Clinical Laboratory[JOURNAL]
Sun
200 papers
Enhanced Understanding of Procalcitonin Utilization as an Infection Biomarker in Non-Hodgkin's Lymphoma.
Chen L, Wu Z, Chen N … +6 more , Xin N, Huo R, Qiu S, Zhou Z, Cui Z, Xiao Z
Clin Lab · 2026 Jun · PMID 41945747 · Publisher ↗
BACKGROUND: This investigation aimed to assess the diagnostic relevance of procalcitonin (PCT) in non-Hodgkin's lymphoma (NHL) and determine factors impacting its diagnostic precision. Additionally, the study endeavored...
BACKGROUND: This investigation aimed to assess the diagnostic relevance of procalcitonin (PCT) in non-Hodgkin's lymphoma (NHL) and determine factors impacting its diagnostic precision. Additionally, the study endeavored to delineate its judicious application in clinical settings. METHODS: By employing a retrospective analysis of clinical records, serum PCT levels were gauged utilizing an automated immunoassay, followed by the generation of a receiver operating characteristic (ROC) curve. RESULTS: The established threshold for serum PCT in diagnosing infection was identified as 0.120 ng/mL. Serum PCT levels were markedly elevated in patients with bloodstream infections compared to those with localized infections. Infections due to Gram-negative bacilli manifested higher PCT levels relative to those caused by Gram-positive cocci. Within the bloodstream infection cohort, patients with coagulase-negative staphylococci infections ex-hibited increased PCT levels compared to those in the contamination cohort. The interplay of various elements induces the onset of tumor metastasis and progression as notable risk factors that augment serum PCT levels in NHL patients. CONCLUSIONS: Serum PCT levels are heightened in NHL patients, influenced by tumor stage and evolution. The diagnostic application of a solitary PCT test is limited for infection detection. It is recommended that NHL patients be hospitalized to establish a baseline serum PCT level, facilitating its use as a benchmark in infection diagnostics.
NT-proBNP and hs-cTnT in Predicting the Incidence and Prognosis of Anthracycline-Caused Cardiovascular Toxicities in Non-Hodgkin's Lymphoma.
Su G, Peng W, Chen Y … +5 more , Lin Y, Chen J, Xiao Y, Cui Z, Xiao Z
Clin Lab · 2026 Jun · PMID 41945746 · Publisher ↗
BACKGROUND: This study aimed to investigate the role of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) in predicting the occurrence and prognosis of symptoma...
BACKGROUND: This study aimed to investigate the role of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) in predicting the occurrence and prognosis of symptomatic cardiovascular toxicities (CVTs) in non-Hodgkin's lymphoma (NHL) patients receiving anthracyclines (ATCs). METHODS: We conducted a retrospective analysis of serum NT-proBNP and hs-cTnT levels in 182 NHL patients undergoing anthracycline treatment. The post-treatment elevation ratio (ER) of NT-proBNP (NT-proBNP-ER) was calculated, and receiver operating characteristic curves (ROCs) were generated. RESULTS: The area under the curves (AUCs) of NT-proBNP-ER, hs-cTnT, and their combination for diagnosing symptomatic CVTs were 0.903, 0.811, and 0.9807, respectively. Serum NT-proBNP-ER ≥ 2.56 and hs-cTnT ≥ 11.68 ng/L were positively correlated with the occurrence of symptomatic CVTs. Patients with a post-treatment NT-proBNP-ER ≥ 2.56 had shorter progression-free survival (PFS) and overall survival (OS) than those with an NT-proBNP-ER < 2.56. Similarly, patients with post-treatment hs-cTnT ≥ 11.68 ng/L experienced markedly shorter PFS and OS compared to those with hs-cTnT < 11.68 ng/L. CONCLUSIONS: An NT-proBNP-ER ≥ 2.56 or hs-cTnT ≥ 11.68 ng/L, individually or combined, are significant predictors of symptomatic CVTs. Exceeding these thresholds indicates a poor prognosis in NHL patients treated with anthracyclines.
Acquired Factor XIII Deficiency with Multiple Hematoma.
Chen L, Tu Q, Zhao CF … +5 more , Zhang JC, Tu Y, Ni LH, Zhu TJ, Ge SC
Clin Lab · 2026 Jun · PMID 41945745 · Publisher ↗
BACKGROUND: Acquired factor XIII (FXIII) deficiency is a rare but potentially life-threatening hemorrhagic disorder, most commonly observed in middle-aged and elderly individuals. Due to its normal routine coagulation pr...
BACKGROUND: Acquired factor XIII (FXIII) deficiency is a rare but potentially life-threatening hemorrhagic disorder, most commonly observed in middle-aged and elderly individuals. Due to its normal routine coagulation profile, it is frequently misdiagnosed or diagnosed late, especially in patients presenting with unexplained bleeding or hematoma. METHODS: We report a case of acquired FXIII deficiency in a patient with recurrent, unexplained spontaneous hematomas and normal coagulation results. The diagnostic process includes a urea clot lysis test as an initial screen for FXIII deficiency, followed by specific tests, such as the chloroacetic acid lysis test, and assessment of residual FXIII activity. It is treated with infusion of cold precipitates and the use of immunosuppressive therapies, including corticosteroids and azathioprine. RESULTS: The patient showed poor response to conventional multidisciplinary management. Finally, the patient is automatically discharged to a higher-level hospital. CONCLUSIONS: This case underscores the need to consider rare coagulation disorders like acquired FXIII deficiency in patients with unexplained hematomas and normal routine coagulation results. Early identification using targeted diagnostic tests can guide prompt and effective management. Treatment remains challenging in patients with poor response to cold precipitation, corticosteroids, and azathioprine.
A Case of Hb Quong Sze Co-Inherited Thai Deletion Resulting in Falsely Elevated HbA1c Values.
Wei Q, Liang L, Li Z … +4 more , Li Z, Zheng L, Lao Y, Li Y
Clin Lab · 2026 Jun · PMID 41945744 · Publisher ↗
BACKGROUND: Hb Quong Sze (Hb QS) is a rare Hb variant that, when combined with α0-thalassemia, can produce Hb QS-H disease. Reports of Hb QS-H disease affecting HbA1c testing are limited. METHODS: This study reports a ca...
BACKGROUND: Hb Quong Sze (Hb QS) is a rare Hb variant that, when combined with α0-thalassemia, can produce Hb QS-H disease. Reports of Hb QS-H disease affecting HbA1c testing are limited. METHODS: This study reports a case of Hb QS-H disease with abnormally elevated HbA1c levels measured by the G11 high-performance liquid chromatography (HPLC) system. Three additional detection systems (D100, Capillary Electrophoresis [CE], and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry [MALDI-TOF-MS]) were employed for comparative assessment of HbA1c values. Hemoglobin analysis was performed using CE, while conventional thalassemia gene detection utilized Gap-PCR and PCR-reverse dot blot (RDB). RESULTS: The patient exhibited normal blood glucose levels (fasting: 4.18 mmol/L; 2-hour postprandial: 5.96 mmol/L), yet the G11 system recorded a markedly elevated HbA1c value of 18.4%. Among the three alternative detection systems, the D100 system yielded a value of 2.38%, while both CE and MALDI-TOF-MS failed to provide valid HbA1c measurements. Genetic analysis confirmed co-inheritance of Hb QS and Thai deletion in this patient. CONCLUSIONS: Our findings demonstrate that Hb QS-H disease significantly interferes with HbA1c quantification, with methodological variability observed across different detection platforms.
A Case Report of the "Pathological Triad": Infection-Induced Cold Agglutination with Hemolytic Anemia.
Xie J, Chen S, Chen Y … +2 more , Zhang W, Liu G
Clin Lab · 2026 Jun · PMID 41945743 · Publisher ↗
BACKGROUND: Although Mycoplasma pneumoniae is a recognized cause of community-acquired pneumonia, its hematologic complications are often overlooked in primary care settings. Here, we present a case that exemplifies the...
BACKGROUND: Although Mycoplasma pneumoniae is a recognized cause of community-acquired pneumonia, its hematologic complications are often overlooked in primary care settings. Here, we present a case that exemplifies the diagnostic challenges associated with Mycoplasma pneumoniae-induced cold agglutination and hemolytic anemia. METHODS: Complete blood count analysis was performed using an automated hematology analyzer, with discordant erythrocyte indices prompting thermal correction via 37℃ water bath incubation. Serum biochemical markers, including Creatine Kinase-MB (CKMB), Lactate Dehydrogenase (LDH), Hydroxybutyrate Dehydrogenase (HBDH), Total Bilirubin (TBIL), and Direct Bilirubin (DBIL) were quantified using an automated biochemistry analyzer. Mycoplasma pneumoniae IgM and DNA were detected via immunochromatography and PCR, respectively. A direct anti-human globulin test (Coombs test) was conducted using standard reagents. Peripheral blood smears were examined microscopically for erythrocyte agglutination and morphology. RESULTS: Positive results for the Mycoplasma pneumoniae IgM antibody and DNA tests confirmed that the patient had active infectious pneumonia. Initial results of the automated blood cell analysis were as follows: RBC (1.6 x 1012/L), HGB (111 g/L), MCH (69.4 pg), and MCHC (703 g/L). After a 37℃ water bath, the results changed to: RBC: 3.73 x 1012/L, HGB: 113 g/L, MCH: 30.1 pg, MCHC: 337 g/L. The RBC count, HGB, and HCT results were significantly lower than those recorded a week earlier, especially the HGB result, which decreased by 46 units. The Coombs test was positive. There were significantly elevated levels of biochemical markers (CKMB, LDH, and HBDH). Mild elevations were also noted in TBIL and DBIL. No comorbidities or hemolytic triggers were identified. Taken together, the evidence suggests that the patient experienced cold agglutination and progressive hemolysis following Mycoplasma pneumoniae infection. CONCLUSIONS: This case establishes three evidence-based protocols for frontline practice. First, consider testing for Mycoplasma pneumoniae in patients with unexplained anemia following a respiratory infection. Second, apply thermal correction to blood samples when the MCHC results do not match the other erythrocyte parameters. Third, monitor for hemolysis for at least two weeks after Mycoplasma pneumoniae IgM is detected.
Efficacy of Antiplatelet Therapy in Myeloproliferative Diseases in Relation to Immature Platelets and Thrombosis.
Bultasova L, Slavik L, Hajsmanova Z … +3 more , Lavickova A, Sigutova P, Bradacova P
Clin Lab · 2026 Jun · PMID 41945742 · Publisher ↗
BACKGROUND: Patients with myeloproliferative diseases have an increased risk and incidence of thrombotic complications. The mechanisms involved in the pathogenesis of this acquired thrombophilic state are multifactorial....
BACKGROUND: Patients with myeloproliferative diseases have an increased risk and incidence of thrombotic complications. The mechanisms involved in the pathogenesis of this acquired thrombophilic state are multifactorial. One mechanism reported in the literature is increased thrombopoiesis and with it associated increase of young, immature platelets in peripheral blood. This increased washout of new platelets, which are unaffected by antiplatelet drugs, may lead to a reduced response to antiplatelet therapy. METHODS: In our study, we aimed to monitor the efficacy of the standard of antiplatelet therapy with 100 mg of acetylsalicylic acid in relation to immature platelet size fraction and platelet count in a group of 86 patients with myeloproliferative diseases. The efficacy of antiplatelet therapy was investigated by the ASPItest method on the multiplate impedance aggregometer. RESULTS: The results demonstrated that the efficacy of low-dose acetylsalicylic acid treatment was independent of immature platelet fraction size (0.2600, p = 0.0156) and absolute platelet count (0.4505, p < 0.0001). Detailed analysis of the cohort showed no association between the incidence of thrombotic complications and the ASPItest value, nor was there an association between the incidence of thrombotic complications and the size of the immature platelet fraction or the total platelet count. CONCLUSIONS: The mechanisms not assessable by impedance aggregometry are involved in the development of thrombotic complications in patients with MPD; the value of the ASPItest does not provide comprehensive information about thrombotic risk.
Abnormal Liver Function with Low Glycated Hemoglobin: a Case of Hereditary Spherocytosis Concealed by Liver Disease Symptoms.
Zheng Z, Qian Y
Clin Lab · 2026 Jun · PMID 41945741 · Publisher ↗
BACKGROUND: Hereditary spherocytosis (HS), a familial hemolytic disorder caused by red blood cell membrane defects, leads to increased red blood cell destruction. It manifests as jaundice, hemolytic anemia, and splenomeg...
BACKGROUND: Hereditary spherocytosis (HS), a familial hemolytic disorder caused by red blood cell membrane defects, leads to increased red blood cell destruction. It manifests as jaundice, hemolytic anemia, and splenomegaly. HS patients, due to chronic hemolysis, are prone to developing bile duct or gallbladder stones, and some primarily present with 'cholelithiasis' as their main clinical manifestation. METHODS: We reported a case of a patient who was admitted for biliary colic due to choledocholithiasis and was ultimately diagnosed with HS. We conducted a retrospective analysis of this hospitalized patient's clinical manifestations, laboratory test results, and diagnostic process. The evaluated parameters encompassed complete blood count, peripheral blood smear analysis, biochemical markers (including liver function and HbA1c), and iron metabolism. To confirm the diagnosis, the patient's samples were sent to Dean Medical Laboratory Center for genetic testing. By employing high-throughput targeted sequencing technology, the laboratory staff screened multiple erythrocyte membrane protein-related genes. RESULTS: Laboratory test results showed that the patient had a decreased red blood cell count and hemoglobin lev-els, markedly reduced HbA1c values below the normal reference range, and elevated total bilirubin (TBIL) levels (684.0 µmol/L), predominantly direct bilirubin. Genetic testing confirmed the diagnosis of HS. CONCLUSIONS: The clinical laboratory's identification and analysis of abnormal indicators (e.g., low HbA1c and elevated bilirubin) offer crucial diagnostic insights for clinicians. Integrating complete blood count, peripheral blood smear examination, and genetic testing enables accurate diagnosis of hematologic disorders, underscoring the essential role of laboratory medicine in multidisciplinary teamwork.
Performance Evaluation of HB&L Uroquattro System for Urinary Tract Infection Rapid Screening.
Xia C, Na B, Huang L
Clin Lab · 2026 Jun · PMID 41945740 · Publisher ↗
BACKGROUND: Precise and rapid pathogen identification is key in urinary tract infection (UTI) treatment. A negative rapid urine culture screening result provides critical information for clinical decision-making. Though...
BACKGROUND: Precise and rapid pathogen identification is key in urinary tract infection (UTI) treatment. A negative rapid urine culture screening result provides critical information for clinical decision-making. Though the urine culture is the "gold standard" for UTI diagnosis, it usually takes about 48 hours to determine that bacteria aren't present in the culture. The HB&L uroquattro system (Aifax, Italy), formerly URO-QUICK, which can rule out the negative samples within 4 hours, should be evaluated for routine diagnostics. To this aim, this study evaluated the diagnostic accuracy of the HB&L uroquattro system by comparing with the gold standard conventional culture method and exploring the application value in clinical setting. METHODS: A total of 300 midstream urine samples were both cultured by routine method and HB&L uroquattro system in this study. Diagnostic performance in terms of sensitivity, specificity, positive and negative likelihood ratios, positive and negative predictive values were calculated. To evaluate the relationship between turbidity and report time, the urine samples were measured as McFarland turbidity (following the method of reference [13]) before being loaded on the machine. The instrument provided HB&L turbidity when sample was reported as positive. RESULTS: In total, 218 (73%) urine samples showed identical results by both methods, only 13 (6%) samples were misclassified as sterile by HB&L uroquattro system. At 102 CFU/mL, HB&L has the highest sensitivity with 91.67% (95% CI: 86.27% - 95.07%). At 105 CFU/mL, HB&L has the highest specificity with 97.22% (95% CI: 93.08% - 98.91%). McFarland turbidity showed a stronger correlation with report time. CONCLUSIONS: The HB&L uroquattro system can give reliable urine microbiological results within 4 hours in appropriate clinic settings.
Diagnostic Efficacy of Nanopore Sequencing Using Clinical Specimens for Nontuberculous Mycobacterial Pulmonary Disease.
Yu G, Shen Y, Zhong F … +1 more , Xu X
Clin Lab · 2026 Mar · PMID 41945739 · Publisher ↗
BACKGROUND: This study aimed to evaluate the diagnostic efficacy of nanopore sequencing using clinical specimens for the rapid diagnosis of nontuberculous mycobacterial pulmonary disease (NTM-PD) and to provide a new det...
BACKGROUND: This study aimed to evaluate the diagnostic efficacy of nanopore sequencing using clinical specimens for the rapid diagnosis of nontuberculous mycobacterial pulmonary disease (NTM-PD) and to provide a new detection tool for the early diagnosis of NTM-PD. METHODS: Information regarding patients with suspected Mycobacterium infection with lung disease was retrospectively analyzed to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for nanopore sequencing compared with those for NTM culture. RESULTS: Overall, 871 patients were enrolled in the study. By using NTM culture as the reference standard for diagnosing NTM-PD, the sensitivity, specificity, PPV, NPV, and AUC were found to be 93.3% (95% CI: 86.1% - 97.5%), 97.2% (95% CI: 95.8% - 98.2%), 78.5% (95% CI: 69.5% - 85.9%), 99.2% (95% CI: 98.4% - 99.7%), and 0.95 (95% CI: 0.94 - 0.97) for nanopore sequencing, respectively. The overall accuracy of diagnosing NTM-PD was excellent for nanopore sequencing. CONCLUSIONS: Nanopore sequencing analysis of clinical specimens offers high diagnostic accuracy for detecting NTM-PD. Furthermore, this approach can be used as the priority diagnostic tool for detecting NTM-PD.
Platelet-to-White Blood Cell Ratio as a Predictor for Thirty-Day Mortality in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage.
Huang YH, Lee TH, Ting CW
Clin Lab · 2026 Mar · PMID 41945738 · Publisher ↗
BACKGROUND: Spontaneous intracerebral hemorrhage (ICH) presents a substantial public health challenge due to its high mortality rates. Although the platelet-to-white blood cell ratio (PWR) has been identified as an indep...
BACKGROUND: Spontaneous intracerebral hemorrhage (ICH) presents a substantial public health challenge due to its high mortality rates. Although the platelet-to-white blood cell ratio (PWR) has been identified as an independent prognostic factor in various diseases, its association with ICH outcome remains unclear. This study aimed to investigate the relationship between PWR and the thirty-day mortality rate in patients with spontaneous supra-tentorial ICH. METHODS: A retrospective analysis of 296 adult patients was conducted, collecting data on demographics, Glasgow Coma Score (GCS), underlying conditions, and laboratory results. PWR was calculated as the absolute value of the platelet-to-white blood cell ratio. The primary outcome was the thirty-day mortality during hospitalization. Multivariable logistic regression analysis was performed to identify independent predictors of thirty-day mortality. RESULTS: The study revealed a significant inverse association between PWR and thirty-day mortality (odds ratio: 0.88, 95% CI: 0.79 - 0.98, p = 0.02). A 12% increase in mortality risk was observed for every unit decrease in PWR. Kaplan-Meier survival curves demonstrated a significantly lower survival rate within 30 days for patients with PWR < 15.0 (log-rank test: p < 0.01). Admission GCS and chronic kidney disease were also identified as independent predictors of thirty-day mortality (p = 0.04 and p < 0.01, respectively). CONCLUSIONS: PWR is a significant predictor of thirty-day mortality in patients with spontaneous supratentorial ICH. Lower PWR values correspond to a higher mortality risk, highlighting the potential utility of PWR as a prognostic indicator for ICH patients.
Prevalence and Genotype Distribution of HPV Infection Among 16,516 Women in Chaohu, China: a Retrospective Study.
Li X, Zheng M
Clin Lab · 2026 Mar · PMID 41945737 · Publisher ↗
BACKGROUND: Prevalence and genotype distribution of human papillomavirus (HPV) infection among 16,516 women in Chaohu City from May 2023 to May 2025 were not well established. A retrospective study was conducted to analy...
BACKGROUND: Prevalence and genotype distribution of human papillomavirus (HPV) infection among 16,516 women in Chaohu City from May 2023 to May 2025 were not well established. A retrospective study was conducted to analyze the clinical situations and laboratory data of 16,516 women tested for HPV. It might provide valuable information for the epidemiological characteristics of regional differences in infection rate and dominant genotype of HPV. METHODS: A total of 16,516 women from outpatients, inpatients, and physical examinations were randomly selected from May 2023 to May 2025. Exfoliated cells from the cervical orifice were collected with a cervical cytobrush and HPV genotypes were detected. Data of all tests were acquired from the hospital's laboratory information system, and statistical analysis was performed with SPSS 27.0 software. RESULTS: Among 16,516 women, 3,608 were positive and the positive rate was 21.85%. High-risk genotype infection and single infection were respectively more than low-risk genotype infection and multiple infection (p < 0.05). The highest positive rate of HPV infection was found in the ≥ 20 age group, and the ≥ 60 and 51 - 60 age groups had higher positive rate. The positive rate was not significantly different among each age group (p > 0.05). Among 23 genotypes, HPV 52, 53, and 58 were the most common genotypes which were all high-risk genotypes, and HPV 52 was the most dominant in all different age groups. CONCLUSIONS: The retrospective study showed a high prevalence of HPV infection in Chaohu City in the past two years. More high-risk genotype infection and single infection than low-risk genotype infection and multiple infection, and high-risk genotype infection and single infection mainly occurring in the middle and old age were the characteristics of HPV infection in Chaohu. HPV 52, 53, and 58 were the dominant HPV genotypes, suggesting that vaccine which contained HPV 52, 53, and 58 genotypes might be a better choice for this region.
Detection of Macroamylasemia Using Polyethylene Glycol Precipitation.
Lu M, Wang Y
Clin Lab · 2026 Mar · PMID 41945736 · Publisher ↗
BACKGROUND: There are many factors that can cause elevated serum amylase levels, including pancreatic causes such as acute pancreatitis and chronic pancreatitis. Additionally, non-pancreatic causes, such as acute abdomen...
BACKGROUND: There are many factors that can cause elevated serum amylase levels, including pancreatic causes such as acute pancreatitis and chronic pancreatitis. Additionally, non-pancreatic causes, such as acute abdomen and acute parotitis, can also lead to increased serum amylase. These factors generally explain the consistency between elevated serum amylase and clinical symptoms. However, there are some special cases where patients exhibit atypical clinical symptoms but have persistently elevated serum amylase levels. Among these, macroamylasemia is an important differential diagnosis. METHODS: This is a report on a case of persistent serum amylase elevation (ranging from 217.0 to 452.1 U/L over five years) without clinical symptoms. The patient exhibited normal renal function, serum lipase levels, and tumor markers. Serial abdominal CT scans, magnetic resonance cholangiopancreatography (MRCP), and chest CT examinations revealed no significant abnormalities. The polyethylene glycol precipitation method (PEG precipitation) was employed as an adjunctive screening tool for macroamylasemia. RESULTS: The most recent serum amylase test result was 295.8 U/L. Using the polyethylene glycol precipitation method (PEG), the polyethylene glycol precipitation activity (%PPA) was 85.46% (%PPA > 60%), indicating interference from macromolecular proteins during the detection of serum amylase in this patient. This preliminary finding suggests the possibility of macroamylasemia. Further confirmation can be performed with gel filtration chromatography or immunofixation electrophoresis if laboratory conditions permit. CONCLUSIONS: Macroamylasemia is often detected in serological tests due to its atypical clinical symptoms and lack of awareness, leading to common misdiagnosis, unnecessary investigations, and heightened patient anxiety during medical consultations. The polyethylene glycol precipitation method (PEG) serves as a screening tool, and definitive diagnosis can prevent unnecessary healthcare resource utilization.
Evaluation of Platelet Function Detection Using Sequential Platelet Counting Method via Fluorescent Platelet Channel.
Zhou S, Xu X, Cao X … +2 more , Sun C, Wang X
Clin Lab · 2026 Mar · PMID 41945735 · Publisher ↗
BACKGROUND: The sequential platelet counting method (SPCM) for platelet function detection relies on impedance-based platelet counting, which may be affected by factors such as microcytes and red blood cell fragments. Th...
BACKGROUND: The sequential platelet counting method (SPCM) for platelet function detection relies on impedance-based platelet counting, which may be affected by factors such as microcytes and red blood cell fragments. The Sysmex XN series automated hematology analyzer incorporates a fluorescent platelet channel (PLT-F) based on flow cytometry, offering enhanced specificity compared to impedance methods. METHODS: This study compared platelet aggregation function between light transmission aggregometry (LTA) and SPCM-PLTF in healthy individuals and clopidogrel-treated patients. The effects of platelet-poor plasma (PPP) and normal saline (NS) dilution on LTA results were also analyzed. RESULTS: SPCM-PLTF revealed significant differences in platelet aggregation between healthy and patient groups (p < 0.0001). Although LTA and SPCM-PLTF results differed statistically (p < 0.0001), they exhibited strong correlation (r = 0.849, p < 0.0001). PPP dilution progressively reduced platelet aggregation (p < 0.05), while NS dilution showed no significant effect. CONCLUSIONS: SPCM-PLTF effectively monitors platelet function and correlates well with LTA, offering a viable alternative for clinical use.
Procalcitonin: The Laboratory Costs of Misused Tests.
Lilea AA, Oprea OR, Barabas AZ … +2 more , Renghes RA, Dobreanu M
Clin Lab · 2026 Mar · PMID 41945734 · Publisher ↗
BACKGROUND: The study aimed to assess the compliance of procalcitonin (PCT) testing protocols for sepsis diagnosis and antibiotic therapy guidance and evaluate the economic impact of unnecessary or inappropriate testing....
BACKGROUND: The study aimed to assess the compliance of procalcitonin (PCT) testing protocols for sepsis diagnosis and antibiotic therapy guidance and evaluate the economic impact of unnecessary or inappropriate testing. METHODS: The time intervals between tests were evaluated for all PCT requested in a tertiary hospital between January 2022 and December 2023. A cost of 20 €/test was calculated for each PCT. RESULTS: A total number of 5,420 PCT tests were requested. A budget of 108,400 € was spent. Almost 22% of the tests were conducted within 12 hours of the first measurement, and 6% were performed more than 10 days apart, resulting in 33,580 € (30%) spent. A total of 845 patients did not have a follow-up test, and 16,900 € were spent in these cases. The median number of PCT was 3.33 tests/patient. For 23 cases, more than 10 PCT tests/patient were performed; a total of 338 tests, with the cost of 6,760 €. CONCLUSIONS: In total, out of the 108,400 € spent on PCT tests, at least 33,580 € (30%) could have been saved by adherence to the most basic protocols regarding PCT testing: longer than 24-hours interval between measurements and follow-up of initially elevated results.
IgD Multiple Myeloma: a Rare and Aggressive Entity: Report of Three Clinical Cases and Review of the Literature.
Chachi EM, Bouabdellah M, Derbal S … +3 more , Oufir FE, Safir N, Benchekroun L
Clin Lab · 2026 Mar · PMID 41945733 · Publisher ↗
BACKGROUND: IgD multiple myeloma is an exceptionally rare subtype, accounting for less than 2% of all multiple myeloma cases. METHODS: We report three cases diagnosed at the central biochemistry laboratory of the Ibn Sin...
BACKGROUND: IgD multiple myeloma is an exceptionally rare subtype, accounting for less than 2% of all multiple myeloma cases. METHODS: We report three cases diagnosed at the central biochemistry laboratory of the Ibn Sina University Hospital in Rabat, Morocco, involving young patients with a mean age of 38 years. RESULTS: All cases showed a marked male predominance. Clinically, patients presented with frequent bone involvement and renal impairment. Laboratory findings consistently revealed anemia, Bence-Jones proteinuria with a predominance of lambda light chains, hypercalcemia, and variable bone marrow infiltration by plasma cells, reaching up to 88%. The diagnosis is often challenging due to the subtle or absent monoclonal bands on serum protein electrophoresis. CONCLUSIONS: Compared to existing literature, our series aligns with the known features of IgD myeloma, including male predominance, lambda light chain involvement, anemia, renal dysfunction, and lytic bone lesions. However, it is distinguished by the unusually young age of the patients, highlighting the need for heightened clinical suspicion in younger individuals presenting with such symptoms.
Differential Trends of T-cell Receptor and Kappa-Deleting Recombination Excision Circles in Dichorionic Twins.
Suzuki M, Nagano N, Hara K … +4 more , Hijikata M, Fuwa K, Okahashi A, Morioka I
Clin Lab · 2026 Mar · PMID 41945732 · Publisher ↗
BACKGROUND: In April 2023, T-cell receptor excision circles (TREC) and kappa-deleting recombination excision circles (KREC) were added to the expanded neonatal screening panel in Tokyo, Japan. METHODS: We observed dichor...
BACKGROUND: In April 2023, T-cell receptor excision circles (TREC) and kappa-deleting recombination excision circles (KREC) were added to the expanded neonatal screening panel in Tokyo, Japan. METHODS: We observed dichorionic twins with divergent TREC and KREC trends despite no maternal differences. Levels were monitored across screenings. RESULTS: The first-born had normal TREC and KREC, whereas the second-born showed undetectable TREC with low KREC at first screening. Further immunological evaluation found no abnormalities. By the fourth screening on day 190, TREC and KREC levels in the second-born normalized. CONCLUSIONS: TREC and KREC levels may be influenced by the in utero environment.
Development and Evaluation of an LC-MS/MS Method for Determining Paraquat and Diquat in Human Plasma: a Retrospective Study.
Wang J, Li B, Zhao Y … +2 more , Feng L, Gao J
Clin Lab · 2026 Mar · PMID 41945731 · Publisher ↗
BACKGROUND: This study aimed to establish a high-performance liquid chromatography tandem mass spectrometry method for determining paraquat and diquat in human plasma and predict clinical outcomes. METHODS: Each plasma s...
BACKGROUND: This study aimed to establish a high-performance liquid chromatography tandem mass spectrometry method for determining paraquat and diquat in human plasma and predict clinical outcomes. METHODS: Each plasma sample was subjected to methanol protein precipitation and passed through a hydrophilic column and was then analyzed by mass spectrometry to determine paraquat and diquat. Receiver operating characteristic curves were used to calculate herbicide poisoning severity indices and allow herbicide concentrations in plasma to be used to predict clinical outcomes. RESULTS: The responses to paraquat and diquat in plasma were strongly linear over the range of 20 - 10,000 ng/mL. The limit of quantitation and quality control samples met the required criteria. The paraquat and diquat poisoning severity index was significantly higher for the death group than the survival group (p < 0.05). The areas under the paraquat and diquat poisoning severity index receiver operating characteristic curves were 0.946 and 0.998, respectively, and the optimal clinical critical values were 22.84 and 15.64 (h·mg)/L, respectively, indicating good diagnostic performances for both herbicides. CONCLUSIONS: The method is sensitive, accurate, quick, and specific, so it is highly recommended for clinical use.
The Role of VEGF-A in Young Patients with Acute Coronary Syndrome.
Ocak M, Çömez VV, Yadigaroğlu M … +4 more , Görgün S, Köprülü D, Güzel M, Yücel M
Clin Lab · 2026 Mar · PMID 41945730 · Publisher ↗
BACKGROUND: The objective of the present study was to examine the correlation between acute coronary syndrome (ACS) and vascular endothelial growth factor A (VEGF-A) in young adult patients (aged 18 - 50 years). METHODS:...
BACKGROUND: The objective of the present study was to examine the correlation between acute coronary syndrome (ACS) and vascular endothelial growth factor A (VEGF-A) in young adult patients (aged 18 - 50 years). METHODS: In this single-center cross-sectional study, 44 young patients diagnosed with ACS were compared with 44 healthy controls with a similar age and gender distribution. Serum levels of VEGF-A were measured by enzyme-linked immunosorbent assay (ELISA) in blood samples obtained at the time of presentation to the emergency department. RESULTS: Out of the 44 patients included in the study with a diagnosis of ACS, 10 (22.7%) were diagnosed with unstable angina pectoris, 11 (25%) with non-ST-elevation myocardial infarction, and 23 (52.2%) with ST-elevation myocardial infarction (STEMI). Out of the patients diagnosed with STEMI, 13 (29.5%) were classified as inferior STEMI, while 10 (22.7%) were categorized as anterior STEMI. No statistically significant differences were observed between the patient and control groups regarding age, gender, and comorbidities (p > 0.05 for each). The mean serum VEGF-A value of the patient group was 364.19 ± 151.51. The mean serum VEGF-A value of the control group was 538.41 ± 559.70. The serum value of the patient group for VEGF-A was lower than that of the control group, but this difference was statistically nonsignificant (p = 0.052). The creatinine and C-reactive protein (CRP) values of the patient group were found to be significantly higher than those of the control group (p = 0.022 and p = 0.010, respectively). CONCLUSIONS: Serum levels of VEGF-A were found to be lower in young patients with ACS compared to the control group, although this difference was statistically nonsignificant. This finding implies a relationship between low levels of VEGF-A and an increased risk of ACS in young individuals.
Platelet Indices and Cholinesterase in Diagnosis and Prognosis of Pulmonary Embolism.
Akkan-Öz M, Mutlu H, Bulut B … +6 more , Genç M, Yazici R, Gür A, Akkan-Eren Ş, Köylü Ö, Köylü R
Clin Lab · 2026 Mar · PMID 41945729 · Publisher ↗
BACKGROUND: This study aimed to investigate the diagnostic and prognostic value of platelet indices (Platelet (PLT), Platelet Distribution Width (PDW), Mean Platelet Volume (MPV)) and cholinesterase activity in patients...
BACKGROUND: This study aimed to investigate the diagnostic and prognostic value of platelet indices (Platelet (PLT), Platelet Distribution Width (PDW), Mean Platelet Volume (MPV)) and cholinesterase activity in patients with pulmonary embolism (PE) in the emergency department (ED). METHODS: This prospective observational case-control study included 60 patients diagnosed with PE through CT angiography and 40 healthy controls. The platelet indices and cholinesterase levels were measured on admission and day 3. The simplified Pulmonary Embolism Severity Index (sPESI) was calculated for risk stratification. The relationship between these parameters and mortality was analyzed. RESULTS: The mean age was 67.25 ± 17.14 years in the PE group and 64.6 ± 18.12 years in the control group. MPV levels were significantly higher in PE patients compared to controls (10.78 ± 1.05 vs. 10.15 ± 0.96, p = 0.048), while cholinesterase levels were significantly lower (5.54 vs. 7.25, p < 0.001). Among PE patients, those who died had sig-nificantly lower cholinesterase levels (3.54 vs. 5.87, p = 0.043) and systolic blood pressure, along with higher lac-tate levels and sPESI scores compared to survivors. Patients with sPESI scores ≥ 1 had significantly lower cholinesterase levels compared to those with sPESI = 0 (5.08 vs. 7.19, p < 0.001). CONCLUSIONS: Our findings suggest that decreased cholinesterase levels and elevated MPV values may serve as promising biomarkers for PE diagnosis. Additionally, low cholinesterase levels appear to be associated with increased mortality risk in PE patients. These parameters, particularly cholinesterase, could potentially enhance current risk stratification tools when integrated with clinical scoring systems.
A Nomogram Model to Predict the Risk of Concurrent Liver Injury in Pediatric Patients with Infectious Mononucleosis.
Liu Z, Xiao L, Gao C … +2 more , Mao M, Liao H
Clin Lab · 2026 Mar · PMID 41945728 · Publisher ↗
BACKGROUND: Infectious mononucleosis (IM), an acute self-limiting disease predominantly caused by Epstein-Barr virus (EBV), is common in children. Liver injury is one of its most frequent complications. Early identificat...
BACKGROUND: Infectious mononucleosis (IM), an acute self-limiting disease predominantly caused by Epstein-Barr virus (EBV), is common in children. Liver injury is one of its most frequent complications. Early identification and prediction of the risk of liver injury in children with IM are crucial for timely intervention and improved prognosis. This study aimed to develop and validate a nomogram model for predicting the risk of concurrent liver injury in pediatric patients with IM. METHODS: This retrospective study enrolled 202 pediatric patients with IM who were diagnosed and treated at our hospital between January 2023 and December 2024. Based on serum alanine aminotransferase (ALT) levels, patients were divided into a liver injury group (ALT > 50 U/L, n = 116) and a control group (ALT < 50 U/L, n = 86). General clinical data and laboratory parameters were collected and compared between the two groups. Multivar-iable logistic regression analysis was employed to identify independent risk factors for concurrent liver injury in pediatric patients with IM. Subsequently, a nomogram prediction model was constructed and verified based on these factors. RESULTS: Among the 202 pediatric patients with IM, the incidence of liver injury was 57.42%. The incidence of he-patosplenomegaly was significantly higher in the liver injury group compared to the control group (p < 0.05). Statistically significant differences were observed between the two groups regarding neutrophil percentage (NEU), lymphocyte percentage (LYM), platelet count (PLT), platelet distribution width (PDW), uric acid (UA), beta2-mi-croglobulin (β2-MG), atypical lymphocytes, and interleukin-6 (IL-6) (p < 0.05). Multivariable logistic regression analysis revealed that PDW, UA, β2-MG, atypical lymphocytes, and IL-6 were independent risk factors for concurrent liver injury in pediatric patients with IM. The nomogram model constructed based on these independent risk factors exhibited great discrimination and calibration, with a concordance index (C-index) of 0.942 (95% CI: 0.877 - 1.007) and an area under the receiver operating characteristic curve (AUC) of 0.960. Decision curve analysis (DCA) showed the model provided substantial net clinical benefit across threshold probabilities ranging from 4% to 100%. CONCLUSIONS: The nomogram model constructed in this study can effectively predict the risk of concurrent liver injury in pediatric patients with IM.
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