Revista del Laboratorio Clínico最新文献

Acanthocytes, when ≥ 5% of urinary erythrocytes examined, are considered as the most reliable marker of glomerular haematuria. However, some uncertainties still exist in the literature about their morphological definition. The aim of this paper is to discuss this topic and to suggest a univocal definition of acanthocytes as erythrocytes with the shape of a ring with one or more protrusions.

Serine proteases are enzymes widely distributed in nature, and are responsible for multiple and important biological processes. During bacterial infection, pathogens secrete and use their serine proteases as virulent factors to combat against the host, through diverse mechanisms, such as tissue disruption, proteolysis of immunological effectors or inactivation of relevant components for the host physiology. However, some years ago it was observed that serine proteases could modulate physiological processes by a highly specific mechanism, through the activation of protease activated receptors (PARs). In this paper, we review recent knowledge about bacterial serine proteases and their relevance in the pathophysiology of infection. The opportunity for new antimicrobial interventions based on the inhibition of PAR-protease interaction, is also highlighted.

Some recommendations are presented for standardising the measurement of lipids and lipoproteins, as they are critical for clinical decisions making. Recommended methods validated against a reference or definitive method should be employed, as well as the use of control materials that comply with European Directives on in vitro diagnostics. Additionally, the chosen methods must comply with the objectives set forth by the National Cholesterol Education Program (NCEP) and by the Spanish Society of Laboratory Medicine (SEQC^ML). Determination of HDL cholesterol using automatic homogenous methods is considered acceptable for normal clinical practice, and the Friedewald Formula is considered to be usable to estimate LDL cholesterol concentration when triglyceride concentrations are below 200 mg/dL (2.3 mmol/L). If this should not be the case, the use of non-HDL cholesterol is recommended. Routine quantification of apolipoproteins A1 and B, and lipoprotein (a) can be measured using immunonephelometric or immunoturbidimetric methods, with calibrators that are traceable to reference materials.

Streptococcus vestibularis, which has been described at the beginning of last century, has been isolated from different sources (oral cavity, stomach or jejunum, for instance). Regarding its denomination, this microorganism was named after its first isolation source (mucosa from oris vestibulum). In spite of great difficulties in the taxonomy of viridans group streptococci, genetic tests have recently made it possible to distinguish S. vestibularis from other species of the same group, even from those phylogenetically close to it (Streptococcus salivarius and Streptococcus thermophilus). Studies on this bacteria have revealed it possess a considerable number of virulence factors, which may provide it with notable virulence regardless of its opportunistic pathogen behaviour. Identification of viridans group streptococci is also difficult, as phenotypic methods have shown to be troublesome. Nevertheless, sequence-based methods (rRNA 16S) or MALDI-TOF offer relatively reliable identifications, despite the lack of information about these species. Antibiotic susceptibility of S. vestibularis has been poorly studied, as this species is rarely isolated in day-to-day clinical practice in relation to infections. As a result of this, the antibiotic susceptibility profile of this bacteria is based on general information about antibiotic susceptibility of viridans group streptococci.

Background and objective

Sweet's syndrome or acute febrile neutrophilic dermatosis is a rare inflammatory disease of unknown pathophysiology, although clinical and biochemical evidence suggests that cytokines play an important role in its aetiopathogenesis. It is classified into five groups: idiopathic, para-inflammatory, secondary to drugs, associated with pregnancy, and para-neoplastic in 20% of cases, with 85% of these linked to haematological disorders, and 15% to solid tumours.

Patient

A report is presented on a patient with Sweet's Syndrome with atypical dermatological involvement, associated with myelodysplastic syndrome, and iatrogenic Cushing's syndrome secondary to high-doses of corticosteroids, with an unfavorable outcome.

Results

Acute phase reactants (APR) were increased during the outbreaks, with the early elevation of interleukin 6 (IL6) being highlighted, followed by serum amyloid A (SAA) and C-reactive protein (CRP), with statistically significant differences (P< .05) between CRP and SAA.

Conclusions

A Sweet's syndrome in a male with multiple relapses and a non-classical dermatological location, associated haematological abnormalities, and an increase in APR with early elevation of IL6, should lead to a clinical diagnosis of paraneoplastic and haematological origin.

Among the various pleuropulmonary complications of rheumatoid arthritis, rheumatoid pleurisy is the most commonly observed¹, occurring in up to 5% of patients with rheumatoid arthritis. The majority of these correspond to a subtype composed mainly of middle-aged men with high rheumatoid factor titres, rheumatoid nodules, and presence of HLA-B8 and Dw3. Although rheumatoid pleural effusion generally presents as a non-specific exudate, laboratory characteristics have been described that, although infrequent, can be very useful in its diagnosis.