Clinical Laboratory[JOURNAL]
Sun
200 papers
Challenges in the Diagnosis of Hematogenous Disseminated Pulmonary Tuberculosis with Multiple Organ Involvement.
Xie BX, Chen Y, Tan YR … +4 more , Jiang T, Huang MH, Zhu YM, Chen S
Clin Lab · 2026 Apr · PMID 41979623 · Publisher ↗
BACKGROUND: Tuberculosis is a public health problem worldwide, and China is a high-burden country. Hematogenous disseminated pulmonary tuberculosis is one of the most serious forms of tuberculosis, and diagnosing hematog...
BACKGROUND: Tuberculosis is a public health problem worldwide, and China is a high-burden country. Hematogenous disseminated pulmonary tuberculosis is one of the most serious forms of tuberculosis, and diagnosing hematogenous pulmonary tuberculosis is a challenge, even for the most experienced clinicians, who may also feel perplexed. We report a case of hematogenous disseminated tuberculosis involving multiple organs that was initially misdiagnosed as metastatic malignancy. The diagnosis was finally confirmed by metagenomic Next-Generation Sequencing (m-NGS) of peritoneal and pericardial effusions, which detected Mycobacterium tuberculosis complex. METHODS: Appropriate laboratory tests, m-NGS, Chest and abdominal CT, Pericardiocentesis, and Peritoneal puncture. RESULTS: Chest and abdominal CT showed diffuse nodules in both lungs, pericardial effusion, bilateral pleural effusion, and abdominal pelvic effusion. Tuberculosis bacillus antibody was negative, erythrocyte sedimentation rate increased to 42 mm/H, and the carcinoembryonic antigen (CEA) increased to 7.1 ng/mL, peritoneal effusion adenosine deaminase increased to 65.17 U/L, pericardial effusion adenosine deaminase increased to 142.39 U/L. m-NGS of pericardial effusion and peritoneal effusion detected 886,963 M. tuberculosis complex. CONCLUSIONS: Miliary tuberculosis is a severe and rare form of tuberculosis. Delayed diagnosis may be the most important factor leading to death from miliary tuberculosis. We report a case where Mycobacterium tuberculosis was identified through mNGS of pericardial and peritoneal effusions, enabling rapid diagnosis of disseminated tuberculosis. This case provides a new approach for the rapid diagnosis of disseminated tuberculosis.
Diagnostic Aspects of a Bacillus Calmette-Guërin (BCG) Infection Following Intravesical Treatment for Bladder Cancer.
Cha JH, Kim KJ, Yun SG … +3 more , Nam MH, Lee GI, Cho Y
Clin Lab · 2026 Apr · PMID 41979622 · Publisher ↗
BACKGROUND: Bacillus Calmette-Guérin (BCG) infection is a rare complication of intravesical immunotherapy for bladder cancer. Distinguishing Mycobacterium bovis BCG from other Mycobacterium tuberculosis complex members i...
BACKGROUND: Bacillus Calmette-Guérin (BCG) infection is a rare complication of intravesical immunotherapy for bladder cancer. Distinguishing Mycobacterium bovis BCG from other Mycobacterium tuberculosis complex members is crucial due to intrinsic drug resistance. METHODS: We report a case of BCG infection following intravesical immunotherapy and propose three laboratory clues. RESULTS: White, spreading umbonate colony morphology; negative M. tuberculosis protein 64 (MPT-64) antigen test; and nearly identical cycle threshold values for insertion sequence 6110 (IS6110) and internal transcribed spacer targets in real-time PCR strongly suggest BCG infection. CONCLUSIONS: These findings could facilitate the rapid identification of M. bovis BCG and appropriate treatments.
BDNF Exacerbates Visceral Hypersensitivity through Hippocampal TrkB-CRF Signaling in Early-Life Stress.
Zhao H, Chen F, Li B … +3 more , Fu S, Zuo X, Zhang L
Clin Lab · 2026 Apr · PMID 41979621 · Publisher ↗
BACKGROUND: Irritable bowel syndrome (IBS) associated with early-life stress (ELS) commonly manifests as anxiety and visceral hypersensitivity. However, the pathogenic mechanisms underlying these effects are not fully un...
BACKGROUND: Irritable bowel syndrome (IBS) associated with early-life stress (ELS) commonly manifests as anxiety and visceral hypersensitivity. However, the pathogenic mechanisms underlying these effects are not fully understood. This study aims to investigate the role of brain-derived neurotrophic factor (BDNF) as a key mediator of ELS-induced changes through the brain-gut axis. METHODS: A Sprague-Dawley male maternal separation (MS) rat model was used to induce anxiety and visceral hypersensitivity associated with ELS. BDNF levels were measured in the limbic system (cingulate gyrus, amygdala, and hippocampus) and serum. The correlation between BDNF levels, anxiety, and visceral hypersensitivity was analyzed. Corticotropin-releasing factor (CRF) expression in the hippocampus and the extent of visceral hyper-sensitivity were assessed in control, MS, and MS+K252a (a BDNF receptor antagonist) groups. RESULTS: MS rats exhibited higher levels of anxiety and visceral hypersensitivity compared to controls. BDNF production in the hippocampus was elevated in MS rats and positively correlated with anxiety (r = -0.78, p < 0.05) and visceral hypersensitivity (r = 0.93, p < 0.01). CRF expression, a key mediator of stress and visceral hypersensitivity, was also increased in the hippocampus of MS rats. Inhibition of BDNF signaling using K252a reduced CRF expression and alleviated visceral hypersensitivity. CONCLUSIONS: This study demonstrates that BDNF may mediate ELS-induced anxiety and visceral hypersensitivity through hippocampal TrkB-CRF signaling, providing a mechanistic basis for targeting BDNF in stress-related IBS.
B-Acute Lymphoblastic Leukemia Masquerading as Multifocal Langerhans Cell Histiocytosis: a Diagnostic Paradigm Shift.
Xiao D, Liao H, Peng F … +2 more , Wen X, Liu Z
Clin Lab · 2026 Apr · PMID 41979620 · Publisher ↗
BACKGROUND: This report describes a diagnostically challenging case of B-cell acute lymphoblastic leukemia (B-ALL) perfectly mimicking multifocal Langerhans cell histiocytosis (LCH), revealing a critical diagnostic pitfa...
BACKGROUND: This report describes a diagnostically challenging case of B-cell acute lymphoblastic leukemia (B-ALL) perfectly mimicking multifocal Langerhans cell histiocytosis (LCH), revealing a critical diagnostic pitfall in pediatric oncology. METHODS: A 6-year-old girl presented with progressive back pain. MRI showed multilevel vertebral collapse (T11-L2) with classic LCH features, while PET-CT revealed disseminated hypermetabolic bone lesions (SUVmax 2.7). Comprehensive pathology included immunohistochemistry (CD79a, TdT, CD1a, Langerin) and next-generation sequencing. RESULTS: Despite typical LCH imaging, immunohistochemistry demonstrated CD79a⁺/TdT⁺ B-lymphoblasts without CD1a/Langerin expression. Molecular analysis identified a pathogenic KRAS p.Gly13Asp mutation (VAF 1.5%), confirming B-ALL. This represents the first molecularly confirmed case of KRAS-mutated B-ALL mimicking LCH radiographically. CONCLUSIONS: This case mandates: 1) routine TdT staining for LCH-like lesions, 2) recognition of KRAS-driven osteolysis as a novel B-ALL mechanism, and 3) implementation of molecular profiling in atypical osteolytic cases. It highlights the need for integrated diagnostic approaches combining imaging, pathology, and molecular techniques in pediatric bone lesions.
A False Positive HIV Confirmatory Test Result in Pregnancy and its Impact on Patient Management and Outcome.
Kadkhoda K, Alvarez B, Simeone J … +1 more , Guidosh H
Clin Lab · 2026 Apr · PMID 41979619 · Publisher ↗
BACKGROUND: HIV screening and diagnosis during pregnancy is routine and of paramount importance. False positive results are rare but may have catastrophic consequences on both mother's and baby's health. METHODS: The pat...
BACKGROUND: HIV screening and diagnosis during pregnancy is routine and of paramount importance. False positive results are rare but may have catastrophic consequences on both mother's and baby's health. METHODS: The patient was tested using HIV screening assay and HIV confirmatory assay as well as HIV proviral DNA and HIV plasma viral load test. RESULTS: Her HIV screen tests were very low positive. Her HIV confirmatory screen tested positive, indeterminate, and negative across multiple repetitions. Her proviral DNA and plasma HIV tests were both negative. CONCLUSIONS: This report highlights a clear example and provides guidance as to how these scenarios should be handled.
Community-Acquired Methicillin-Resistant Staphylococcus Aureus Pneumonia Complicated by Intracranial Diffuse Thrombotic Microangiopathy.
Bao J, Jiang J, Guo F … +3 more , Gao HM, Wang RX, Luo N
Clin Lab · 2026 Apr · PMID 41979618 · Publisher ↗
BACKGROUND: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a significant pathogen linked to severe infections like pneumonia, which can lead to complications such as thrombotic microangiop-at...
BACKGROUND: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a significant pathogen linked to severe infections like pneumonia, which can lead to complications such as thrombotic microangiop-athy (TMA), characterized by microthrombi causing ischemia and organ dysfunction. Diagnosing these complications remains challenging, requiring timely identification and intervention. METHODS: This case report presents a 24-year-old male with CA-MRSA pneumonia complicated by intracranial diffuse TMA, manifesting as high fever, wheezing, respiratory failure, and altered consciousness. Comprehensive laboratory and imaging studies confirmed the diagnosis. The patient recovered completely with antibiotic therapy, mechanical ventilation, and anticoagulation. CONCLUSIONS: This case highlights the severity of CA-MRSA pneumonia and its potential for intracranial microvascular complications, emphasizing the importance of brain MRI in septic patients with neurological impairment and the need for early intervention. To our knowledge, this represents the first reported case of CA-MRSA pneumonia-associated intracranial diffuse TMA, providing novel clinical insights for managing similar presentations.
Two Cases of Severe Chlamydia psittaci Pneumonia with Respiratory Failure and Literature Review.
Li G, Dan N, Lu T
Clin Lab · 2026 Apr · PMID 41979617 · Publisher ↗
BACKGROUND: Chlamydia psittaci pneumonia is a zoonotic disease with non-specific clinical manifestations, often leading to delayed diagnosis. Metagenomic next-generation sequencing (mNGS) can help us identify pathogens i...
BACKGROUND: Chlamydia psittaci pneumonia is a zoonotic disease with non-specific clinical manifestations, often leading to delayed diagnosis. Metagenomic next-generation sequencing (mNGS) can help us identify pathogens in a timely manner and quickly adjust treatment strategies. METHODS: We reported two cases of severe Chlamydia psittaci pneumonia with respiratory failure and reviewed relevant literature. RESULTS: Both patients were diagnosed with Chlamydia psittaci infection through mNGS after routine pathogen testing failed. After using Omadacycline based treatment, the patients' clinical and radiological characteristics improved significantly and were successfully cured. CONCLUSIONS: For patients infected with Chlamydia psittaci pneumonia, timely identification of the pathogen is crucial. mNGS can quickly detect Chlamydia psittaci in critically ill patients, guide clinical timely targeted treatment, and improve patient symptoms.
Rheumatoid Factor Interference in Dual Immunoassays: False-Positive Procalcitonin and CK-MB Results.
Han J, Lu X
Clin Lab · 2026 Apr · PMID 41979616 · Publisher ↗
BACKGROUND: Immunoassays for procalcitonin (PCT) and CK-MB are critical in diagnosing sepsis and myocardial injury. However, rheumatoid factor (RF), an autoantibody against IgG-Fc, may cause false-positive results by bri...
BACKGROUND: Immunoassays for procalcitonin (PCT) and CK-MB are critical in diagnosing sepsis and myocardial injury. However, rheumatoid factor (RF), an autoantibody against IgG-Fc, may cause false-positive results by bridging capture and detection antibodies in sandwich immunoassays. METHODS: An 81-year-old female with rheumatoid arthritis (RF: 652.0 IU/mL) presented discordant PCT and CK-MB mass results. Interference was investigated via serial dilution, platform comparison (StarPilot immunofluorescence vs. Roche electrochemiluminescence), and RF blocking using IgM-specific inhibitors. RESULTS: StarPilot assays showed elevated PCT (12.38 ng/mL) and CK-MB mass (96.29 ng/mL), contradicting clinical findings (no infection/cardiac symptoms) and CK-MB activity (12 U/L). Ten-fold dilution reduced PCT/CK-MB by 94% and 93%, respectively. Roche platforms returned normal results (PCT: 0.038 ng/mL; CK-MB: 0.203 ng/mL). Adding IgM-blocking reagent (800 µg/mL) normalized PCT (0.023 ng/mL) and CK-MB (0.323 ng/mL). CONCLUSIONS: High-titer RF simultaneously interferes with PCT and CK-MB immunoassays. Dilution tests, alternative platforms, and RF blocking are essential to mitigate misdiagnosis. Laboratories should implement RF interference protocols for discordant results.
Diagnostic Dilemma of Milky Yellow Pleural Effusion.
Han J, Cheng C, Xu Q
Clin Lab · 2026 Apr · PMID 41979615 · Publisher ↗
BACKGROUND: Chylothorax, a common complication post-lung cancer surgery, lacks standardized laboratory diagnostic criteria. Misdiagnosis remains prevalent due to variable pleural fluid appearance. METHODS: We analyzed pl...
BACKGROUND: Chylothorax, a common complication post-lung cancer surgery, lacks standardized laboratory diagnostic criteria. Misdiagnosis remains prevalent due to variable pleural fluid appearance. METHODS: We analyzed pleural fluid via biochemical tests, lipid profiling, and Sudan III staining. Ratios of effusion-to-serum triglycerides (P/S TG > 1) and cholesterol (P/S CHOL < 1) were applied to confirm chylous effusion. RESULTS: The patient's pleural fluid exhibited milky yellow appearance, elevated TG (5.46 mmol/L), P/S TG ratio (3.62), and positive Sudan III staining. P/S CHOL ratio (0.43) and CHOL/TG (0.32) aligned with chylous criteria. Conservative management resolved the lymphatic leak. CONCLUSIONS: Integrating TG/CHOL ratios with Sudan III staining enhances diagnostic accuracy for chylothorax, reducing false negatives in non-milky effusions.
The Immune Cost: How Virtual Life Becomes a Modifiable Risk Factor for Immune Dysregulation.
Ibrahim MN
Clin Lab · 2026 Apr · PMID 41979614 · Publisher ↗
BACKGROUND: The emergence of technology-based lifestyles has led to what may be called "virtual isolation," as people spend more and more time in front of screens and less and less time in the world. Though the psycholog...
BACKGROUND: The emergence of technology-based lifestyles has led to what may be called "virtual isolation," as people spend more and more time in front of screens and less and less time in the world. Though the psychological consequences of this isolation are broadly appreciated, the biological impact of such isolation, especially on the immune system, has not been well-studied. METHODS: This letter synthesizes interdisciplinary research in neuroendocrinology, psychoneuroimmunology, and microbiome science to explore the biological implications of digital isolation on immune system regulation. RESULTS: Long-term digital immersion has been linked to higher levels of the stress hormone cortisol, disrupted sleep and reduced oxytocin signaling - all which disarray both innate and adaptive immune function. The lack of social bonding in the real world limits the sharing of microbes and gut microbiome diversity, making immune homeostasis even worse. Digital addiction is also associated with raised inflammatory indicators and increased sus-ceptibility to infections and immune dysregulation. CONCLUSIONS: The virtual bubble is nice, psychologically, but carries an insidious and deepening challenge to the integrity of the immune system. Tackling digital over exposure is essential to restore immunological balance, particularly in a post-pandemic society prone to stress-driven immunosuppression.
Prognostic Value of NPAR/UAR in MINOCA Patients with Coronary Slow Flow Phenomenon.
Li Q, Hu X
Clin Lab · 2026 Apr · PMID 41979613 · Publisher ↗
BACKGROUND: Patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) combined with the coronary slow flow phenomenon (CSFP) often exhibit microvascular dysfunction. However, the underlying infl...
BACKGROUND: Patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) combined with the coronary slow flow phenomenon (CSFP) often exhibit microvascular dysfunction. However, the underlying inflammation-metabolism interplay and effective prognostic tools remain unclear. This study aimed to investigate the predictive value of two novel inflammation-metabolism composite biomarkers, the neutrophil-to-albumin ratio (NPAR) and the uric acid-to-albumin ratio (UAR), in MINOCA patients with CSFP and to assess the synergistic effect of these markers on short-term outcomes. METHODS: A total of 176 MINOCA patients were prospectively enrolled, including 61 with CSFP diagnosed via corrected TIMI frame count (CTFC) and 115 with normal coronary flow as controls. Baseline clinical data, inflammation-metabolism biomarkers (NPAR, UAR), and imaging parameters were collected. Patients were followed for one year to track a composite endpoint, including cardiovascular death, recurrent myocardial infarction, and heart failure hospitalization. Multivariable logistic regression and Cox proportional hazards models were used to analyze the independent and interactive effects of NPAR and UAR. Model performance improvement was evaluated using the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices. RESULTS: MINOCA patients with CSFP showed significantly elevated levels of both NPAR and UAR. Multivariate analysis revealed that NPAR (OR = 1.45, p = 0.008), UAR (OR = 1.35, p = 0.04), and their interaction term (OR = 1.30, p = 0.02) were independent predictors of the composite endpoint. Combined assessment of these biomarkers significantly improved risk stratification (AUC increased from 0.73 to 0.75; NRI = 0.12, IDI = 0.015). The Cox model further confirmed an increased risk of 30% of adverse events with NPAR/UAR interaction (HR = 1.30, p = 0.027), with no significant effect modification by CSFP status (p > 0.05). CONCLUSIONS: Elevated NPAR and UAR levels jointly predict poor short-term outcomes in MINOCA patients, and their synergistic effect is independent of CSFP status. These findings suggest a novel biomarker-based strategy for risk stratification and targeted intervention in microvascular myocardial infarction.
Adjusted EBV Seroprevalence in Infants: Impact of Maternal IgG on IgG Interpretation.
Sookaromdee P, Wiwanitkit V
Clin Lab · 2026 Apr · PMID 41979612 · Publisher ↗
Abstract loading — click title to view on PubMed.
Evaluating Random-Access CLIA for Anti-TNF Drug Monitoring: a Comparison with Traditional ELISA.
Ashorov O, Huta Y, Gingold-Belfer R … +2 more , Dickman R, Perets TT
Clin Lab · 2026 Apr · PMID 41979611 · Publisher ↗
BACKGROUND: Accurate therapeutic drug monitoring of anti-TNF biologics such as infliximab and adalimumab and their corresponding antibodies is essential for optimizing treatment in inflammatory conditions. This study aim...
BACKGROUND: Accurate therapeutic drug monitoring of anti-TNF biologics such as infliximab and adalimumab and their corresponding antibodies is essential for optimizing treatment in inflammatory conditions. This study aimed to evaluate the analytical and clinical performance of a novel chemiluminescence immunoassay-based system, the i-TRACK10 and compare it to the established LISA Tracker ELISA kits. METHODS: A total of 200 clinical serum samples were analyzed for infliximab, adalimumab, and their respective antibodies using both platforms. Positive and negative agreements and precision were calculated using sample sets and controls. Method agreement was assessed via Deming regression, Bland-Altman analysis, and Lin's concordance correlation, following CLSI EP09-A3 guidelines with MedCalc software. RESULTS: The iTrack10 demonstrated strong association with ELISA across analytes (Pearson's r: 0.91-0.95), but concordance varied (Lin's CCC: 0.75 - 0.93) due to biases. Deming regression slopes (0.58 to 1.52), and Bland-Altman mean biases (-3.52 to 12.58), confirmed proportional differences with moderate variability between methods. Positive and negative agreement values were above 95% across all assays. Precision analysis confirmed low intra- and inter-assay variability, with coefficient of variations generally below 5%. The chemiluminescence immunoassay system offered rapid turnaround, expanded measurement ranges, and random-access operation. CONCLUSIONS: The i-TRACK10 analyzer provides a reliable, accurate, and efficient alternative to traditional ELISA kits for therapeutic drug monitoring of anti-TNF agents. Its enhanced automation and performance characteristics support its integration into routine clinical laboratory workflows.
The Prevalence of Coagulation Factor Deficiency Among Pediatric Populations in Medina City, Saudi Arabia.
Mansour AA, Shaikh A, Aljohni B … +7 more , Salem AA, Bokhari AM, Fadul AN, Abohassan M, Saif A, Alasmari S, Makkawi M
Clin Lab · 2026 Apr · PMID 41979610 · Publisher ↗
BACKGROUND: Coagulation factor deficiencies, a subset of inherited bleeding disorders, are characterized by impaired clotting due to insufficient or dysfunctional coagulation factors. This study aims to explore the preva...
BACKGROUND: Coagulation factor deficiencies, a subset of inherited bleeding disorders, are characterized by impaired clotting due to insufficient or dysfunctional coagulation factors. This study aims to explore the prevalence of coagulation factor deficiencies in pediatric patients at the Maternity and Children Hospital in Medina, Saudi Arabia, between 2019 and 2023, and to assess their impact on platelet counts and coagulation profile parameters. METHODS: A retrospective analysis was conducted involving 221 pediatric patients diagnosed with coagulation factor deficiencies. Clinical and laboratory data, including platelet count, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and coagulation factor levels, were extracted from patient clinical metadata. A control group of 50 healthy children were included for comparison. RESULTS: Retrospective analysis revealed that the most common deficiencies were factor VIII (hemophilia A, 15.38%) and factor IX (hemophilia B, 14.47%), among both males and females (50.22% males and 49.78% females). Prothrombin time, INR, and APTT were significantly prolonged across all coagulation deficiencies (p < 0.0001). The findings also highlighted the importance of monitoring platelet and coagulation parameters in children with unexplained bleeding symptoms. CONCLUSIONS: The high prevalence of coagulation factor deficiencies in Medina, Saudi Arabia, underscores the need for early diagnosis, genetic counseling, and specialized care. This study emphasizes the importance of a comprehensive approach to managing bleeding disorders, including close monitoring of coagulation profiles and platelet counts.
Karyotype Analysis and Chromosomal Microarray Analysis in 568 Couples with Balanced Translocation for Prenatal Diagnosis.
Fan M, Sui R, Yan X … +1 more , Wang G
Clin Lab · 2026 Apr · PMID 41979609 · Publisher ↗
BACKGROUND: Chromosomal balanced translocation is a prevalent structural chromosomal abnormality. Carriers typically exhibit no phenotypic differences, as the genetic material remains unchanged. However, during germ cell...
BACKGROUND: Chromosomal balanced translocation is a prevalent structural chromosomal abnormality. Carriers typically exhibit no phenotypic differences, as the genetic material remains unchanged. However, during germ cell meiosis, unbalanced gametes may be produced, leading to genetic effects in offspring and potentially resulting in adverse outcomes. This study aims to explore the prenatal diagnostic value of combining chromosome karyotype analysis with chromosomal microarray analysis (CMA) for carriers of balanced chromosomal translocations, and to provide a reference for clinical genetic counselling. METHODS: A total of 568 pregnant women who underwent prenatal diagnosis at our hospital from January 2018 to December 2023, in which one of the spouses was a balanced translocation carrier, were included. Amniocentesis was performed for karyotype analysis and CMA to detect abnormal chromosomes and assess the risk of adverse pregnancy outcomes in the fetus. RESULTS: Among the 568 examinees, karyotype analysis identified 236 cases of abnormal fetuses (41.55%), whereas CMA identified 200 cases (35.21%). The combination of both methods detected a total of 265 cases of abnormal fetuses (46.65%). Karyotype analysis identified 163 cases (28.70%) as high risk for adverse pregnancy outcomes, whereas CMA and the combined use of both methods identified 183 cases (32.22%) as high risk. These differences were attributed to each method's adaptability and limitations. Follow-up revealed a 100% rate of adverse outcomes among those at high and moderate risk. CONCLUSIONS: Couples with balanced chromosomal translocations face an increased risk of adverse pregnancy outcomes. While karyotyping is effective in identifying diverse chromosomal abnormalities, its ability to detect minor fragments is limited. Conversely, CMA excels at identifying chromosomal abnormalities with small fragments but struggles with detecting balanced structural variations. The concurrent application of both technologies enhances the precision of diagnosing the risk of adverse pregnancy outcomes.
Comparison of Diagnostic Algorithms with Commercial Kits Used to Detect Syphilis Antibodies.
Koca Ö, Kandirali-Duygun E, Çekin Y … +3 more , Erman-Daloğlu A, Özen N, Aydin-Tiğli G
Clin Lab · 2026 Apr · PMID 41979608 · Publisher ↗
BACKGROUND: Nowadays, especially in laboratories with high testing capacity, the widespread use of automated treponemal tests has increased the importance of algorithms used for syphilis serodiagnosis. In suspected syphi...
BACKGROUND: Nowadays, especially in laboratories with high testing capacity, the widespread use of automated treponemal tests has increased the importance of algorithms used for syphilis serodiagnosis. In suspected syphilis cases, choosing the best algorithm is important from the aspect of diagnosis, treatment initiation, and treatment follow-up. In this study, we aimed to compare the diagnostic performance of traditional, reverse, and European Center for Disease Prevention and Control (ECDC) algorithms according to the clinical diagnosis of syphilis using rapid plasma reagin (RPR), chemiluminescence immunoassay (CLIA), and Treponema pallidum hemagglutination (TPHA) tests. METHODS: Between March 2023 and July 2023, a total of 297 patients from various units of our hospital, suspected of having syphilis, were included in the study. All samples were analyzed using RPR, CLIA, and TPHA tests, and three different algorithms were examined separately. Clinical diagnosis was considered the gold standard. RESULTS: A total of 105 patients have been diagnosed with syphilis. When the patients' clinical diagnosis were used as a reference, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the traditional algorithm were found to be 41.9%, 100%, 100% and 75.9%, respectively, and all these parameters were found to be 100% for the reverse and ECDC algorithms. Moderate agreement (kappa value 0.483, p < 0.001) was found between the traditional and reverse algorithms. Very good agreement (kappa value 1.0, p < 0.001) was found between ECDC and the reverse algorithm. CONCLUSIONS: In diagnosing suspected syphilis cases, the reverse algorithm and ECDC algorithms utilizing treponemal tests as the initial step were found to be superior to the traditional algorithm. Our study demonstrates that treponemal antibody tests are superior when employed as the initial step in diagnosing syphilis in patients with latent syphilis among suspected cases. Nontreponemal tests should be used solely to evaluate disease activity and response to therapy.
Associations of CRP, PCT, NC, and NLR with Anti-Infective Effect on Patients with Hematological Malignancy and Pulmonary Infection.
Su Y, An X, Zhang X … +4 more , Li L, Zuo J, Ge S, Bian J
Clin Lab · 2026 Jun · PMID 41945751 · Publisher ↗
BACKGROUND: We aimed to analyze the associations of C-reactive protein (CRP), procalcitonin (PCT), neutrophil count (NC), and neutrophil-to-lymphocyte ratio (NLR) with the anti-infective effect on hematological malignanc...
BACKGROUND: We aimed to analyze the associations of C-reactive protein (CRP), procalcitonin (PCT), neutrophil count (NC), and neutrophil-to-lymphocyte ratio (NLR) with the anti-infective effect on hematological malignancy patients complicated with pulmonary infection during chemotherapy. METHODS: One hundred hematological malignancy patients complicated with pulmonary infection during chemotherapy admitted from March 2020 through December 2024 were selected as a study group, while another 100 patients without pulmonary infection in the same period were selected as a control group. Their serum CRP and PCT levels, NC, and NLR were compared. The study group was further divided into an effective group and an ineffective group, and the two groups were compared in regards of serum CRP and PCT levels, NC, and NLR. RESULTS: The serum CRP and PCT levels, NC, and NLR in the study group were higher than those in the control group (p < 0.05). The serum CRP and PCT levels, NC, and NLR in the ineffective group were higher than those in the effective group (p < 0.05). Serum CRP, PCT, NC, and NLR were risk factors for ineffective anti-infective therapy (odds ratio > 1, p < 0.05). The areas under the ROC curves of serum CRP, PCT, NC, and NLR alone and in combination for predicting the anti-infective effect were 0.748, 0.818, 0.840, 0.770, and 0.952, respectively. CONCLUSIONS: CRP, PCT, NC, and NLR are high in hematological malignancy patients complicated with pulmonary infection during chemotherapy. Their levels are related to the outcome of anti-infective therapy, and the combination of the four can effectively enhance the predictive value.
Correlation between CVS and SII in Aneurysmal Subarachnoid Hemorrhage and Construction of Risk Assessment System.
Chen Y, Tan J
Clin Lab · 2026 Jun · PMID 41945750 · Publisher ↗
BACKGROUND: This study aimed to investigate the correlation between cerebral vasospasm (CVS) and systemic im-mune-inflammation index (SII) in aneurysmal subarachnoid hemorrhage (aSAH) patients and to construct a risk ass...
BACKGROUND: This study aimed to investigate the correlation between cerebral vasospasm (CVS) and systemic im-mune-inflammation index (SII) in aneurysmal subarachnoid hemorrhage (aSAH) patients and to construct a risk assessment system based on SII. METHODS: This study included 230 eligible patients with aSAH from June 1, 2021, through December 30, 2024. By retrospective analysis method, clinical information and laboratory data of the patients were collected. Patients were divided into two groups: those with CVS (CVS+) and those without CVS (CVS-). The clinical characteristics of patients were compared, and the correlation between SII index and CVS was analyzed. The risk assessment system was constructed using a Cox regression model, which analyzed independent variables with significant differences. RESULTS: Age of CVS+ patients was significantly higher than that of CVS- patients. The CVS+ group exhibited higher proportions of patients with medium-sized aneurysms, more severe CT imaging features of hemorrhage, increased electrolyte disturbances, and elevated immune system markers compared to the CVS- group. The median time for CVS onset was 7.5 days when SII was at least 1.58, considerably shorter than the 16 days for SII less than 0.64 and 15 days for SII between 0.64 and 0.93 (p < 0.0001). When the SII index was elevated, the risk of CVS increased. The SII-based risk assessment system reduced the significance of age and modified Fisher grade in endpoint event prediction, while increasing the overall predictive value of the model. CONCLUSIONS: This study revealed a significant correlation between CVS and SII index in aSAH patients and successfully constructed a risk assessment system based on SII. This system can more accurately predict the risk of CVS in aSAH patients and provides an important reference for clinical decision-making.
Randomized Evaluation of Nutritional Risk Screening and HLA-DMB Gene Expression in Early Prediction of Sepsis.
Wang F, Zhang Y, Wang X … +7 more , Zhang Z, Yin X, Huang L, Zhang T, Xu C, Wang X, Wang Y
Clin Lab · 2026 Jun · PMID 41945749 · Publisher ↗
BACKGROUND: Sepsis, a life-threatening syndrome with escalating mortality per treatment delay, requires prognostic tools beyond current Sepsis-3 criteria. This study investigated the dual predictive capacity of Nutrition...
BACKGROUND: Sepsis, a life-threatening syndrome with escalating mortality per treatment delay, requires prognostic tools beyond current Sepsis-3 criteria. This study investigated the dual predictive capacity of Nutrition Risk Screening 2002 (NRS-2002) and Human Leukocyte Antigen-DMB (HLA-DMB), proposing a novel early-warning framework for sepsis risk stratification. METHODS: This case-control study enrolled 90 patients with acute infections from the Department of Pulmonary and Critical Care Medicine at Hefei Second People's Hospital. Participants were stratified into sepsis (n = 45) and non-sepsis (n = 45) groups according to Sepsis-3 diagnostic criteria. Clinical baseline characteristics, laboratory parameters, nursing-assessed nutritional risk scores, and HLA-DMB gene expression levels were systematically collected through standardized case report forms. Binary logistic regression identified independent predictors, while ROC curve analysis was employed to construct a combinatorial prediction model. RESULTS: In patients with sepsis, HLA-DMB gene expression levels were significantly lower, while NRS-2002 scores were higher; both were independent predictors of sepsis (p < 0.001). Restricted cubic spline analysis indicated that higher HLA-DMB levels might reduce the risk of sepsis, whereas lower NRS-2002 scores were associated with an increased risk. Furthermore, receiver operating characteristic curve analysis demonstrated that the combined predictive efficacy of HLA-DMB expression and NRS-2002 scores surpassed that of either variable alone (AUC = 0.8430). CONCLUSIONS: HLA-DMB gene expression levels and NRS-2002 scores have been utilized to assess the risk of developing sepsis. Their combined evaluation has enhanced predictive accuracy, facilitating the rational allocation of medical resources in the early stages.
Comparison of Fingertip Hemoglobin Value with Venous Hemoglobin Value in Bleeding Patients Followed at the Emergency Department.
Zortuk Ö, Şimşek SD, Bedel C … +3 more , Selvi F, Karanci Y, Yildiz G
Clin Lab · 2026 Jun · PMID 41945748 · Publisher ↗
BACKGROUND: Hemoglobin's pivotal role in human health is monitored through hospital-based complete blood count (CBC) by utilizing automated methods like electrical impedance and photon scattering. This study explored bed...
BACKGROUND: Hemoglobin's pivotal role in human health is monitored through hospital-based complete blood count (CBC) by utilizing automated methods like electrical impedance and photon scattering. This study explored bedside fingertip hemogram and hematocrit analysis' reliability versus CBC´s in emergency department patients, crucial for hemorrhagic condition management. METHODS: The study included emergency department patients requiring hemogram monitoring. Participant data, CBC, and fingertip hemogram and hematocrit result values from venous blood using a conventional device were compared during monitoring. RESULTS: In this study, 88 participants (63.6% female, mean age 47.68 ± 19.80) were assessed for hemoglobin and hematocrit levels using both fingertip and conventional methods. Fingertip hemogram measurements showed a significant correlation with conventional CBC devices, yet tended to be 1.20 g/dL lower. Similarly, fingertip hematocrit measurements correlated positively but were 3.59% lower compared to conventional measurements. CONCLUSIONS: Bedside fingertip devices for hemogram measurement in emergency departments provide time-efficient and resource-saving advantages.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe