Annales de biologie clinique最新文献

The STA R Max3 (Stago, France) and Cobas t511 (Roche Diagnostics, Germany) are two automated hemostasis analysers that can be used to perform a wide range of tests. The STA R Max3 uses a mechanical clot detection system to measure coagulation times, while the Cobas t511 uses optical detection. The aim of this study was to compare the analytical performance of these two analysers using fresh plasma samples with or without a risk of interference due to hemolysis or lipemia. For plasma samples without interference, acceptable agreement was observed for prothrombin time (PT) (n = 55), activated partial thromboplastin time (APTT) (n = 56), fibrinogen (n = 56) and factor II (n = 43) with R² of 0.907, 0.963, 0.979 and 0.968 respectively. For factor V (n = 43) and D-dimers (n = 45), agreement was less acceptable, with respective R² of 0.756 and 0.887, but with no clinical impact. For hemolysed samples, acceptable results were observed for PT, fibrinogen and D-dimers, but three results were clinically discordant for APTT, and STA R Max3 offered greater robustness for processing highly lipemic samples.

Neurocryptococcosis is a severe neurological complication of Cryptococcus neoformans infections, primarily affecting immunocompromised individuals. This report describes the case of a 53-year-old man with no known medical history who experienced severe headaches and vomiting while on a business trip to Pakistan. He was given preventive antibiotic therapy, followed by a combination of sulfamethoxazole and trimethoprim for suspected toxoplasmosis. The patient's condition initially improved and he was discharged from the hospital, but later experienced a recurrence of symptoms and sought emergency care. The diagnosis of neurocryptococcosis was confirmed through various biological tests, including flow cytometry. Treatment with Amphotericin B and 5-Fluorocytosine was initiated. Further testing revealed significant CD4+ T-cell lymphopenia, which was attributed to sarcoidosis-like systemic granulomatosis. This case presents an atypical clinical manifestation, with the abrupt onset of an opportunistic infection in a patient without any known immunosuppression.

Blastic plasmacytoid dendritic-cell neoplasm (BPDCN) is an extremely rare disease that originates from dendritic cells, characterized by co-expression of CD4 and CD56 without any other lineage-specific markers. It is associated with a poor prognosis. Previously, it was referred to by several names, including blastic NK-cell lymphoma, agranular CD4+ natural killer cell leukemia, and agranular CD4+CD56+ hematodermic neoplasm. The various nomenclatures and its evolution reflect the uncertainty of its histogenesis and the challenges involved in describing this hematopoietic neoplasm. Diagnosis challenge is due to similarities with CD4+CD56+ acute myeloid leukemia (AML) and histiocytic sarcoma (HS) immunophenotypic and histopathological features. We report a case of a 42-year-old male who presented with skin lesions and pancytopenia. While biologists suspected the diagnosis of BPDCN or CD4+ CD56+ AML based on the flow cytometry (FCM), anatomic pathologists retained the diagnosis of HS. The patient didn't respond to a systemic combination chemotherapy regimen and passed away rapidly. BPDCN diagnosis requires careful and exhaustive analyses in order to formulate the most appropriate therapeutic plan and to improve its prognosis.

The single-specimen pneumatic tube (PTS) is a commonly used rapid specimen delivery system in modern clinical laboratories. However, its impact on sample integrity and laboratory test results remains controversial. The installation and configuration of single-specimen PTS are unique to their institution. We sought to validate our single-specimen PTS by comparing routine chemistry, immunology, and hematology results with a repeat sample integrity index for manual transport. In 2023, 30 employees were randomly selected from the company medical examination, and three tubes of procoagulant serum samples and three tubes of EDTA anticoagulant blood samples were collected from each of them. Group A uses a single specimen PTS at 8 m/s, Group B uses a single specimen PTS at 15 m/s, and Group C uses manual transfer. Specimens from all three groups were simultaneously analysed for ALT, AST, TG, TC, LDL, K, NA, CI, TSH, hs-cTnT, NSE, Cyfra21-1 and haematological analysis. The differences between the three groups of NSE and Cyfra21-1 were statistically significant (P < 0.05). The differences of the rest of the items were not statistically significant. The difference in NSE was not statistically significant between groups A and B (P = 0.401), B and C, and C and A (P < 0.05). The difference in Cyfra21-1 was not statistically significant between groups A and B (P = 0.897), B and C (P = 0.052), and C and A (P = 0.145). Individual sample PTS should be validated for testing prior to use to ensure the results' accuracy.

Adrenal insufficiency secondary to opioid use remains inadequately acknowledged in medical literature. We present the case of a 33-year-old female patient diagnosed with central adrenal insufficiency (CAI), where methadone use was identified as the underlying cause after ruling out known etiologies. This article aims to enhance awareness among prescribing clinicians and medical professionals regarding the potential occurrence of AI in patients undergoing methadone treatment. This is especially pertinent given the widespread utilization of methadone in France for managing drug withdrawal.

Laboratory medicine plays a crucial role in patient care, contributing to approximately 70 % of clinical decisions. In collaboration with clinicians, laboratory medicine specialists perform analyses that are useful for diagnosis, screening and prevention. Laboratories are known for their efficiency, which is reached through a rigorous quality system. However, errors can occur, especially given the complexity of the total testing process. These errors may lead to severe consequences, such as incorrect diagnoses or delays in treatment. Errors can occur at every stage of the total testing process, those related to the pre-analytical phase being the most prevalent. To reduce medical errors related to laboratory processes, it is essential to provide training for medical and paramedical staff, optimize production automation, and leverage technological advancements. These considerations have led to the creation of a French Working Group on Sources of Errors in Laboratory Medicine, under the aegis of the French lean society of clinical chemistry and laboratory medicine (Société Française de Biologie Clinique - SFBC). The objectives of this working group are to produce an educational handbook on sources of errors in laboratory medicine, provide training for clinical chemists, and conducting applied research projects to better understand the mechanisms behind specific errors. Ultimately, the aim is to minimize errors and enhance the quality of laboratory tests.

Determine the epidemiological characteristics of urolithiasis in the South region of Tunisia and the impact of age and sex on stone composition. We conducted a retrospective study including patient records whose urinary lithiasis was analyzed within the biochemistry department of CHU Habib Bourguiba of Sfax (2011-2020). Stone analysis was performed using a stereomicroscope and infrared spectroscopy. A total of 1127 stones were analyzed. The sex ratio was 2,6. Renal Colic pain was the most common symptom (48,3%). The most frequent localization of the stones (84.6%) was the upper urinary tract. Whewellite was the most common component (64.1%). The study of stone component according to age showed a decrease in the frequency of weddellite (p = 0,024) and an increase in the frequency of uric acid stones with age (p < 0,001). Whewellite was more frequent in men (p = 0.022) and, notably in our series, uric acid was significantly more frequent in women (p < 0.001). The epidemiological profile of urolithiasis in south of Tunisia is similar to that observed in industrialized countries.

The assessment of von Willebrand factor (VWF) multimer distribution, particularly following the implantation of circulatory support devices, is a crucial parameter in hemostasis. Our study aimed to evaluate the semi-automated quantification of VWF multimers using the Sebia Hydrasys analyzer. Our analysis focused on quantifying high molecular weight, intermediate weight, and low molecular weight VWF multimers. Electrophoretic migration was performed using the Hydrasys 2 scan, and interpretation was carried out using densitometric analysis with the Phoresis software. The Hydrasys scan 2 successfully separated all the expected VWF multimer profiles based on the type of von Willebrand disease. The analysis revealed that in patients with circulatory support devices, elevated levels of plasma VWF rendered multimer migration unanalyzable using the methodology recommended by the manufacturer. Therefore, adjustment to a 100 % VWF antigenic level improved gel precision. We also suggest using as a standardized control the Cryocheck™ plasma, and have established reference values. Overall, this semi-automated, standardized, and optimized VWF multimer analysis system allows for an effective assessment of the VWF multimeric profile.

The susceptibility modules and characteristic genes of patients with osteoarthritis (OA) were determined by weighted gene co-expression network analysis (WGCNA), and the role of immune cells in OA related microenvironment was analyzed. GSE98918 and GSE117999 data sets are from GEO database. R language was used to conduct difference analysis for the new data set after merging. The formation of gene co-expression network, screening of susceptibility modules and screening of core genes are all through WGCNA. GO and KEGG enrichment analyses were used for Hub genes. The characteristic genes of the disease were obtained by Lasso regression screening. SSGSEA was used to estimate immune cell abundance in sample and a series of correlation analyses were performed. WGCNA was used to form 6 gene co-expression modules. The yellow-green module is identified as the susceptible module of OA. 202 genes were identified as core genes. Finally, RHOT2, FNBP4 and NARF were identified as the characteristic genes of OA. The results showed that the characteristic genes of OA were positively correlated with plasmacytoid dendritic cells, NKT cells and immature dendritic cells, but negatively correlated with active B cells. MDSC were the most abundant immune cells in cartilage. This study identified the Hippo signaling pathway, mTOR signaling pathway, and three characteristic genes (RHOT2, FNBP4, NARF) as being associated with osteoarthritis (OA). These three genes are downregulated in the cartilage of OA patients and may serve as biomarkers for early diagnosis and targeted therapy. Proper regulation of immune cells may aid in the treatment of OA. Future research should focus on developing tools to detect these genes and exploring their therapeutic applications.