures with great precision.NeurosurgeryWhen medication is not sufficient to control the seizures, surgery may be considered. Depending on the situation, the neurosurgeon may remove or isolate the small area of the brain responsible for the seizures so that it can no longer trigger them. Before this procedure, it may sometimes be necessary to temporarily place fine electrodes in the brain to record brain activity and precisely locate the region responsible for the seizures. When surgery is not possible or is not the best option, other treatments may be offered. In particular, it is possible to implant a small stimulator, comparable to a pacemaker, which sends mild electrical impulses to a nerve in the neck (the vagus nerve) or directly to certain areas of the brain. In some patients, these stimulations can reduce the frequency or intensity of the seizures. In certain very specific situations, a minimally invasive technique using a laser beam (LITT) may also be offered. Guided with very high precision, the laser makes it possible to treat the area responsible for the seizures without open surgery.Radiology and medical imagingImaging examinations (MRI, CT scan, etc.) make it possible to obtain highly detailed images of the brain in order to look for an abnormality that may be responsible for the seizures. Some examinations also show how different regions of the brain function.Nuclear medicineA PET scan is an imaging examination that makes it possible to observe how the brain functions by measuring the activity of its different regions. It helps doctors identify the areas involved in the seizures when these are not visible on an MRI.Interventional neuroradiologyBefore certain surgical procedures, specialised examinations make it possible to determine which areas of the brain are involved in essential functions such as language or memory. The team also performs a highly precise mapping of the brain’s blood vessels in order to safely prepare for the placement of electrodes when necessary.Neuropsychology and Speech TherapyTests make it possible to assess memory, attention, concentration, language and other cognitive functions. They help measure the impact of epilepsy on daily life and prepare for possible surgery.Translational neuroimagingThe clinic has access to cutting-edge technology known as magnetoencephalography (MEG). This completely painless and non-invasive examination measures the very weak magnetic fields naturally produced by brain activity. It makes it possible to locate the areas responsible for the seizures with a very high degree of precision and complements the other examinations. Erasme Hospital is currently the only hospital in Belgium to have this technology. Image Research and innovation As an academic hospital and referral centre for the management of complex epilepsies, our clinic places research at the heart of its mission. The scientific knowledge acquired in the laboratory and at patients’ bedsides directly contributes to the improvement of the care, diagnosis and treatments offered.Our teams participate in numerous national and international research projects, as well as in clinical trials aimed at improving our understanding of the mechanisms of epilepsy, developing new diagnostic approaches and evaluating innovative treatments. The scientific publications of our doctors and researchers demonstrate this expertise and their commitment to advancing care for people living with epilepsy. Our scientific publications (1/3) Lien vers https://www.nature.com/articles/s41588-023-01485-w GWAS meta-analysis of over 29,000 people with epilepsy identifies 26 risk loci and subtype-specific genetic architecture International League Against Epilepsy Consortium on Complex Epilepsies. Nat Genet. 2023 Sep;55(9):1471-1482.  31 August 2023 Lien vers https://pubmed.ncbi.nlm.nih.gov/39363051/ Exome sequencing of 20,979 individuals with epilepsy reveals shared and distinct ultra-rare genetic risk across disorder subtypes Epi25 Collaborative. Nat Neurosci. 2024 Oct;27(10):1864-1879.  03 October 2024 Lien vers https://pubmed.ncbi.nlm.nih.gov/39480921/ Brain malformations and seizures caused by impaired TRiC chaperonin function Kraft F, Rodriguez-Aliaga P, Yuan W, Franken L, Zajt K, Hasan D, Lee TT, Flex E, Hentschel A, Innes AM, Zheng B, Julia Suh DS, Knopp C, Lausberg E, Krause J, Zhang X, Trapane P, Carroll R, McClatchey M, Fry AE, Wang L, Giesselmann S, Hoang H, Baldridge D, Silverman GA, Radio FC, Bertini E, Ciolfi A, Blood KA, de Sainte Agathe JM, Charles P, Bergant G, Čuturilo G, Peterlin B, Diderich K, Streff H, Robak L, Oegema R, van Binsbergen E, Herriges J, Saunders CJ, Maier A, Wolking S, Weber Y, Lochmüller H, Meyer S, Aleman A, Polavarapu K, Nicolas G, Goldenberg A, Guyant L, Pope K, Hehmeyer KN, Monaghan KG, Quade A, Smol T, Caumes R, Duerinckx S, Depondt C, Van Paesschen W, Rieubland C, Poloni C, Guipponi M, Arcioni S, Meuwissen M, Jansen AC, Rosenblum J, Haack TB, Bertrand M, Gerstner L, Magg J, Riess O, Schulz JB, Wagner N, Wiesmann M, Weis J, Eggermann T, Begemann M, Roos A, Häusler M, Schedl T, Tartaglia M, Bremer J, Pak SC, Frydman J, Elbracht M, Kurth I. Science. 2024 Nov;386(6721):516-525. 31 October 2024 Lien vers https://pubmed.ncbi.nlm.nih.gov/40592404/ Diagnostic yield of clinical exome sequencing in 868 children with neurodevelopmental disorders Neuens S, Soblet J, Penninckx A, Detry C, Badoer C, Desmyter L, Peyrassol X, Wilkin F, Busson A, Bruneau M, Grenet ML, Le Morillon A, Aeby A, Deconinck N, Prigogine C, Monier A, Juvené E, Balfroid T, Van Hecke A, Christiaens F, Depondt C, Brachet C, Delvenne V, Lufin N, Bouysran Y, Kammoun M, Daneels D, Caljon B, Croes D, Olsen C, Van Dooren S, Migeotte I, Vandernoot I, Marangoni M, Coppens S, Smits G, Vilain C. Eur J Med Genet. 2025 Aug;76:105030.  Our scientific publications (2/3) Lien vers https://pubmed.ncbi.nlm.nih.gov/34049028/ Assessment of a standardized EEG reactivity protocol after cardiac arrest Caroyer S, Depondt C, Rikir E, Mavroudakis N, Peluso L, Taccone FS, Legros B, Gaspard N. Clin Neurophysiol. 2021 Jul;1 32(7):1 687-1693. 01 July 2021 Lien vers https://pubmed.ncbi.nlm.nih.gov/41937627/ Added prognostic value of EEG reactivity in post-anoxic comatose patients Caroyer S, Obrecht M, Damien C, De Maeseneire C, Depondt C, Rikir E, Mavroudakis N, Annoni F, Taccone FS, Legros B, Gaspard N. Annals of Clinical and Translational Neurology. In press 06 April 2026 Lien vers https://pubmed.ncbi.nlm.nih.gov/33765473/ False-predictive EEG and clinical signs after post-anoxic brain injury under sevoflurane anaesthesia Peluso L, Legros B, Caroyer S, Taccone FS, Gaspard N. Clin Neurophysiol. May 2021;1 32(5):1 080–1082. S P 01 May 2021 Lien vers https://pubmed.ncbi.nlm.nih.gov/40720710/ Characteristics, Outcomes, and Treatment of Post-Anoxic Status Epilepticus: A Pooled Analysis of Three Cohorts De Stefano P, Hofmeijer J, Quintard H, Damien C, Misirocchi F, Caroyer S, Horn J, et al. (TELSTAR investigators). Neurology. 2025 Aug 26;1 05(4):e 213913. 26 August 2025 Our scientific publications (3/3) Lien vers https://pubmed.ncbi.nlm.nih.gov/41934725/ Clinical applications of EEG connectivity in acute brain injuries: A systematic review Anzalone L, Cottin L, Caroyer S, Nonclercq A, Gaspard N. Clin Neurophysiol. 2026 Apr 1;187:2111868. doi: 10.1016/j.clinph.2026.2111868 01 April 2026 Lien vers https://pubmed.ncbi.nlm.nih.gov/41963278/ Monitoring Consciousness and Predicting Outcomes Using EEG Connectivity in Severe Traumatic Brain Injury Anzalone L, Deschamps M, Cottin L, Caroyer S, Damien C, De Maeseneire C, Depondt C, Legros B, Nonclercq A, Gaspard N. J Neurotrauma. 2026 Apr 10:8977151261442469. doi: 10.1177/08977151261442469 10 April 2026 FAQ – Epilepsy 1. What is epilepsy? Epilepsy is a neurological disorder that causes recurrent seizures due to abnormal electrical activity in the brain. There are many forms of epilepsy, with symptoms that vary greatly from one person to another. 2. What are the symptoms of an epileptic seizure? An epileptic seizure is not limited to convulsions. It can also cause loss of consciousness, a brief absence lasting a few seconds, involuntary movements, unusual sensations, speech or visual disturbances. The symptoms vary depending on the area of the brain affected. 3. How is epilepsy diagnosed? Diagnosis is based on a medical consultation, analysis of the seizures described by the patient or their relatives, a neurological examination, and additional tests such as an electroencephalogram (EEG), which records the brain’s electrical activity, and a brain MRI. 4. Can epilepsy be treated? Yes. In most cases, seizures can be controlled with medication. When medication is not sufficiently effective, other solutions may be considered, such as surgery, neurostimulation or certain minimally invasive techniques. 5. Can one live a normal life with epilepsy? Yes. With appropriate treatment and specialised follow-up, most people with epilepsy can work, pursue leisure activities, travel and lead an active life. However, certain precautions may be necessary depending on the type of seizures. 6. What are the causes of epilepsy? There are multiple causes. Epilepsy may be related to a brain malformation, a cerebrovascular accident, a head injury, a tumour, a genetic disease or an infection. In many cases, no specific cause is identified. 7. When should you consult an epilepsy specialist? It is advisable to consult a neurologist after a first unexplained seizure, if seizures persist despite treatment, or when their cause remains difficult to identify. Care at a specialised centre helps refine the diagnosis and assess the various treatment options. 8. What should you do when someone has an epileptic seizure? Remain calm, protect the person from injury, loosen clothing around the neck, and place them on their side as soon as possible after the seizure. Never try to restrain their movements or put anything in their mouth. If the seizure lasts more than five minutes or if several seizures occur one after another, call the emergency services. 9. When is epilepsy surgery considered? Surgery may be considered when seizures persist despite several properly conducted treatments and a specific area of the brain is identified as the source of the seizures. Each case is thoroughly assessed by a multidisciplinary team. 10. Why consult a centre specialising in epilepsy? A specialised centre has expert teams and access to high-tech examinations, enabling accurate diagnosis and the most appropriate treatments, including for the most complex forms of epilepsy. Patients may also benefit from innovative approaches and, in some cases, participate in clinical studies. Resources and useful links [VIDEO] What is refractory epilepsy? Dr Benjamin Legros, Neurologist, Director … [VIDEO] Epilepsy: let’s talk about it! [ARTICLE] Can epileptic seizures occur after a stroke? Prof. Nicolas Gaspard, D… [WEBSITE] EpiCARE: The European Reference Network for Rare and Complex Epilepsi… [WEBSITE] European Rare Disease Research Alliance [WEBSITE] Epi25 Collaborative: international genetic sequencing collaboration f… [WEBSITE] Consortium for Complex Epilepsies of the International League Against… [WEBSITE] ENIGMA Consortium on Neuroimaging and Genetics / Consortium on Neuroi… [BELGIAN WEBSITE] French-speaking Belgian League Against Epilepsy (Patient Asso… Our page dedicated to the health condition

Appointments that are neither attended nor cancelled are a major cause of delays in our hospitals. If you are unable to keep your appointment, please let us know as soon as possible.  Any appointment that is missed and not cancelled at least 48 hours before the scheduled time will incur a fee:30 euros for a consultation or a standard scintigraphy scan100 euros for an MRI, an X-ray, a CT scan or a PET-CT scan€200 for a procedureThere are several ways to cancel an appointment:Through the MyHUB app, if you originally booked your appointment via the appUsing the cancellation forms available on our websiteOr by calling 02 555 55 55 and following the menu options until you reach the relevant department. 

Appointments that are neither attended nor cancelled are a major cause of delays in our hospitals. If you are unable to keep your appointment, please let us know as soon as possible. Any appointment that is missed and not cancelled at least 48 hours before the scheduled time will incur a fee: 30€ for a consultation or a standard scintigraphy scan100€ for an MRI, an X-ray, a CT scan or a PET-CT scan200€ for a procedure There are several ways to cancel an appointment: Through the MyHUB app, if you originally booked your appointment via the appUsing the cancellation forms available on our websiteOr by calling 02 555 55 55 and following the menu options until you reach the relevant department.  You can cancel your appointment up tu 48 hours before with no fees incurred

What is eosinophilic oesophagitis? Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease of the esophagus that affects children and young adults and manifests as difficulty swallowing (dysphagia), chest pain, and sometimes food becoming lodged in the esophagus. In children, esophagitis often manifests as vomiting, abdominal/chest pain, and refusal to eat. Patients often adapt their diet, avoid certain foods (bread, meat, rice), and eat more slowly. Chronic inflammation makes the esophagus stiffer, which can lead to narrowing (strictures). Therefore, to prevent this progression, long-term follow-up and maintenance treatment are indicated. First consultation Gastroenterology consultation, recording of symptoms, recording of any allergies and atopic diseases, and assessment of nutritional status. Diagnosis The diagnosis of EoE is based on the triad of symptoms of oesophageal dysfunction (particularly dysphagia), eosinophilic infiltration on oesophageal biopsies, and exclusion of other causes of oesophageal eosinophilia.Investigations Gastroscopy (OGD) with biopsies: Essential examination that may reveal rings, furrows, a trachealised appearance, white exudates (microabscesses), or a fragile mucosa. At least 6 oesophageal biopsies (proximal and distal) are essential.Histology: Confirmation of the presence of at least 15 eosinophils per high-power field.Full blood count (FBC): To look for blood eosinophilia, which is often moderate. Allergy assessment: Not indicated as a first-line investigation in adult patients; skin tests (prick tests) or specific IgE measurements, often targeting milk, wheat, eggs or soya, are sometimes performed, although their sensitivity is limited.Barium oesophagram (TOGD or OED X-ray): Performed in cases of significant stenosis (narrowing) to map the lesions before endoscopic dilatation. Treatments Treatment of EoE aims to reduce inflammation, relieve symptoms (dysphagia) and prevent fibrosis. First-line treatment is based on proton pump inhibitors (PPIs), topical corticosteroids (swallowed), or elimination diets, often continued long term. PPIs: Often the first step in reducing inflammation, although their exact mechanism in EoE is not strictly related to reflux (intrinsic anti-inflammatory effect). Topical/local corticosteroids: Orodispersible budesonide is highly effective in treating inflammation and relieving symptoms; it is reimbursed in Belgium in cases of resistance to PPIs.Elimination diets: Removal of the most frequently implicated allergenic foods (milk, wheat, soya, eggs, tree nuts, fish and shellfish), ideally under dietary supervision. These diets are difficult to follow in adults and affect quality of life. For these reasons, an elimination diet excluding one or two allergens (milk, or milk and wheat) may be offered as first-line treatment.Biological therapies: New biological medicines targeting inflammation, such as dupilumab, are used when treatment with PPIs and budesonide fails. Dupilumab is reimbursed in Belgium for this indication.Oesophageal dilatation: Performed endoscopically in cases of significant narrowing (stricture) of the oesophagus. Follow-up Eosinophilic oesophagitis is a chronic disease requiring long-term medical follow-up to prevent complications, particularly fibrosis or strictures. Follow-up, supervised by a gastroenterologist, combines symptom assessment, endoscopies with biopsies, and management of treatments (PPIs, corticosteroids, biologic medication, diet).Regular medical follow-up: An annual consultation, or even one every two years, is recommended to assess treatment adherence and symptoms.Endoscopic monitoring: This is necessary because symptoms alone are not sufficient to assess disease activity. A follow-up endoscopy is necessary if treatment is modified (dose reduction or discontinuation of a medication) to confirm histological remission (a decrease in the number of eosinophils to < 15 per field).Maintenance treatments: prescribed to prevent recurrences. Most patients relapse when treatment is stopped, underscoring the importance of chronic management. Multidisciplinary approach: Follow-up often involves an allergist and a dietitian, particularly if an elimination diet is undertaken (milk, wheat, etc.).Monitoring for complications: Repeated endoscopies make it possible to monitor the development of strictures (narrowing of the oesophagus).  Transition to adulthood The transition of patients treated and followed in paediatrics takes place during a gastroenterology consultation, in order to provide the necessary follow-up in adulthood. Our specialists Associated department

On the day of your consultation please go to one of the registration terminals in the central hall 20 minutes before your appointment.  Documents to bring with you Your identity documents Any document attesting to your rights to receive care (“BIM”, “réquisitoire” to cover medical expenses.) The results of or prescription for any examinations if applicable Documents to bring with you

What is it? Primary immunodeficiencies are rare diseases, most often of genetic origin, in which part of the immune system does not function properly from birth. They affect both children and adults and may sometimes only become apparent later in life. They most commonly manifest as infections that recur frequently, last a long time or respond poorly to treatment; some are associated with autoimmune or inflammatory manifestations. Recognising these signs enables an appropriate diagnosis and management. In the event of unusual and recurrent infections, a specialist consultation, following referral by your general practitioner, is recommended. Assessment and diagnosis Our Immunodeficiency Treatment Unit brings together internist-immunologists, paediatricians, biologists, pulmonologists, gastroenterologists and infectious disease specialists around the patient. The process begins with an immunological assessment: measurement of antibodies (immunoglobulins IgG, IgA and IgM), evaluation of the response to vaccines, analysis of immune cells and, when useful, genetic testing. This assessment enables an accurate diagnosis and identification of the type of deficiency. Care is personalised: prevention and rapid treatment of infections, appropriate vaccinations and, for many antibody deficiencies, replacement therapy with immunoglobulins administered in hospital (intravenously) or at home (subcutaneously). Regular follow-up aims to detect and treat any complications (autoimmune, pulmonary or digestive) and to adapt treatment over time. This coordinated, multidisciplinary approach, from childhood through adulthood, improves quality of life and reduces the risk of complications. Advice On a daily basis, simple measures help limit infections: keeping vaccinations up to date, good hand hygiene, regular dental care and prompt treatment of infections. Most episodes can be managed on an outpatient basis. However, you should seek medical advice without delay, or even go to the Emergency Department on the advice of our available specialist doctors, in the event of a high and persistent fever, breathing difficulties, a sudden deterioration in your general condition, neck stiffness or signs of a severe infection. If in doubt, contact your healthcare team: it is better to make one call too many. Specific care pathway 1. First signs and referral — Recurrent, persistent or poorly responsive ENT, bronchial or pulmonary infections may suggest an immunodeficiency. The general practitioner or paediatrician then refers the patient to a specialist consultation.2. Assessment and diagnosis — A blood test measures antibodies (IgG, IgA and IgM) and the response to vaccines; analysis of immune cells and, sometimes, genetic testing complete the assessment. These tests confirm the diagnosis and determine its type, such as common variable immunodeficiency (CVID), the most common form in adults.3. Starting treatment — When an antibody deficiency is confirmed, replacement therapy with immunoglobulins is generally offered, either by intravenous infusion in hospital or subcutaneously at home. This is combined with prompt treatment of infections and appropriate vaccinations.4. Long-term follow-up — Regular consultations are used to monitor treatment effectiveness, adjust doses and detect any autoimmune, pulmonary or digestive complications. Follow-up is coordinated between the various specialists.5. Daily life and support — Therapeutic education, support from patient associations and, for children, planning the transition to the adult team help patients live as well as possible with the condition. Useful documents File trajet.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_immunitaires_secondaires.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_entites_frontieres.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_immunitaires_combines.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_immunitaires_combines_severes.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficits_du_complement.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficit_selectif_iga.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficit_immunitaire_commun_variable.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_deficit_en_anticorps_specifiques.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_defauts_phagocytaires.pdf File 2026_medecine_interne_immunodeficiences_primaires_document_defauts_de_commutation_de_classe.pdf Transition to adulthood Many primary immunodeficiencies diagnosed in childhood require lifelong follow-up. To ensure a seamless transition, the move from paediatrics to adult medicine is prepared in advance, progressively and with support. The young patient meets the adult care team, gains a better understanding of their condition and treatment, and becomes more independent. Paediatricians and adult physicians share medical information so that the transition takes place smoothly, without any loss of information or interruption in care. Focus / Research Our team participates in international research on inborn errors of immunity. The work of Jean-Christophe Goffard, conducted in collaboration with major academic networks, has notably helped explain why some people develop severe forms of viral infection: it has demonstrated the role of autoantibodies directed against type I interferons—key molecules in antiviral defence—and of underlying immune deficiencies, for example in severe COVID-19. This research improves the diagnosis of immunodeficiencies and paves the way for more personalised care. Our Specialists Associated department

Description Epilepsy is a chronic neurological disease. It is common, can first appear at any age and covers a very heterogeneous group of diseases with multiple causes. In one third of cases epileptic seizures continue despite medication (refractory epilepsy).  A considerable number of patients present a rare and distinct epileptic syndrome for which the prognosis for controlling the seizures and neurological development is poor. These rare epilepsies are for the most part of genetic origin. Rare and complex epilepsies affect almost 5 persons in every 10,000 of the population.  Treatment The Epileptology Clinic of the Erasmus Hospital and Queen Fabiola Children’s University Hospital (HUDERF) possesses specific expertise in treating complex epilepsies.  The centre is recognised by the INAMI/RIZIV [Belgian National Institute for Health and Disability Insurance] as an approved Belgian centre for the treatment of refractory epilepsies.  The rooms at our Epilepsy Exploration Unit ere specially equipped for prolonged video EEG monitoring. The Erasmus Hospital is specialised in intracranial EEG monitoring for the pre-surgery assessment of refractory epilepsies while the HUDERF is specialised in treating epilepsy in children. The multidisciplinary approach at the two sites permits a full range of diagnostic and treatment methods, from the latest medicines and ketogenic diet to surgery.   The H.U.B’s Rare Diseases Function provides access to leading edge  genetic diagnostic technologies that make it possible to identify a genetic cause in a large number of patients with rare and complex  epilepsies and thereby permit targeted treatment. Thanks to close cooperation with neuropaediatrics at the Erasmus Hospital and the HUDERF we are able to offer paediatric patients a structured transition to care in adulthood that is adapted specifically to the individual needs of each patient. Our multidisciplinary medical and paramedical care allows us to treat not only epilepsy but also the medical conditions that are often associated with epilepsy. Advice Genetic factors play an important role in epilepsy, especially if the epilepsy first appears in childhood or is associated with developmental disorders.  Specialised genetic testing is then indicated. Several hundred genes are associated with epilepsy. Identifying a genetic cause not only permits a precise diagnosis but also genetic advice, the prognosis and – increasingly frequently – precision treatment. For patients with refractory epilepsy, pre-surgery exploration can lead to a surgical solution (brain surgery, gamma knife, vagus nerve stimulation, deep brain stimulation, Laser Interstitial Thermal Therapy (LITT). Research Other areas of expertise and research activities:Prolonged EEG monitoring at the Intensive Care Unit to diagnose epileptic seizures in seriously ill patientsParticipation in pharmaceutical trials sponsored by the industry on the use of the latest drugsParticipation in research and expertise networks:Epinord (Franco-Belgian intracranial ’EEG expertise group)ERN EpiCARE (European Reference Network for Rare and Complex Epilepsies)The genetic research networks EpiGen, Epi25 and Consortium on Complex Epilepsies of the International League Against Epilepsy (ILAE)Critical Care EEG Monitoring Research Consortium(CCEMRC)  Documents and useful links Epileptology Clinic HUDERF Department of NeuropaediatricsEpilepsy Exploration UnitERN EpiCARE (European Reference Network for Rare and Complex Epilepsies)Epi25 NetworkConsortium on Complex Epilepsies of the International League Against Epilepsy (ILAE)Critical Care EEG Monitoring Research Consortium (CCEMRC)Patients’ associations: https://ligueepilepsie.behttps://www.epilepsieliga.be Our specialists Neurologists specialising in epilepsy: Prof. Chantal Depondt (Head of the Rare Neurological Diseases Clinic)Prof. Nicolas Gaspard (Head of the Department of Neurology)Dr. Benjamin Legros (Head of the Adult Epileptology Clinic and of the Reference Centre for the treatment of Refractory Epilepsy)Paediatricians specialising in epilepsy: Prof. Alec Aeby (Head of the Department of Neuropaediatrics)Dr. Tom Balfroid (Erasmus Hospital)Dr. Cynthia Prigogine (HUDERF)Dr. Claudine Sculier (Erasmus Hospital – Medical consultant at the Epilepsy Exploration Unit)Dr. Pauline Van Gyseghem (HUDERF)