Annales de biologie clinique最新文献

The reliability of HbA1c test results is essential for the screening, diagnosis, and monitoring of diabetes. The objective of our study was to evaluate the analytical performance of HbA1c testing on the HLC®-723 G11 Tosoh analyzer, as well as the impact of the absence of a sample homogenization system prior to analysis on the stability of results. The analytical performance verification protocol was developed with reference to the recommendations of the Clinical and Laboratory Standards Institute and the SH 04 guide of the French Accreditation Committee. Repeated measurements were performed on samples at the following times: initial (T0), 30 minutes, 1 h, 2 h, 3 h, 4 h, 5 h, and 6 h, without prior homogenization. Biases were calculated and compared to the acceptability limits defined by Fraser. The coefficients of variation (CV) for repeatability and intermediate precision, as well as inaccuracy, were below the limits set by the French Society of Clinical Biology and the European Federation of Clinical Chemistry and Laboratory Medicine. The contamination rate was 0.05%. An excellent correlation between HLC®-723 G11 and Capillarys Octa3® was observed, both with and without a hemoglobin variant, with R² = 0.99 and R² = 0.97, respectively. HbA1c results were stable for up to 6 hours in the absence of a stirring system. The analytical performance of the HLC®-723 G11 analyzer was verified, allowing its routine use for HbA1c testing.

Pheochromocytoma with ectopic ACTH secretion is very unusual. The diagnosis is difficult. This case report illustrates the necessity of a thorough endocrinological investigation. In this case, normalization of biological result just after tumorectomy has confirmed the diagnosis. In addition, diagnosis needs also medical imaging and eventually immunostaining on resected tumor. Clinical symptoms and biological results presentation are more serious than pheochromocytoma without ACTH secretion or than Cushing disease. In this kind of situation, the removal of tumor remains the main treatment and a symptomatic treatment has to be initiated before surgery.

We report a case of pseudohyperphosphatemia in a patient with multiple myeloma that progressed to plasma cell leukaemia. This pseudohyperphosphatemia was caused by an analytical interference between monoclonal immunoglobulin and ammonium molybdate, a reagent used for measuring inorganic phosphate. Accurate measurement of blood inorganic phosphate levels requires prior protein precipitation to eliminate assay interference. Extrarenal purification treatments helped reduce the monoclonal immunoglobulin concentration and eliminated the interference during phosphate measurement. Pseudohyperphosphatemia is a rare event that can lead to inappropriate and harmful medical management for affected patients; thus, prompt recognition by clinical biologists is crucial to avoid misdiagnosis and inappropriate interventions. This case report also provides an opportunity to do a brief review of the literature and to remind some recommendations and actions to take into consideration in the presence of discrepancies between the clinic and the biology.

The arrival of AI in medical biology is inevitable, and in many ways these tools are already in use in our laboratories. Given this observation, it was determined that it was imperative for the French Society of Clinical Biology to offer a set of resources to enable medical biologists to master these new tools by understanding their complexity and the risks inherent in using such powerful but obscure tools. The "Clinical Biology and Artificial Intelligence" workgroup was created to meet this need. Beginning with a user survey to identify needs, we will eventually offer a set of educational content, guidelines, checklists, and practical guides to facilitate the successful integration of AI tools and their long-term monitoring in medical biology laboratories.

Screening for hepatitis C virus (HCV) infection relies on detecting total anti-HCV antibodies through an enzyme-linked immunosorbent assay (ELISA) performed on a single serum sample. However, in population with low seroprevalence, this one-step approach may lack specificity, leading to false-positive results. A low ELISA ratio combined with negative viremia can raise concerns about either a resolved infection or a non-specific result. The aim of our study was to assess the added value of HCV immunoblot testing in clarifying the serological status of patients without known risk factors for infection when a low ELISA ratio and no detectable viremia is retrieved. We retrospectively reviewed the risk factors of 176 non-viremic individuals with low-positive HCV screening results. An immunoblot was performed on samples from 50 individuals with no documented risk factors for HCV infection. The majority of immunoblot tests (36/50) were negative, while a smaller proportion were indeterminate (8/50) or positive (6/50), including cases with very low ratios close to 1. When used selectively, the HCV immunoblot can resolve ambiguities sometimes generated by the enzyme immunoassay.

Cluster headache (CH) is a severe and disabling headache disorder generally considered as the greatest level of physical pain a person can experience. Despite the significant range of -therapeutic and pharmacological options available, the intense pain the patient endures is poorly controlled. In this way, drugs misuse and illicit substances use, notably amphetamines is widely reported in patient with cluster headache. We herein describe a case of addiction to cocaine and other drugs in a patient with cluster headache following intranasal treatment with Bonain anesthetic mixture, a compounded preparation including cocaine and still used in some european countries. Cocaine misuse was confirmed by the clinical observations and the use of toxicological screening using liquid chromatography on urines. This last one highlights the presence of cocaine and its metabolites (benzoylecgonine, anhydroecgonine, ecgonine, ecgonine methylester, norbenzoylecgonine) and some other drugs the patient used to misuse (cyamemazine, codeine). In blood, the concentrations of cocaine, benzoylecgonine and ecgonine methylester were 2.5 ng/mL, 149.3 ng/mL and 6.5 ng/mL respectively. These results are consistent with a misuse of cocaine due to the benzoylecgonine high concentration and the absence of phenol and menthol, the other compounds of the Bonain anesthesic mixture. This case highlights the importance of performing toxicological monitoring in CH patients, particularly among those who have an increased risk of addictological behavior.

In a context where public procurement of biomedical equipment increasingly includes environmental criteria, this article presents a 2025 overview of sustainable development commitments among major suppliers of in vitro diagnostic (IVD) medical devices, specifically in biochemistry, hematology, and hemostasis. Through interviews and document analysis, the study evaluates suppliers' initiatives based on ISO 14001 (environmental management), ISO 50001 (energy performance), and carbon footprint assessments. Many companies report ISO certifications and concrete actions: carbon footprint reduction, energy optimization (renewables, Light-Emitting Diode (LED), solar panels), water stewardship, and waste recycling. The analysis reveals that sustainability criteria are often underweighted in tenders compared to financial ones. The article offers recommendations to strengthen environmental requirements in hospital purchasing, such as requiring tangible proof of certifications and measurable outcomes. Emphasis is also placed on incorporating scopes 1, 2, and 3 in carbon footprint reports, aligning with recent French legislation. This integration is presented as a key driver for the ecological transition in healthcare. The article advocates for better-structured CSR strategies across the IVD sector, encouraging companies to align with the United Nations Sustainable Development Goals (SDGs) and adopt a more holistic and measurable approach to environmental responsibility.