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Laboratory Medicine

Gurmukh Singh
Background: Concentration of serum free light chains has been promoted as an assay in the evaluation of monoclonal gammopathic manifestations. A high false-positive rate in patients without monoclonal gammopathic manifestations and a high false-negative rate in patients with those manifestations have been reported. The false-negative rate for lambda chain-associated lesions is higher than that for kappa chain-associated lesions. Objective: To assess the serum free light chains in light-chain myelomas...
November 13, 2018: Laboratory Medicine
Xiaofeng Mu, Wen Chen, Junying Shi, Xinmin Li, Ye Wang
Objective: To develop a multiplex quantitative polymerase chain reaction (qPCR) assay based on the GenomeLab™ GeXP Genetic Analysis System (GeXP) for detection of long noncoding RNA in hepatocellular carcinoma (HCC). Methods: From PubMed database articles published between 2011 and 2016, we selected 8 kinds of long noncoding RNAs (lncRNAs) related to HCC. Further, we examined 23 pairs of HCC and adjacent noncancerous tissues, using the optimized GeXP multiplex reverse transcription polymerase chain reaction (RT-PCR) assay...
November 13, 2018: Laboratory Medicine
Donald Turbiville, Xiaotang Du, Jacob Yo, Bagi R Jana, Jianli Dong
Hereditary hemochromatosis (HH) is an autosomal recessive disorder of iron metabolism characterized by increased iron absorption and tissue deposition. Three loss-of-function mutations in the hemochromatosis gene (HFE), namely, C282Y (c.845G>A), H63D (c.187C>G), and S65C (c.193A>T), account for the vast majority of HH cases. These mutations cause alterations in HFE membrane expression, structure, and/or activity, leading to dysregulation of iron absorption. It is well established that the phenotypic expression of HFE mutations varies markedly...
October 18, 2018: Laboratory Medicine
Vani Chandrashekar, Anil Tarigopula
Platelet distribution width (PDW) and mean platelet volume are markers of platelet activation and have prognostic value in coronary heart diseases, as well as in cancers of solid organs. In this study, we evaluated the possibility of using PDW to predict chronic myeloproliferative neoplasms by comparing platelet indices obtained by automated analyzers in chronic myeloproliferative neoplasms with those in control specimens. We found that PDW greater than 66.4% has specificity of 99% and likelihood ratio of 19...
October 17, 2018: Laboratory Medicine
Christopher M Lehman, Lauren Pearson, Jennifer Salmond, Kalani Raphael, Robert L Schmidt
Background: The Jaffe and enzymatic methods are the 2 most common methods for creatinine measurement. The Jaffe method is less expensive but subject to interferences. Some laboratory scientists have called for the Jaffe method to be retired. Objective: To determine the most cost-effective and safe protocol for creatinine measurement. Method: We performed a retrospective database review of all outpatient creatinine measurements for 1 year, testing the risk-based reflex testing protocol we had implemented for creatinine measurement...
October 17, 2018: Laboratory Medicine
Zhenjing Shi, Ya Luo, Minghui Zhu, Yu Zhou, Bingru Zheng, Daoyi Wu, Shuting Wang, Xiangbang Xie, Heping Lin, Xixiang Yu
Objective: To determine the clinical relevance of long noncoding RNA (lncRNA) HAR1A and HAR1B expression in hepatocellular carcinoma (HCC). Methods: In this study, we enrolled 50 cases of chronic hepatitis B (CHB) without cirrhosis, 50 cases of CHB and liver cirrhosis (LC), and 100 cases of HBV and HCC. The expression profiles of lncRNA HAR1A and HAR1B were analyzed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results: The expression levels of HAR1A and HAR1B were significantly lower in the HCC group, compared with the CHB and LC groups (P <...
October 9, 2018: Laboratory Medicine
Pei-Chin Lin, Tai-Tsung Chang, Yu-Mei Liao, Shih-Pien Tsai, Yen-Chu Chen, Wan-Yi Hsu, Hsiu-Lan Su, Yu-Sheng Zeng, Yu-Hsin Tseng, Shyh-Shin Chiou
Background: The genetic background of patients with hemoglobin (Hb) H disease in Taiwan has been investigated; however, the clinical features and treatment outcomes were not reported. Objective: To analyze the clinical features and genotypes of patients with HbH who reside in Taiwan. Methods: We conducted a retrospective analysis of the clinical and molecular characteristics of 38 patients with HbH disease who were undergoing treatment at Kaohsiung Medical University Hospital, Taiwan...
October 5, 2018: Laboratory Medicine
Magdalena Krintus, Jon Ardanza Fernandez, Christine Chesters, Rossana Colla, Clare Ford, Daniele Frattolillo, Ursula Köller, Jacques Mairesse, Daniel Martinez Jimenez, Jérôme Motol, Kevin Padmore, Hayley Sharrod-Cole, Grazyna Sypniewska
Background: Early access for routine testing with the Alinity c clinical chemistry system (Abbot Laboratories) presented the opportunity to characterize the analytical performance of multiple analytes across clinical laboratories in Europe. Methods: A total of 8 laboratories from 7 European countries evaluated 10 high-volume chemistry assays on the Alinity c system for imprecision, linearity, and accuracy by method comparison to the routine ARCHITECT (Abbott Laboratories) method...
September 24, 2018: Laboratory Medicine
Sakorn Pornprasert, Monthathip Tookjai, Manoo Punyamung, Kanyakan Kongthai
Objective: To establish a simple formula to be used for discrimination between β-thalassemia/hemoglobin E (β-thal/HbE) and homozygous hemoglobin (Hb)E in specimens with absent hemoglobin (Hb)A, HbE of greater than 75%, and HbF between 5% and 15%. Methods: We analyzed laboratory results from February 2015 through February 2018. Molecular analysis for diagnosis of β-thal mutation and HbE was performed in specimens that contained HbE of greater than 75% and HbF from 5% to 15%, as measured by high-performance liquid chromatography (HPLC)...
September 18, 2018: Laboratory Medicine
Kyung-Hwa Shin, Hyun-Ji Lee, Duyeal Song, Sun-Min Lee, In Suk Kim, Hyunghoi Kim, Eu Jeen Yang, Kyung-Hee Park
Background: Hyperbilirubinemia, which is a sign of hemolytic disease of the newborn (HDN), can irreversibly damage the central nervous system. Objectives: To determine the etiology of HDN in affected patients and characterize the changing pattern of bilirubin using direct antiglobulin testing (DAT). Methods: We collected clinical data from newborns who underwent perinatal DAT and from their mothers, between August 2008 and July 2017. Results: Among 303 neonates, 37 (12...
September 6, 2018: Laboratory Medicine
Jeffrey S Mohlman, Jonathan R Genzen, Ronald L Weiss, Robert L Schmidt
Objectives: To determine whether different laboratory developed test (LDT) risk stratification proposals would assign differing levels of risk to selected LDTs as a measure of the validity of those proposals, and whether there would be differing interrater agreement rates as a measure of the reliability of those proposals. Methods: A total of 4 reviewers applied 6 proposals for risk stratification of 4 LDTs. Interrater agreement was calculated as a measure of the reliability of the proposals...
August 29, 2018: Laboratory Medicine
Sen Wang, Xian Wang, Shengnan Tang, Yuxin Chen, Jia Jia, Junhao Chen, Han Shen, Bing Bai
Background: The sensitivity of the commonly used immunochromatographic fecal occult blood test (iFOBT) is critical in the routine screening of digestive tract cancers. Objective: To determine whether the performance of the iFOBT might be improved by optimizing detergents and buffers in stool solution. Methods: We tested different buffers and detergents in stool solution. The specificity of the new solution condition was confirmed by dot immunoblotting...
August 28, 2018: Laboratory Medicine
Austin Adams, Joely A Straseski, Christopher M Lehman, Lauren N Pearson
Background: Chemistry testing is requested for body fluid (BF) specimens despite the lack of assays approved by the US Food and Drug Administration (FDA). The criteria for categorizing fluids as transudate or exudate are not validated across analyzers. Objective: To compare BF chemical analysis and classification by different analyzers. Methods: We analyzed 10 pleural and 18 peritoneal fluids with corresponding plasma specimens using the Vitros 5,1 FS; Abbott ARCHITECT ci8200; and Roche Modular P platforms...
August 24, 2018: Laboratory Medicine
Elizabeth M Staley, Sierra C Simmons, Alexander Z Feldman, Lance A Williams, Huy P Pham
Heparin-induced thrombocytopenia (HIT) is a not-uncommon adverse effect of heparin exposure, with potentially serious and/or fatal thrombotic consequences. Recent studies looking at the off-label use of fondaparinux for HIT show similar efficacy and adverse-effect profiles, as well as improved costs, compared with some commonly used direct thrombin inhibitors. Although routine laboratory monitoring of fondaparinux-specific anti-Xa levels typically is not recommended, we present a case report that suggests fondaparinux monitoring may be needed in patients with hepatic impairment causing acquired antithrombin deficiency...
August 24, 2018: Laboratory Medicine
Roger L Bertholf, Pietro Ghezzi
No abstract text is available yet for this article.
October 11, 2018: Laboratory Medicine
Ashwin S Akki, Sun M Chung, Bryan J Rudolph, Michelle R Ewart
Background: We describe the differential diagnosis of an obese 12-year-old boy of Mexican origin who presented with a 6-year history of abnormal lipid profile and elevated liver transaminase levels. Methods: The patient underwent routine clinical testing, an abdominal ultrasound and, ultimately, a liver biopsy. Based on the histologic findings, a serum leukocyte lysosomal acid lipase (LAL) assay and DNA sequencing of the lipase A (LIPA) gene were performed. Results: Liver biopsy revealed diffuse microvesicular steatosis with clusters of foamy histiocytes in the lobules and portal areas...
October 11, 2018: Laboratory Medicine
Rekha Gautam, Joo-Yeun Oh, Marisa B Marques, Richard A Dluhy, Rakesh P Patel
Background: The therapeutic efficacy and safety of stored red blood cells (RBCs) relies on minimal in-bag hemolysis. The accuracy of current methods of measuring hemolysis can suffer as a result of specimen collection and processing artefacts. Objective: To test whether Raman spectroscopy could be used to assess hemolysis. Methods: RBCs were stored for as long as 42 days. Raman spectra of RBCs were measured before and after washing, and hemolysis was measured in supernatant by visible spectroscopy...
October 11, 2018: Laboratory Medicine
Nipaporn Deejai, Suwannee Wisanuyotin, Choochai Nettuwakul, Sookkasem Khositseth, Nunghathai Sawasdee, Kiattichai Saetai, Pa-Thai Yenchitsomanus, Nanyawan Rungroj
Background: Two common mutations of the solute carrier family 4 member 1 (SLC4A1) gene, namely, Southeast Asian ovalocytosis (SAO) and band 3 Bangkok 1 (G701D), cause autosomal recessive distal renal tubular acidosis (AR dRTA) in ethnic Southeast Asian populations. In this study, we applied the high-resolution melting (HRM) method for screening of AR dRTA associated with SLC4A1 mutations in 10 new patients with unknown cause(s) of AR dRTA. Methods: We analyzed SAO and G701D mutations in the patients and their family members using HRM...
August 17, 2018: Laboratory Medicine
Ishwarlal Jialal, Richa Singh
Allergy to insulin occurs in approximately 2% of patients treated with insulin. However, major guidelines fail to emphasize this serious adverse effect. In this article, we report on a 61 year old ethnic Filipino man who developed urticaria and pruritus with a swollen tongue, which necessitated a visit to the emergency department. His clinical diagnosis was confirmed by a high titer of anti-insulin antibodies. His condition was successfully managed by discontinuing insulin and by treatment with oral hypoglycemic agents, with no additional adverse reactions...
August 17, 2018: Laboratory Medicine
Zahra Sepehri, Zohre Kiani, Farhad Kohan, Saeid Ghavami
Objective: To review the main Mycobacterium tuberculosis (Mtb) pathogen-associated molecular patterns (PAMPs) and the roles played by toll-like receptor (TLR)4 in determination of Mtb infection outcome. Methods: Several scientific databases, including Scopus, PubMed, and Google Scholar, were used for searching appropriate research articles from the literature for information on our topic. Results: TLR4 plays positive roles in induction of immune responses against Mtb and participates in eradication of the infection...
August 17, 2018: Laboratory Medicine
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