Mécanismes et implications cliniques des altérations fonctionnelles des polynucléaires neutrophiles dans les états de surcharge en fer

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Applications of the monoclonal antibody PC10 assessment of proliferative grade in cell smears

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Accurate flow cytometric measurement of bacteria concentrations

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Hyronéphrose bilatéraele congénitale

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Artefactually-normal automated platelet counts due to malaria-infected RBC

Protein aggregates, red cell or white cell fragments are known to interfere with platelet counts in automated blood analysers, both by aperture impedance and optical technologies. When a falsely high value is suspected, interference by pseudo-platelet particles can be confirmed by systematic examination of stained blood films. The method that best avoids these sources of interference is the reference, immunological platelet count. We describe a case of treated malaria with a false normal platelet count. The blood smear revealed small red cells, infected by trophozoites of Plasmodium falciparum, that interfered with the platelet count. The Cell Dyn® 4000 shows different patterns of interference by infected red cells in its impedance and optical counts, and thrombocytopenia was suspected immediately. This was confirmed by a phase-contrast microscopic platelet count.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Performance and abnormal cell flagging comparisons of three automated blood cell counters

Objectives: To compare two hematological analyzers-the DxH-800 (DxH; Beckman-Coulter, Miami, FL) and XN-2000 (XN; Sysmex, Kobe, Japan)-with the Cell-Dyn Sapphire (SAPH; Abbott, Santa Clara, CA). Methods: We analyzed 4,375 samples. Slide reviews were made in the presence of blast, abnormal lymphocyte, and immature granulocyte (IG) flags or nucleated RBC (NRBC) count. Results: The analyzers exhibited excellent correlations for CBC and neutrophils but displayed a limit correlation for lymphocytes. The XN did not miss circulating blasts (0.5%-95% in microscopy). For NRBCs, the XN demonstrated a sensitivity of 90%; DxH, 74%; and SAPH, 29%. Only the XN demonstrated a correlation with microscopy, permitting a WBC six-part differential until 15% of NRBCs. The XN and DxH gave useful IG counts with a cutoff less than 5% and a WBC level more than 2,500/mm3. For abnormal lymphocytes detection, only XN demonstrated sensitivity of more than 95%, but its specificity of 54% requires adaptation. Conclusion: The XN increases the sensitivity of abnormal cell detection compared with the other counters, permitting a seven-part differential between predefined levels, decreasing the slide review from 20% to 9%. © American Society for Clinical Pathology.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Un cas de purpura thrombotique thrombocytopénique revue de la littérature

We report the case of a 70 years old woman who developed a thrombotic thrombocytopenic purpura. Despite a treatment with corticoids and high doses IV gammaglobulins ,the patient developed seizures. Treatment with plasma exchanges combined with plasma infusions allowed recovery. The authors review the clinical and biological aspects as well as the pathogeny of the disease. The authors insist on the importance of the plasma exchanges in the treatment of this disease.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Applying a direct aPTT ratio (PlatelinLS/ActinFS) permits to identify rapidly and reliably a bleeding-related factor deficiency or a lupus anticoagulant sequential to an isolated prolongation of aPTT in paediatric pre-operative screening

Objectives: An isolated prolongation of activated partial thromboplastin time (aPTT) found in paediatric pre-operative screening could be due to bleeding or non-bleeding aetiologies. The aim of our study was to evaluate clinical benefits of an additional ActinFS and/or a mixing aPTT study to identify a bleeding-related factor deficiency (BRFD). Methods: Over a 4-yr period, isolated prolongation of aPTT with PlatelinLS was detected in 308 paediatric patients and confirmed in 161 cases by a 2nd sample. ActinFS, a mixing study, FVIII, FIX, FXI, FXII and lupus anticoagulant (LA) were performed. Three different aPTT ratios between PlatelinLS and ActinFS were analysed. Results: We found 17 BRFD, 31 FXII deficiencies and 64 positive LA. A prolonged ActinFS had a significant association with BRFD (P < 0.0001) while a corrected mixing study did not. The direct aPTT ratio had a significant relationship with positive LA (P < 0.05), and with BRFD (P < 0.0001). Using this ratio, the sensitivity of BRFD's and LA's detection could be increased, respectively, to 82% from 59% using ActinFS alone, and to 86% from 55% using mixing study. Conclusions: Applying this direct aPTT ratio allows to quickly and reliably identify both BRFD and LA sequential to an isolated prolongation of aPTT.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Impaired neutrophil defense against Yersinia enterocolitica in patients with iron overload who are undergoing dialysis

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