Elévation faible d’hCG en dehors d’un contexte gravidique : à propos de deux cas et revue de la littérature

in Annales de Biologie Clinique (2013), Sous presse

Unexpected finding or persistence of low human chorionic gonadotropin (hCG) levels is not a rare situation. It requires a clinico-biological approach in order to avoid misunderstandings that could lead to ... [more ▼]

Unexpected finding or persistence of low human chorionic gonadotropin (hCG) levels is not a rare situation. It requires a clinico-biological approach in order to avoid misunderstandings that could lead to inappropriate diagnostic or therapeutic attitudes. Outside the context of a pregnancy, persistent low levels of hCG may be associated with various benign and malignant conditions, i.e. quiescent gestational trophoblastic disease (QTD), raised pituitary hCG or false positive elevation caused by circulating heterophile antibodies. We report the cases of two non-pregnant patients with low serum hCG. In the first case, hCG levels raised during several years following a spontaneous abortion. The likelihood of heterophilic antibodies interference was ruled out and extensive clinical investigation excluded the presence of a tumour. The diagnosis was QTD. In the second case, elevated hCG came to light as an incidental finding in a women with chronic renal failure and led the clinicians to question the laboratory. The cause was probably an increase in pituitary hCG consecutive to terminal renal failure. These cases illustrate the importance of understanding the biology of the hCG and the causes of its persistent low elevation, which are reviewed in this article. It is essential to demonstrate clinically the presence of a tumour in order to avoid unnecessary and ineffective chemotherapy and/or hysterectomy. [less ▲]

Recommandations pour le choix et l'harmonisation des techniques de dosage de la créatinine

in Annales de Biologie Clinique (2011), 69(1), 9-16

En 2010, un groupe de travail mixte constitué de la Société française de biologie clinique (SFBC) et de la Société de nephrologie (SN) a formulé les propositions suivantes afin de réactualiser les ... [more ▼]

En 2010, un groupe de travail mixte constitué de la Société française de biologie clinique (SFBC) et de la Société de nephrologie (SN) a formulé les propositions suivantes afin de réactualiser les recommanadations pour le dosage de la créatinine plasmatique. [less ▲]

Anticorps anti-gliadines déamidées et maladie coeliaque : données actuelles et évaluation des faux positifs de cinq trousses de dosage

in Annales de Biologie Clinique (2010), 68(2), 149-56

Recently, anti-deamidated gliadin antihodies were proposed for the serological diagnosis of celiac disease. We evaluate the specificity of different anti-deamidated gliadin antibodies ELISA in comparison ... [more ▼]

Recently, anti-deamidated gliadin antihodies were proposed for the serological diagnosis of celiac disease. We evaluate the specificity of different anti-deamidated gliadin antibodies ELISA in comparison with conventional anti-native gliadin kits. Serum sainples froin 46 non celiac patients trere analyzed by five different quantitative ELISA for anti-native gliadin, antideamidated gliadin and anti-fransglutaininase neo-epitope antibodies together with a screening ELISA. Twenty-four percent of the patients deinonstrated anti-native gliadin lgA and 63% 1gO antibodies. Using anti-dearnidated gliadin antibodies, tire number of false positive IgA and, particularly, 1gG results,markedly decreased in the non celiac patients: 21 and 24% respectively with anti-Gliadin (GAF-3X) Euroimmun kit, 7 and 26% with Bindazyme 1-lurnan Anti-Gliadin (MGP) The Binding Site kit and 0 and 41% with Celiac G+ Immco kit. The new assay which makes use of the physiological complex of tissue transglutaminase cross-linked with deamidated gliadin peptides, called neo-epitope, did not improve the differential diagnosis of celiac disease with 30% of false positive results in IgG (2% in IgA). IJsing the Inova screening kit, a positive resuit for IgA and/or IgG anti-deamidated gliadin and!or anti- tissue transglutaminase antibodies was obtained in 24% of the non celiac patients. In conclusion, our study assessed the superiority, in ternis of specificity, of anti-deamidated gliadin antibodies, over the conventional anti-gliadin antibodies for die differential diagnosis of celiac disease. [less ▲]

La creatinine : d'hier a aujourd'hui.

in Annales de Biologie Clinique (2010), 68(5), 531-43

Serum creatinine is certainly one of the most prescribed biological parameters. In this review article, we remind some historical data regarding creatinine. Different methodologies to measure creatinine ... [more ▼]

Serum creatinine is certainly one of the most prescribed biological parameters. In this review article, we remind some historical data regarding creatinine. Different methodologies to measure creatinine in blood and urine are deeply described. We also discuss the physiological reason for its use as a glomerular filtration rate marker. However, analytical and physiological limitations are described and discussed. Creatinine clearance usefulness is finally largely discussed. [less ▲]

Comparison of BNP and NT-proBNP performances for assessing heart failure in a population of patients with high incidence of with renal insufficiency

in Annales de Biologie Clinique (2009), 67(1),

Encore un pas vers la standardisation internationale du dosage d'HbA1c

in Annales de Biologie Clinique (2008), 66(1), 6-8

Evolution des modalités d'évaluation de la fonction rénale basée sur la créatinine entre 2005 et 2008: conséquences pour les biologistes

in Annales de Biologie Clinique (2008), 66(3), 263-8

Les recommandations internationales de 2005 concernant l’insuffisance rénale chronique proposent une classification basée sur le débit de filtration glomérulaire (DFG). Depuis cette date, la question ... [more ▼]

Les recommandations internationales de 2005 concernant l’insuffisance rénale chronique proposent une classification basée sur le débit de filtration glomérulaire (DFG). Depuis cette date, la question posée de la validité des formules évaluant le DFG, et des créatininémies qui y sont insérées, se pose de façon encore plus cruciale qu’il y a quelques années. Pour les biologistes, les conséquences de ces recommandations cliniques sont importantes. En premier lieu, la formule classique de Cockcroft-Gault doit être abandonnée au profit de l’équation dite MDRD à 4 variables, et ce malgré les recommandations officielles françaises actuelles, qui devraient être modifiées d’ici peu. D’autre part, afin d’optimiser l’évaluation du DFG par cette formule, les biologistes doivent choisir entre la version dite « 186 » de l’équation MDRD, adaptée aux méthodes de dosage de la créatininémie non raccordées à la méthode de référence (chromatographie liquide ou gazeuse couplée à la spectrométrie de masse) et la version dite « 175 », adaptée aux méthodes de dosages raccordées. A ce jour, seules certaines méthodes enzymatiques ont fait la preuve de leur raccordement à une méthode de référence. L’avenir des méthodes colorimétriques classiques est incertain. [less ▲]

Cystatine C: point d'etape et perspectives.

in Annales de Biologie Clinique (2008), 66(3), 301-23

Cystatin C is a low molecular weight-protein, which may replace creatinine for the evaluation of renal function, particularly in the clinical settings where the relationship between creatinine production ... [more ▼]

Cystatin C is a low molecular weight-protein, which may replace creatinine for the evaluation of renal function, particularly in the clinical settings where the relationship between creatinine production and muscular mass impairs the clinical performance of creatinine. This paper intends to summarize the current knowledge about the physiology of cystatin C and about its use as a renal marker, alone or within formulas developed to estimate the glomerular filtration rate. Moreover, this paper reviews the recent data about potential other applications of cystatin C, especially in cardiology, in oncology and in clinical pharmacology. [less ▲]

Comparaison de cinq techniques de détection des anticorps anti-saccharomyces cerevisae (ASCA) dans le sérum pour le diagnostic de la maladie de Crohn

in Annales de Biologie Clinique (2007), 65(6), 601-608

Biomarqueurs de toxicité et anomalies métaboliques dans les principales intoxications graves. Symptomatologie clinique et toxique. Le prélèvement conservatoire.

in Annales de Biologie Clinique (2003), 61