Clinical Laboratory[JOURNAL]
Sun
200 papers
A Case of Antinuclear Antibody-Negative Dermatomyositis with Interstitial Lung Disease.
Qian Y, Xie K
Clin Lab · 2026 Jan · PMID 41544611 · Publisher ↗
BACKGROUND: Antinuclear antibody (ANA) is important for the diagnosis of autoimmune diseases. When ANA is positive, further specific autoantibody tests are needed to make a definite diagnosis. METHODS: This article repor...
BACKGROUND: Antinuclear antibody (ANA) is important for the diagnosis of autoimmune diseases. When ANA is positive, further specific autoantibody tests are needed to make a definite diagnosis. METHODS: This article reports a case of a patient with an autoimmune disease who had inconsistent results in the detection of antinuclear antibodies by indirect immunofluorescence assay (IIFA) and linear immunoblotting assay (LIA). RESULTS: This patient presented with negative ANA and positive anti-SSA/Ro52. CONCLUSIONS: IIF-ANA negative and LIA-ANAS positive exists in clinical tests. The combination of IIFA and LIA is important.
Gene Mutation and S100 Protein can be Prognostic Predictive Factors for Mucosal Melanoma Patients.
Tao J, Ling L, Ding F … +2 more , Nie X, He Y
Clin Lab · 2026 Jan · PMID 41544610 · Publisher ↗
BACKGROUND: Primary mucosal melanoma is a rare tumor that is usually diagnosed at advanced stages. It is of unknown etiopathogenesis with poor prognosis due to unfavorable response to treatments. METHODS: The aim of this...
BACKGROUND: Primary mucosal melanoma is a rare tumor that is usually diagnosed at advanced stages. It is of unknown etiopathogenesis with poor prognosis due to unfavorable response to treatments. METHODS: The aim of this study was to analyze the clinical and laboratory characteristics of 28 cases of primary mucosal melanoma in Southwest China. RESULTS: The mean age of the patients was 57 years, and 12 patients (43%) were men. Gene mutations were detected in 25% of the study population, and patients with gene mutations had a lower risk of relapse compared to patients without mutation (HR 0.258, p = 0.048). The study population had mucosal melanoma originating from head/neck (46%), anorectum (43%), and genital tract (11%). Patients with mucosal melanoma originating from genital tract had a higher peripheral blood lymphocyte-to-monocyte ratio (6.7) and a larger number of eosinophil (0.34 x 109/L) when compared to patients with mucosal melanoma originating from head/neck (3.1; 0.16 x 109/L) or patients with mucosal melanoma originating from anorectum (4.3; 0.14 x 109/L). At diagnosis, 3 patients (11%) developed organ metastasis. Patients with organ metastasis had a higher level of S100 protein (0.706 ng/mL) when compared to patients without metastasis (0.095 ng/mL) or patients with lymph node metastasis (0.067 ng/mL). S100 protein could be used to predict organ metastasis (cutoff value, 0.0935 ng/mL; AUC, 0.924; sensitivity, 0.89; specificity, 0.90). CONCLUSIONS: Among primary mucosal melanoma patients, gene mutations are associated with longer disease-control survival. S100 protein could help to improve the stratification process with a high risk of tumor progression.
Tropheryma whipplei Infection Presenting Initially with Chest Pain.
Xu S, Fan Y, Chen Z … +1 more , Deng ZP
Clin Lab · 2026 Jan · PMID 41543108 · Publisher ↗
BACKGROUND: Tropheryma whipplei is a rare pathogenic bacterium, a Gram-positive actinomycete widely distributed in the natural environment. It mainly infects individuals with immunodeficiency, but is rarely observed in i...
BACKGROUND: Tropheryma whipplei is a rare pathogenic bacterium, a Gram-positive actinomycete widely distributed in the natural environment. It mainly infects individuals with immunodeficiency, but is rarely observed in individuals with normal immune function. Most patients present with non-specific symptoms, and since it is not feasible to culture the bacteria using conventional methods, diagnosing this infection is very difficult. In this case, next-generation sequencing (NGS) detection via bronchoscopy confirmed the final diagnosis of Tropheryma whipplei infection. METHODS: Bronchoscopy and next-generation sequencing were used. RESULTS: Through bronchoscopy, NGS of bronchoalveolar lavage fluid indicated the presence of Tropheryma whipplei. Therefore, anti-infective treatment was administered. CONCLUSIONS: For cases of long-standing chest pain of unknown origin with abnormal findings on chest imaging, it is crucial to stabilize the patient's condition while identifying the underlying cause. Prompt implementation of relevant diagnostic procedures, such as bronchoscopy, is essential for establishing a diagnosis.
Hidden Mercury Poisoning Causing Pulmonary Embolism, Nephrotic Syndrome, and Hypothyroidism.
Luo JF, Chen QC, Zhang T … +3 more , Zhang D, Li XD, Ge YL
Clin Lab · 2026 Jan · PMID 41543107 · Publisher ↗
BACKGROUND: Mercury is a highly toxic heavy metal, and mercury poisoning often presents with different symptoms in multiple systems. While lung and kidney damage have been studied separately, involvement of the endocrine...
BACKGROUND: Mercury is a highly toxic heavy metal, and mercury poisoning often presents with different symptoms in multiple systems. While lung and kidney damage have been studied separately, involvement of the endocrine system has rarely been reported. We report on a case with pulmonary embolism, nephrotic syndrome, and hypothyroidism in a woman who used a mercury-containing whitening cream. METHODS: Chest enhancement CT; Laboratory tests. RESULTS: Chest enhancement CT suggested the presence of pulmonary embolism. Laboratory tests suggested nephrotic syndrome and hypothyroidism, and blood and urine were positive for mercury. The patient made a full recovery after treatment with immunosuppressants and mercury chelators. CONCLUSIONS: This case demonstrates the need for greater public awareness and stricter regulatory action to prevent health hazards associated with mercury in skin-lightening products.
A Novel Terahertz-Based Metamaterial System for the Detection of Multidrug-Resistant Mycobacterium tuberculosis.
Wang J, Ding J, Tang M … +3 more , Chen L, Liu J, Zhou X
Clin Lab · 2026 Jan · PMID 41543106 · Publisher ↗
BACKGROUND: Terahertz metamaterial is a label-free affinity sensor that is particularly sensitive to changes in the surface dielectric environment, so it can be used to detect protein molecules, human tissues, and drug r...
BACKGROUND: Terahertz metamaterial is a label-free affinity sensor that is particularly sensitive to changes in the surface dielectric environment, so it can be used to detect protein molecules, human tissues, and drug reaction processes. This study aimed to construct a detection system for multidrug-resistant Mycobacterium tuberculosis (MTB) based on terahertz metamaterials. METHODS: Linear padlock probes (PLP) were designed to contain sequences complementary to the DNA sequences of drug-resistant MTB (target sequences), and linear PLP hybridizes to the target sequence to form a circular PLP. The primers fixed on the magnetic beads hybridize with the circular PLP to initiate rolling circle amplification (RCA). We placed RCA nucleic acid products on terahertz metamaterials for terahertz measurements. RESULTS: We determined the detection system primer concentration to be 15 μmol/L and the RCA reaction time to be 2 hours. Under the abovementioned optimal conditions, the minimum detection limits of the terahertz metamaterial detection system for the target sequences of katG315, rpoB531, and rpsL43 were 7.7 × 10-5 pmol/L, 1.03 × 10-5 pmol/L, and 1.3 × 10-4 pmol/L, respectively. CONCLUSIONS: This terahertz metamaterial-based detection system can achieve high-sensitivity and rapid detection of multiple drug-resistant MTB.
Clinical and Laboratory Characteristics of ABO-Incompatible Hemolytic Disease of the Fetus and Newborn.
Kim HJ, Jung K, Kim JS … +6 more , Seo SW, Chung Y, Hwang SH, Oh HB, Kim H, Ko DH
Clin Lab · 2026 Jan · PMID 41543105 · Publisher ↗
BACKGROUND: ABO incompatibility is the most common cause of hemolytic disease of the fetus and newborn (HDFN). We investigated HDFN at our institute and discuss clinical characteristics and considerations during transfus...
BACKGROUND: ABO incompatibility is the most common cause of hemolytic disease of the fetus and newborn (HDFN). We investigated HDFN at our institute and discuss clinical characteristics and considerations during transfusions and laboratory testing. METHODS: We reviewed the medical records of newborns with HDFN due to ABO incompatibility over a period of 5 years. Laboratory results such as the ABO blood type of mothers and newborns, direct antiglobulin test, hemoglobin, and total bilirubin were collected. History of transfusion and phototherapy were also taken. RESULTS: During the 5 years, 275 newborns were diagnosed with HDFN by ABO blood type testing and crossmatching. Group O mothers were predominant, with 259 newborns, followed by B and A types, with 11 and five newborns, respectively. For the newborns, group A was the most common, with 151, followed by group B with 108 and AB with 16 newborns. The most common type of incompatibility was O/A, accounting for 54.9%, followed by O/B, B/AB, and A/AB at 54.9%, 4.0%, and 1.8%, respectively. DAT was conducted on only half of the group O mothers, and among them, 38.5% had positive results. For the 16 newborns of non-O mothers, six underwent DAT, and all were negative. Further, 21.6% and 31.3% of newborns from group O and non-group O mothers received transfusions, and 49.4% and 43.8% received phototherapy, respectively. CONCLUSIONS: Our findings highlight the importance of considering ABO HDFN even in DAT-negative neonates. Reverse typing may provide important diagnostic value, especially in transfusion settings with ABO compatibility with the maternal blood group.
Comparison of Anti-dsDNA Evaluation with 20x and 40x Objectives in Automated Systems to Expert Agreement.
Durmus MA, Oncel B
Clin Lab · 2026 Jan · PMID 41543104 · Publisher ↗
BACKGROUND: In this study, we investigated the effect of using a 40x objective instead of the recommended 20x objective in the computer-assisted automated evaluation of anti-dsDNA antibodies using the Crithidia luciliae...
BACKGROUND: In this study, we investigated the effect of using a 40x objective instead of the recommended 20x objective in the computer-assisted automated evaluation of anti-dsDNA antibodies using the Crithidia luciliae indirect immunofluorescence (CLIF) test. By using a 40x objective, we aimed to increase the accuracy and specificity of the CLIF test by improving image clarity and enabling easier interpretation by the expert physician. METHODS: Anti-dsDNA tests of 156 positive and 40 negative samples were evaluated using the automated EURO-Pattern system at 20x and 40x magnifications. The results were compared with the assessments of experienced physicians. Statistical analysis included chi-squared and kappa agreement tests. Sensitivity, specificity, and accuracy metrics were calculated for both objectives. RESULTS: When evaluated with the 20x objective, the system achieved a sensitivity of 100%, specificity of 29.85%, and accuracy of 50.26%, with a kappa coefficient of 0.199 (95% CI: 0.129 - 0.267). With the 40x objective, sensitivity was 94.55%, specificity was 90.30%, and accuracy was 91.53%, with a kappa coefficient of 0.805 (95% CI: 0.714 - 0.895). The agreement between the automated system and the expert evaluations significantly improved with the 40x objective. CONCLUSIONS: Using a 40x microscope objective enhances the compatibility between automated systems and expert evaluations, providing clearer and larger images. This adjustment reduces false positives, increases accuracy, and facilitates decision-making for specialists, supporting the adoption of 40x objectives for routine laboratory use.
Correlation of Plasma Neuropeptide Y with Specific Cognitive Domains in Patients with Parkinson's Disease Cognitive Impairment.
Zhang AR, Wu ML, Pang WJ … +3 more , Ning XB, Wu YJ, Pang JF
Clin Lab · 2026 Jan · PMID 41543103 · Publisher ↗
BACKGROUND: We aimed to investigate the correlation of plasma neuropeptide Y (NPY) with specific cognitive domains in patients with Parkinson's disease (PD) cognitive impairment (CI). METHODS: The study included thirty-s...
BACKGROUND: We aimed to investigate the correlation of plasma neuropeptide Y (NPY) with specific cognitive domains in patients with Parkinson's disease (PD) cognitive impairment (CI). METHODS: The study included thirty-six PD patients with normal cognitive function (PD-NC), 57 PD patients with mild cognitive impairment (PD-MCI), 30 PD patients with dementia (PDD), and 46 healthy individuals. Every patient underwent thorough clinical evaluations and neuropsychological examinations. Plasma NPY expression was assessed using ELISA. The effects of plasma NYP levels on PD-CI events or PDD were analyzed using univariate and multivariate logistic models. Multiple linear regression analyses were constructed to assess the independent associations of plasma NYP levels with z scores in 5 cognitive domains. RESULTS: Plasma NYP levels were reduced in patients with PD compared with healthy controls (p < 0.001). Plasma NYP levels were the highest in PD-NC patients and decreased with increasing CI, with the PDD group having the lowest plasma NYP levels. Multivariate logistic regression adjusted for years of education and UPDRS-III subscores showed a significant correlation between NYP and CI (p = 0.005). Plasma NYP was significantly correlated with a linear model between each of the 5 cognitive domains, including attention, executive function, language, memory, and visuospatial function. CONCLUSIONS: Reduced plasma NPY levels are associated with CI in PD patients and are strongly correlated with 5 cognitive domains.
Can Serum C-Reactive Protein/Albumin Ratio be Used as a Marker of Chronic Helicobacter Pylori Infection?
Eser U, Özkan Z, Karabayir N
Clin Lab · 2026 Jan · PMID 41543102 · Publisher ↗
BACKGROUND: Helicobacter pylori (H. pylori) is a Gram-negative bacterial agent that colonizes the gastric mucosa and leads to chronic infections. Various techniques are available for the detection of H. pylori; however,...
BACKGROUND: Helicobacter pylori (H. pylori) is a Gram-negative bacterial agent that colonizes the gastric mucosa and leads to chronic infections. Various techniques are available for the detection of H. pylori; however, many of these methods are invasive, costly, and can only be performed in tertiary laboratories. It is necessary to find cost-effective and non-invasive novel indicators that can identify H. pylori infection and its activity. OBJECTIVE: The objective of this study was to investigate the correlation between the CRP/albumin ratio (CAR), which is frequently analyzed in laboratory settings, and the presence of H. pylori, as well as the activation of H. pylori infection. METHODS: The medical records of patients who had upper gastrointestinal endoscopy at our hospital were reviewed retrospectively. The data were analyzed using suitable tests with the IBM SPSS 27 software. RESULTS: The study included 613 patients, comprising 375 females (61.2%) and 238 males (38.8%). Among the participants, 327 (53.3%) tested positive for H. Pylori, while 286 (46.7%) tested negative. All patients presented with dyspeptic symptoms, and other indications for UGISE included anemia, gastroesophageal reflux, epigastric discomfort, dysphagia, nausea and vomiting, bleeding, and scanning. Upon comparing the laboratory results of H. pylori-positive and -negative patients, no significant change in CRP values was observed (p > 0.05). The albumin level was statistically considerably elevated in H. pylori-negative pa-tients relative to -positive patients (p = 0.009). The CAR in H. pylori-positive patients was statistically substantially elevated compared to negative ones (p = 0.04). CONCLUSIONS: We assert that CAR may serve as a valuable biomarker for confirming the presence of H. pylori infection and for reflecting the systemic inflammatory status of patients.
The Clinical Application Value of Blood Lipid Levels in Multiple Myeloma.
Yu D, Miao J, Xu L … +1 more , Liu W
Clin Lab · 2026 Jan · PMID 41543101 · Publisher ↗
BACKGROUND: This study aimed to investigate the significance of serum lipid concentration in patients with multiple myeloma (MM) at different clinical stages and types, and the relationship between the change of serum li...
BACKGROUND: This study aimed to investigate the significance of serum lipid concentration in patients with multiple myeloma (MM) at different clinical stages and types, and the relationship between the change of serum lipid concentration before and after treatment, and to evaluate the application value of serum lipid index in MM disease. METHODS: Retrospectively, 130 patients who visited Shaoxing People's Hospital from July 2022 through July 2024, diagnosed with MM and meeting the inclusion criteria, were collected as the MM group. Additionally, 130 healthy individuals were collected as the NMM group. The study examined indicators such as triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) in both groups. RESULTS: Statistical analysis showed that TG, TC, HDL, and LDL concentrations in the MM group were lower than those in the NMM group (p < 0.05). In ISS staging, TC, LDL, and HDL concentrations were higher in stage I patients than in stage II and III patients, with a statistically significant difference (p < 0.05), and the difference in TG concentrations was statistically nonsignificant (p > 0.05). Among the common clinical subtypes, the TC and LDL concentrations of patients with light chain type were higher than those of patients with IgG type and IgA type, and the difference was statistically significant (p < 0.05); the TC and LDL concentrations of patients with IgG type were higher than those of patients with IgA type, and the difference was statistically significant (p < 0.05); and the differences between the different subtypes of the rest of the indicators were statistically nonsignificant (p > 0.05). In the remission group, MM patients showed increased TC, TG, HDL, and LDL concentrations after treatment compared to before, with statistically significant differences. CONCLUSIONS: The serum TG, TC, HDL, and LDL concentrations of MM patients were lower than those of normal controls. The serum TC, HDL, and LDL concentrations of MM patients negatively correlated with the clinical stage of the disease (ISS stage), suggesting that the concentration of blood lipid can be used as a reference index for the clinical stage of multiple myeloma. Serum lipid indicators showed statistically significant differences among different protein subtypes (IgA, IgG, light chain type) in MM, indicating that combining lipid concentrations with MM clinical staging can help assess the progression of the disease. In the remission group, serum lipid concentrations in MM patients increased after treatment, which is significant for the monitoring of treatment efficacy in MM.
Pneumonia in Children Caused by Infection of Bordetella pertussis and Two Respiratory Viruses: Case Report and Literature Review.
Zhang D, Wu D, Lu S … +3 more , Mao G, Sun G, Zhang X
Clin Lab · 2026 Jan · PMID 41543100 · Publisher ↗
BACKGROUND: "Pertussis reappearance" and its epidemic pattern have changed, and the overall incidence group has shifted from infants and children to adolescents and adults. METHODS: We use real-time PCR technology for nu...
BACKGROUND: "Pertussis reappearance" and its epidemic pattern have changed, and the overall incidence group has shifted from infants and children to adolescents and adults. METHODS: We use real-time PCR technology for nucleic acid detection of multiple pathogens in respiratory specimens. RESULTS: Children infected with pertussis are prone to coinfection with other pathogens. In February and March of this year, ADV and HRV were highly prevalent in the local area. The child visited the hospital multiple times, increasing the possibility of cross infection, resulting in coinfection of pertussis with ADV and HRV. CONCLUSIONS: Early nucleic acid testing for Bordetella pertussis is helpful for the diagnosis of pertussis. Mixed infection pathogens are mainly viral infections. The common mixed infection pathogens in different regions are different and related to the prevalence of local pathogens.
Knowledge, Towards, and Practice of Blood Donation: a Cross-Sectional Study in Makkah City, Saudi Arabia.
Halawani AJ
Clin Lab · 2026 Jan · PMID 41543099 · Publisher ↗
BACKGROUND: Insufficient blood supply negatively affects transfusion-dependent patients. Sustaining adequate blood units relies on community education. As future healthcare professionals, medical science students may ass...
BACKGROUND: Insufficient blood supply negatively affects transfusion-dependent patients. Sustaining adequate blood units relies on community education. As future healthcare professionals, medical science students may assist in increasing the number of blood donations. This study assessed blood donation knowledge among medical science students at Umm Al-Qura University in Makkah City, Saudi Arabia. METHODS: Twenty-three questions were administered in an online survey to assess knowledge, attitudes, and practices (KAP) of medical science students regarding blood donation. A chi-squared test was used to examine associations with the status of the blood donation. RESULTS: A total of 286 students from four departments responded to the questionnaire. Remarkably, higher contributions regarding knowledge and attitude questions were observed in female participants, compared to male participants. Furthermore, students that donated blood demonstrated greater awareness of their blood group (p < 0.05), minimum weight legibility, and knowledge regarding the duration of the blood donation procedure (p < 0.01). CONCLUSIONS: This study assessed the KAP regarding blood donation among medical science students at Umm Al-Qura University, Saudi Arabia. Furthermore, the most commonly reported barrier was the belief that the individual was not sufficiently fit or healthy to donate. Consequently, targeted education is crucial to emphasize the importance of blood donation and mitigate hospital blood shortages, especially for patients who require blood transfusion units regularly.
Association of Red Blood Cell Distribution Width with Diabetic Nephropathy in Type 2 Diabetes: Findings from a Cross-Sectional Study.
Wang H, Ji Y, Yu P
Clin Lab · 2026 Jan · PMID 41543098 · Publisher ↗
BACKGROUND: Diabetic nephropathy (DN) is a prevalent and significant complication associated with diabetes mellitus (DM). Although several risk factors have been established, there is still a need to explore additional i...
BACKGROUND: Diabetic nephropathy (DN) is a prevalent and significant complication associated with diabetes mellitus (DM). Although several risk factors have been established, there is still a need to explore additional indicators for the early detection and intervention planning of DN. Red cell distribution width (RDW) has been noted to play a role in cardiovascular events and metabolic syndrome. This study aimed to explore the potential association between RDW and DN in patients with type 2 DM (T2DM). METHODS: Data were gathered from 2011 through 2018 through NHANES, and we performed a cross-sectional study that included 3,704 T2DM patients. Logistic regression, curve fitting, and interaction effects were utilized to examine the relationship between RDW and diabetic nephropathy. RESULTS: The mean RDW values were significantly elevated in patients with diabetic nephropathy compared to those without diabetic nephropathy (p < 0.001). Logistic regression analysis indicated a positive correlation between RDW and DN, even after adjusting for the confounding variables (odds ratio: 1.16, 95% confidence interval: 1.12 - 1.21, p < 0.001). Furthermore, after accounting for all confounding variables, curve fitting demonstrateed a linear relationship between RDW and DN (p for non-linearity = 0.658). RDW was positively correlated with DN. CONCLUSIONS: In conclusion, our research suggests that there is a link between higher RDW levels and the presence of DN, indicating that RDW may serve as a valuable biomarker for the early identification, prevention, and strategic intervention of this serious complication.
Th17/Treg Imbalance in Acute Kidney Injury.
Zhou X, Bai G, Duan M
Clin Lab · 2026 Jan · PMID 41543097 · Publisher ↗
BACKGROUND: Helper T cell 17 (Th17) and regulatory T cells (Treg) play an important role in the inflammatory response. However, the role of Th17/Treg imbalance in acute kidney injury is not yet established. The aim of th...
BACKGROUND: Helper T cell 17 (Th17) and regulatory T cells (Treg) play an important role in the inflammatory response. However, the role of Th17/Treg imbalance in acute kidney injury is not yet established. The aim of the study was to analyze Th17/Treg imbalance in acute kidney injury caused by sepsis or other reasons. METHODS: An observational prospective study was conducted. We enrolled adult patients admitted to the intensive care unit (ICU) with acute kidney injury caused by sepsis or other reasons and then followed up until 28 days or discharge. Healthy volunteers were followed during the same period as the control group. We investigated the differences in renal injury markers and inflammatory indicators between acute kidney injury (AKI) patients and the control group. The clinical data and peripheral blood samples of all patients were collected immediately after enrollment. An analysis of the data was conducted to determine if the Th17/Treg ratio could serve as a predictive marker of sepsis induced acute kidney injury (SAKI) in AKI patients. RESULT: A total of 104 AKI patients were enrolled in the study, including 60 SAKI, 44 AKI without sepsis, while 10 healthy volunteers served as the control group. Infections, especially thoracoabdominal infection leading to sepsis, were the major cause of AKI in the study population (58%). Th17/Treg ratio, the proportion of Th17 cells, the concentration of interleukin-10 (IL-10), and the concentration of interleukin-17 (IL-17) of AKI patients showed a significant increase compared to that in the control group. The proportion of Th17 cells and Treg cells as well as the Th17/Treg ratio of the SAKI group were higher than those of the AKI without sepsis group. Chronic kidney disease (CKD) and Th17/Treg ratio were independent risk factors for SAKI. The AUC demonstrated that the Th17/Treg ratio measured 0.775 (95% CI 0.683 - 0.851, p < 0.0001). The cutoff value of Th17/Treg ratio for predicting SAKI was 0.033. When the Th17/Treg ratio was > 0.033, the sensitivity of predicting SAKI was 0.967, and the specificity was 0.500. The 28-day mortality and renal function recovery rate between the SAKI group and the AKI without sepsis group did not differ. CONCLUSIONS: There was an imbalance of Th17/Treg in acute kidney injury. Compared with AKI caused by other factors, Th17/Treg ratio was higher in SAKI patients. There was no difference in 28-day mortality and renal function recovery rate among AKI patients with different etiologies.
Elevated Lactate, D-dimer, and IL-6 Associated with Elderly Community-Acquired SARS-CoV-2 Pneumonia Severity.
Han X, Wang Q, Li D … +4 more , Zheng Y, Meng Q, Mu J, Wang Y
Clin Lab · 2026 Jan · PMID 41543096 · Publisher ↗
BACKGROUND: Uncontrolled systemic inflammatory responses significantly contribute to the pathogenesis of severe community-acquired pneumonia (CAP) following SARS-CoV-2 infection (CASP). Elderly populations, being particu...
BACKGROUND: Uncontrolled systemic inflammatory responses significantly contribute to the pathogenesis of severe community-acquired pneumonia (CAP) following SARS-CoV-2 infection (CASP). Elderly populations, being particularly vulnerable to respiratory infections, demonstrate both increased susceptibility to SARS-CoV-2 infection and greater disease severity. This study aimed to identify readily available routine hematological biomarkers that could serve as independent risk factors for predicting severe CASP (sCASP) in elderly patients. METHODS: A retrospective study was conducted to analyze 77 elderly people with CASP. According to the severity of the disease, the elderly people were divided into a non-sCASP group and a sCASP group, and the routine comprehensive laboratory examinations were compared. RESULTS: A total of 77 elderly patients with CASP were enrolled in this study, comprising 35 cases in the non-sCASP group and 42 cases in the sCASP group. Significant differences were observed in admission laboratory parameters, including routine blood counts, coagulation profiles, liver and kidney function tests, inflammatory markers, and composite laboratory-derived indices, between non-sCASP and sCASP cases infected with SARS-CoV-2 Omicron subvariants BA.5.2 and BF.7 (p < 0.05). Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses identified lactate > 1.95 mmol/L, D-dimer > 0.85 mg/L, and IL-6 > 33.5 pg/mL as the most probable independent risk factors for sCASP in elderly patients. Notably, the combined diagnostic model (lactate-D-dimer-IL-6) demonstrated superior predictive performance for disease severity (AUC = 0.981; 95% CI: 0.954 - 1) compared to any single biomarker alone. CONCLUSIONS: Elevated admission lactate, D-dimer, and IL-6 can be used as independent risk factors for the evaluation of CASP severity in elderly people, and the joint detection might be a better choice. This is imperative for guiding the development of effective interventions to alleviate severe patients' symptoms and burden.
Serum Calprotectin - What is the Scope of Clinical Application?
Cho HE, Lee JJ, Cho SY
Clin Lab · 2026 Jan · PMID 41543095 · Publisher ↗
BACKGROUND: Calprotectin (CLP), a heterodimer of S100A8 and S100A9, is a calcium-binding protein with key intracellular and extracellular roles, especially in inflammatory processes. Predominantly expressed by neutrophil...
BACKGROUND: Calprotectin (CLP), a heterodimer of S100A8 and S100A9, is a calcium-binding protein with key intracellular and extracellular roles, especially in inflammatory processes. Predominantly expressed by neutrophils and monocytes, CLP is released in response to infection or inflammation and serves as a potent antimicrobial and pro-inflammatory mediator. METHODS: We performed a systematic search of electronic databases to identify studies evaluating serum CLP in inflammatory diseases. RESULTS: Serum CLP levels are elevated in numerous inflammatory conditions, making it a valuable biomarker for disease activity, prognosis, and therapeutic monitoring. In rheumatoid arthritis (RA), CLP reflects disease severity more accurately than conventional markers like CRP and ESR, correlates with radiographic progression, and is strongly expressed at inflammation sites. In juvenile idiopathic arthritis (JIA), serum CLP levels are significantly higher in active, treatment-naïve patients and correlate well with clinical activity. In spondyloarthritis (SpA), especially ankylosing spondylitis, CLP levels tend to be elevated, though results vary among studies. In inflammatory bowel disease (IBD), CLP is proposed as a non-invasive marker for disease burden and response to treatment. It is especially useful in systemic inflammation assessment. Elevated CLP levels are also observed in psoriasis, Behçet's disease, ANCA-associated vasculitis, and preeclampsia. CLP has emerged as a promising prognostic marker in bacterial infection and coronavirus disease 2019 (COVID-19), with higher levels correlating with ICU admission and disease severity. CONCLUSIONS: Serum CLP is a promising inflammatory biomarker, though disease specificity remains limited.
Intravenous Immunoglobulin Administration Induces Severe Anemia and Cross-Matching Incompatibility in Neonates.
Ling D, Ping C, Hongbing H
Clin Lab · 2026 Jan · PMID 41543094 · Publisher ↗
BACKGROUND: This study aimed to explore the severe anemia and cross-matching incompatibility caused by intravenous immunoglobulin (IVIG) administration and the selection of accurate red blood cells (RBC) for transfusion....
BACKGROUND: This study aimed to explore the severe anemia and cross-matching incompatibility caused by intravenous immunoglobulin (IVIG) administration and the selection of accurate red blood cells (RBC) for transfusion. METHODS: Cross-matching, direct antiglobulin test (DAT), free antibody test (FAT), and elution test (ET) were performed with the neonatal samples before and after IVIG administration simultaneously. The blood samples after IVIG administration were performed by cross-matching with antihuman globulin (AHG) microcolumn gel card (AHG-card) and AHG tube method (AHG-tube) with the same packed RBC suspension simultaneously. The laboratory results before and after IVIG administration and after packed RBC suspension transfusion were collected. The incidence of RBC transfusion adverse reactions was collected as well. RESULTS: Out of 30 neonates enrolled in this study, the indication of IVIG was sepsis in 18, necrotizing enterocolitis (NEC) in 10, and undetermined reason in 2. The IVIG administration ranges of dose, frequency, and dose/weight were 1.8 - 7.5 g, 1 - 3 times, and 0.8 - 2.9 g/kg. Cross-matching tests by AHG-card, DAT, FAT, and ET were all positive in 30 neonates after administration of IVIG, the elevation of lactic dehydrogenase (LDH) and unconjugated bilirubin and reduction of RBC and HGB were statistically significant after IVIG administration. The incompatibility cases of AHG-card and AHG-tube were 30 and 6, respectively. Compared with laboratory test results before IVIG administration, after packed RBC suspension transfusion, the RBC and HGB of 30 neonates increased significantly. No RBC transfusion adverse reaction was observed. CONCLUSIONS: IVIG administration can lead to severe anemia and cross-matching incompatibility using AGH-card. Safe and cautious IVIG administration is necessary for neonates. AGH-tube can be a solution for cross-matching incompatibility using AGH-card.
Clinical Factors Associated with Postnatal Urinary Titin N-Fragment in Neonates.
Okuda K, Fuwa K, Sato Y … +6 more , Go H, Imaizumi T, Hijikata M, Okahashi A, Nagano N, Morioka I
Clin Lab · 2026 Jan · PMID 41543093 · Publisher ↗
BACKGROUND: Titin is a large sarcomeric protein (~ 3,800 kDa) essential for muscle function. The urinary N-terminal fragment of titin (N-titin) has emerged as a noninvasive biomarker for muscle injury in adults, but its...
BACKGROUND: Titin is a large sarcomeric protein (~ 3,800 kDa) essential for muscle function. The urinary N-terminal fragment of titin (N-titin) has emerged as a noninvasive biomarker for muscle injury in adults, but its clinical significance in neonates remains unclear. METHODS: A retrospective cohort study involving 523 neonates admitted to the NICU/GCU at Nihon University Itabashi Hospital between October 2021 and December 2023 was conducted. Urinary N-titin, collected within 24 hours of birth, was measured using enzyme-linked immunosorbent assay (ELISA) and normalized to creatinine (N-titin/Cr). Associations among neonatal, maternal, and delivery factors were analyzed. A subgroup analysis was performed in neonates with asphyxia. Reference percentiles of N-titin/Cr were separately established for neonates with and without asphyxia. Clinical courses were reviewed for neonates whose N-titin/Cr ratio exceeded the 95th percentile as well as for those with neuromuscular diseases or chromosomal abnormalities. RESULTS: Urinary N-titin levels negatively correlated with gestational age (p = 0.0035) and Apgar score (p < 0.0001). Positive correlations were found among AST, ALT, LDH, creatine kinase (CK), and lactate levels (all p < 0.0001). Stronger correlations with muscle-derived enzymes were observed in neonates with asphyxia. Higher N-titin levels were associated with non-reassuring fetal status, placental abruption, and emergency cesarean delivery. Six neonates with asphyxia exceeded the 95th percentile; three died and two had mild developmental delays. No neuro-muscular disease was identified. Seven patients with Down syndrome were identified in this study. CONCLUSIONS: Urinary N-titin levels reflect acute perinatal stress, particularly neonatal asphyxia. The establishment of reference values may support its use as an early biomarker in neonates.
Initial Lactate vs. Lactate Clearance in Predicting Hyperbaric Oxygen Therapy Requirement in Carbon Monoxide Poisoning.
Satilmis H, Guzel M, Yadigaroglu M … +4 more , Ocak M, Kocyigit C, Ekiz M, Yucel M
Clin Lab · 2026 Jan · PMID 41543092 · Publisher ↗
BACKGROUND: This study aimed to determine the relationship between baseline blood lactate levels and lactate clearance (CL) and the need for hyperbaric oxygen therapy (HBOT) in patients with carbon monoxide (CO) poisonin...
BACKGROUND: This study aimed to determine the relationship between baseline blood lactate levels and lactate clearance (CL) and the need for hyperbaric oxygen therapy (HBOT) in patients with carbon monoxide (CO) poisoning. METHODS: This retrospective study included patients admitted to the emergency department for CO poisoning between January 1, 2017, and March 1, 2024. Patients were classified into normobaric oxygen therapy (NBOT) and HBOT groups based on the treatment received. Initial and peak lactate levels (measured 2 - 6 hours post-admission) were recorded in mmol/L from venous blood gas analysis. CL was calculated using the formula: CL = [(initial lactate - final lactate)/initial lactate] x 100. RESULTS: One hundred and sixty-nine patients were included in the study, out of which 78.7% (n = 133) did not receive HBOT, while 21.3% (n = 36) were treated with HBOT. Median lactate levels were significantly higher in the HBOT group (3 [1.2 - 10] mmol/L) compared to the NBOT group (2.1 [0.5 - 14.6] mmol/L) (p < 0.001). Median CL values were 35.29% (-50 - 89.06) for the NBOT group, and 35.28% (-31.58 - 87.95) for the HBOT group, and no significant association was found between CL and the treatment modality (p = 0.596). Receiver operating characteristic analysis identified lactate > 2.8 mmol/L as predictive of HBOT need, with 63.89% sensitivity and 72.93% specificity (area under the curve: 0.705, 95% confidence interval: 0.631 - 0.773, p < 0.0001). CONCLUSIONS: In CO poisoning patients, initial lactate levels at admission may better indicate the need for HBOT than CL.
Alloimmunization Rates and Associated Factors in Transfusion-Dependent Patients: a Regional Study from Saudi Arabia.
Shaikh A, Asiri A, Alasmari S … +2 more , Makkawi M, Mansor AA
Clin Lab · 2026 Jan · PMID 41543091 · Publisher ↗
BACKGROUND: Blood transfusion is effective in treating and managing numerous medical conditions. However, repeated transfusions increase the risk of alloimmunization. This study aimed to determine the prevalence and risk...
BACKGROUND: Blood transfusion is effective in treating and managing numerous medical conditions. However, repeated transfusions increase the risk of alloimmunization. This study aimed to determine the prevalence and risk factors associated with alloimmunization in transfusion-dependent patients in the Aseer province. METHODS: This study included 149 patients. Data were obtained retrospectively from medical records and include age, gender, diagnosis, blood group, Rh phenotype, presence of alloantibodies, and transfusion history. RESULTS: Out of the 149 patients, 78 (52.3%) were male and 71 (48.6%) were female, with a mean age of 24.58 ± 23.21 years (range 1 - 88 years). Alloimmunization was detected in 15 (10.2%) patients, predominantly in those with blood group O (8, 53%) and Rh-D positive status (12, 80%). A significant proportion (12, 80%) had received > 15 transfusion units per year. The most frequently identified alloantibodies were anti-E (4, 26%) and anti K (4, 26%). Alloimmunization was significantly associated with age, Rh-D blood group, and the number of transfusion units received (p ≤ 0.05). CONCLUSIONS: Transfusion-dependent patients are at increased risk of alloimmunization, particularly those with Rh-D positivity, older age, and a high transfusion burden. The risk of alloimmunization could be mitigated by implementing extended red cell phenotyping and matched transfusion strategies. These findings underscore the need for optimized transfusion policies to minimize alloimmunization-related complications in this vulnerable patient population.
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