Annales de biologie clinique最新文献

A 75-year-old men is adressed in rheumatology for lower back pain, asthenia, and recent weight loss. Myeloma is suspected. Anemia, hyperproteinemia as well as a monoclonal IgG kappa with serum protein immunofixation are discovered. The diagnosis is confirmed by the myelogram with 14% of medullar plasmocytes. Osteolytic lesions are also found on the scanner.

In pediatrics, accurate measurement of total serum bilirubin (TSB) is of major importance for reliable diagnosis and appropriate management of neonatal jaundice. However, several studies evidenced poor comparability of results obtained with the different available methods either in central lab or in POCT, on serum, capillary blood or transcutaneous. This situation is partly due to the lack of Reference Materials, especially for high bilirubin concentrations but also on poor communication between central lab and neonatology unit. To progress on these issues, we have compiled some data from CNRHP to propose guidelines for choice, use and management of POCT devices and to help clinical laboratories to achieve a better answer to clinical needs with specific local constraints. The results from several CNRHP studies are presented: traceability to International System of Units, inter-laboratories comparability, POCT vs central labs comparisons with POCT CO-oximeter or photometer, integration of transcutaneous bilirubinometer. We propose, based on an analysis of devices advantages and issues, guidelines to help labs either to improve neonates monitoring in their local context; we distinguished the choices inside laboratory for a better harmonization of results compared to published thresholds and outside lab contexts, to organize a coordinated chain with POCT devices, with capillary and/or transcutaneous approaches.

G6PD deficiency is one of the most common genetic disorders in the world, affecting more than 400 million people. The large majority of patients do not have anemia of chronic hemolysis but are subject to acute haemolytic anemia after exposure to triggering factor, usually eating fava beans, exposure to oxidative drugs or acidosis. We report the case of a 53-year-old woman that had an acute haemolytic anemia revealed by abnormally rapid increase of MCV that eventually led to discover G6PD deficiency. As investigation did not identify any common triggering factor, we discuss the involvement of the patient’s acute alcohol consumption in this haemolytic event.

Neurological biomarkers are of great use for clinicians, as they can be used for numerous purposes: guiding clinical diagnosis, estimating prognosis, assessing disease stage and monitoring progression or response to treatment. This field of neurology has evolved considerably in recent years due to analytical improvements in assay methods, now allowing the detection of biomarkers not only in cerebrospinal fluid (CSF) but also in blood. This progress greatly facilitates the repeated quantification of biomarkers, the collection of blood being much less invasive than that of CSF. Among the various informative biomarkers of neurological disorders, neurofilaments light chains (NfL) have proven to be particularly attractive in many contexts, in particular for the diagnosis and prognosis of neurodegenerative diseases (which this review will present), but also in other contexts of neurological disorders (which will be detailed in part 2). We further address the added value of NfL compared to other biomarkers commonly used to monitor the diseases described in this review.

Background: Increasing evidence shows that genetic and environmental factors can influence neovascular age-related macular degeneration (nAMD) risk. The aim of this study was first to analyse the association of insertion/deletion polymorphism in VEGF gene and environmental factors with the risk of nAMD, and then to investigate whether these factors have an impact on the age of onset of nAMD in a sample of the Algerian population.

Methods: Seventy two patients with nAMD and one hundred twenty-four controls were recruited; standardized questionnaire was used to collect information regarding underlying systemic diseases and important environmental factors. Genotyping of VEGF (I/D) SNP was conducted using PCR-based assay approach, and statistical analyses were conducted using IBM SPSS statistics 21.

Results: A significant association was reported of age (p < 0.05), smoking (p = 0.02), alcohol (p < 0.01), hypertension (p = 0.04), hyperlipidaemia (p = 0.008) and thyroid disease (p = 0.03) with nAMD. Also, Thyroid disease may have a role in accelerating the development of nAMD in an earlier age in our sample (p < 0.001). No association was found between the VEGF – 2549 I/D genotype and the presence of nAMD (p = 0.27), neither with the age of onset of nAMD (p = 0.21).

Conclusion: Our results suggest that age, smoking, alcohol, hypertension, hyperlipidaemia and thyroid diseases are possible risk factors that could increase the risk of nAMD in a sample of Algerian population. In addition, VEGF – 2549 I/D might not be associated with the risk of nAMD development. Finally, thyroid disease may accelerate the development of nAMD in an earlier age.

Abnormal elevation of thyroid antibodies in the CSF is observed in 62-75% of Hashimoto's encephalopathy cases. However, the relationship between CSF thyroid antibody levels and response to therapy has been poorly evaluated. We report the case of a 68-year-old man with Hashimoto's encephalopathy, in whom there was a relation between the favorable clinical outcome and the disappearance of antithyroid antibodies from the CSF and a decrease in serum thyroid antibodies.

Primary plasma leukemia is defined by the presence of more than 20% plasma cells in the peripheral blood or number of circulating plasma cells greater than 2G/L. It has points in common with multiple myeloma and has certain characteristics, in particular its aggressiveness and poor prognosis. Through 02 cases diagnosed in the flow cytometry laboratory, the authors present the clinical, cytological and especially immunophenotypic features of this disease, with the emphasis on the role of flow cytometry in the diagnosis.