Annales de biologie clinique最新文献

A 65-year-old man with a history of sequelae from strokes and aspiration pneumonia was hospitalized for a new episode of pneumococcal pneumonia. In the emergency department, laboratory tests revealed severe hypernatremia associated with multiple other biological abnormalities, followed by a sudden normalization of serum sodium levels.

The diagnosis of B- and T-cell lymphomas relies on a multidisciplinary approach that combines morphological, immunological (via flow cytometry - FCM), and genetic analyses. The integration of cytological evaluation from tissue biopsy imprints with FCM enables rapid diagnostic orientation, which is valuable for guiding further complementary investigations. This atlas illustrates the main types of B- and T-cell lymphomas using cytology images, FCM data, and histological analyses derived from lymph node and splenic samples. The FCM profiles were established using routinely employed antibody panels. While results may show slight variations depending on the cytometer settings and fluorochromes used, they remain generally comparable across different instruments. An orientation panel consisting of 16 antibodies is used for the initial classification of lymphomas, with specific markers allowing for subsequent assessment of antigen expression according to cell type and pathological context. The combined study of cytological and histological features provides an integrated perspective of lymphoid pathology.

Malaria is a major public health issue in Niger. This study aims to provide information on the therapeutic efficacy of antimalarials, specifically focusing on artemether-lumefantrin (AL) in children aged 5 to 15 years in Aderbissinat, Aguié, and Baban Tabki. To evaluate the therapeutic efficacy of AL in children in the specified regions. The study was conducted from August 26 to October 25, 2022, using the standard WHO/2015 28-day follow-up method. Biological confirmation was done using rapid diagnostic tests (RDT) and microscopy, while PCR was used to distinguish between reinfections and recrudescences. Out of 352 suspected malaria patients, 263 were included in the study. There were 5 lost to follow-up, 1 voluntary withdrawal, and 3 protocol violations. The malaria prevalence was 92%, with an average parasite density of 42,606 P/μL and a sex-ratio of 1.02. The overall adequate clinical and parasitological response (ACPR) after PCR correction was 97.25%, with 100% in Aderbissinat and Aguié, and 90% in Baban Tabki. No major adverse events were recorded. The results support the use of AL for the treatment of uncomplicated malaria as per the National Malaria Control Program (NMCP).

The latest international recommendations advocate for the measurement of cardiac troponin (cTn) in the context of acute coronary syndrome (ACS) with a result turnaround time of less than 1 or 2 hours. To establish a national overview of organizational practices and turnaround times for these measurements. Two surveys targeting emergency physicians and biologists described the qualitative and quantitative organizational data of cTn measurement. 27 hospitals with an annual number of visits totaling 35,000 [28,700-55,500], with 8.5% of patients presenting with chest pain and 0.9% with ACS. The satisfaction rate of emergency physicians regarding the turnaround time is 27%, and 50% wish to see it reduced. Quantitatively, 74,112 troponin requests were analyzed, 33% of which were performed during on-call periods. Cardiac cTnT represents 70% of the measurements, and 98 % of the methods are highly sensitive. The median pre-registration time is 19 minutes [10-35], laboratory-processing time is 55 minutes [42-82], and overall turnaround time is 81 minutes [60-121]. The turnaround time is shorter when there is a connected prescription or an expert system for biological validation (p < 0.0001). The turnaround times for troponin results are on average >1 hour. For most laboratories (83 %), the turnaround time is in line with European recommendations allowing the application of an H0-H2 algorithm.

An 86-year-old woman is monitored for IgA λ-associated multiple myeloma, treated in second intention with dexamethasone, revlimid and daratumumab after a relapse. A control serum protein electrophoresis detects the presence of a new monoclonal spike, later confirmed by immunofixation as an IgG κ. Suspecting an interference due to the immunotherapy, a daratumumab specific immunofixation reflex assay (DIRA) is performed, with the addition of anti-daratumumab antibodies, confirming the interference. A second multiple myeloma case is presented, describing interference with daratumumab co-migrating with the original monoclonal immunoglobulin. Based on these cases, we propose an algorithm of action to confirm the interference and provide an accurate biological result consistent with the therapeutic and clinical context.

To explore the relationship between early coagulation changes, cerebral hemodynamics, and neurological prognosis in acute ischemic stroke (AIS) patients with rheumatoid arthritis (RA). Seventy-two AIS patients with RA were included. Coagulation markers (PT, APTT, FIB) and transcranial Doppler ultrasound (TCD) assessments of middle cerebral artery (MCA) mean velocity (Vm) and pulsatility index (PI) were measured at baseline and after 14 days of treatment. Prognosis was evaluated using the modified Rankin Scale (mRS) at 3 months, dividing patients into good (mRS ≤ 2) and poor prognosis (mRS > 3) groups. Multivariate logistic regression and ROC analysis assessed the predictive value of coagulation and hemodynamic changes for adverse outcomes. After 14 days, APTT and MCA (PI) increased, while FIB decreased in both groups (P < 0.05). The good prognosis group had higher MCA Vm and lower FIB at baseline (P < 0.05). Independent risk factors for poor prognosis included diabetes, NIHSS score ≥ 8, FIB, and MCA (Vm, PI) (P < 0.05). ROC analysis showed combined FIB, Vm, and PI had better predictive value for poor outcomes. Early hypercoagulable state and suboptimal cerebral hemodynamics are associated with poor neurological outcomes in AIS with RA.

Thrombin is one of the key components of the hemostatic system. The thrombin generation assay (TGA) assesses the activation, propagation and inhibition of coagulation. This global coagulation test is of interest for assessing the risk of bleeding and thrombosis. Numerous studies have been performed in the "thrombophilia". We performed a systematic review of studies on thrombinography in thrombophilia. The included studies, published in English, were original investigations using TGT during venous thromboembolic disease, arterial occlusive pathology, pregnancy, anti-phospholipid syndrome, constitutional thrombophilias, or oncology. Eighty studies were selected between January 2003 and June 2022. Most had fewer than 100 patients. The only two studies that included more than 1000 patients showed an increased risk of thrombotic recurrence or increased mortality from cardiovascular disease associated with increased thrombin generation. All "thrombophilia" have been studied, but lack of standardization between conditions has limited the development of clinical research with this assessment technique. Harmonization of practices may provide more relevant systems for predicting the occurrence of arterial or venous thrombotic events.

A woman pregnant with her first child, blood group B+, showed pan-agglutination on antibody identification panels during her pregnancy follow-up. The absence of agglutination between the patient's plasma and a panel of B-phenotype red blood cells led to the conclusion of the presence of an anti-H1I1. This antibody is not thought to be responsible for fetal anemia or neonatal hemolytic disease, thus follow-up of fetal anemia is not necessary. However, in the event of transfusion, prior compatibility with blood of the same ABO group is necessary. In emergencies, group O depot blood should not be used whenever possible.