Annals of Clinical Biochemistry最新文献_第8页

Performance of the Binding Site cerebrospinal fluid kappa free light chains assay. 结合位点脑脊液kappa游离轻链测定的性能。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-04-12 DOI: 10.1177/00045632251337616

Simon Alfred Handley, Suzanne Barnes, Nicole Jenkins, Troy Wanandy

{"title":"Performance of the Binding Site cerebrospinal fluid kappa free light chains assay.","authors":"Simon Alfred Handley, Suzanne Barnes, Nicole Jenkins, Troy Wanandy","doi":"10.1177/00045632251337616","DOIUrl":"https://doi.org/10.1177/00045632251337616","url":null,"abstract":"BackgroundMeasurement of cerebrospinal fluid (CSF) kappa free light chains (KFLCs) for the detection of intrathecal immunoglobulin synthesis has generated interest as an alternative to CSF oligoclonal bands due to its rapid turnaround time and ability to automate the assay. A turbidimetric immunoassay - Freelite Mx, is available from the Binding Site, but published data on performance is scant. Therefore, we undertook a multicentre sample comparison and investigated reagent lot-to-lot-variation (LTLV).MethodsIntra-/inter-assay accuracy and imprecision of the Freelite Mx assay on the Binding Site Optilite analyser was assessed. Twenty paired CSF/serum samples were sent to three laboratories within Australia for the measurement of CSF/serum KFLC/albumin and concentrations compared using the Kruskal-Wallis test, Spearman's rank (rs), and Passing-Bablok analysis. Lot-to-lot-variation between three reagent lots was undertaken by analysis of 20 CSF samples.ResultsIntra- and inter-assay imprecision was ≤4.4 and ≤4.1%, respectively. There was a good correlation (rs = ≥0.98) between sites for the measured CSF KFLC concentration, and no significant difference in the median concentration measured between sites (3.31, 2.78, and 3.48 mg/L, P = .98). The median bias between reagent lots was <4%, the intercept of the regression between lots was between -0.02 and 0.06 mg/L, and the slope ranged from 0.96 to 1.07.ConclusionOverall, there was a good agreement in CSF KFLC concentrations among laboratories, and LTLV was deemed acceptable. Ascertaining biological variability of CSF KFLCs and the participation of laboratories in quality assurance schemes would assist with harmonisation.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251337616"},"PeriodicalIF":2.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigating the effect of icterus interference on a creatinine Roche enzymatic methodology. 探讨黄疸干扰对肌酐罗氏酶法的影响。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-04-12 DOI: 10.1177/00045632251337619

Kelsey S Spencer, Louise E Duvall

{"title":"Investigating the effect of icterus interference on a creatinine Roche enzymatic methodology.","authors":"Kelsey S Spencer, Louise E Duvall","doi":"10.1177/00045632251337619","DOIUrl":"https://doi.org/10.1177/00045632251337619","url":null,"abstract":"BackgroundIt is well established that high bilirubin concentrations can lead to erroneous creatinine results when measured by a Jaffe-based method. However, the effects of bilirubin on enzymatic methods appear less well-defined. The Roche Cobas 8000 enzymatic creatinine (CREP2) has an unconjugated bilirubin icterus limit of 20 mg/dL, equivalent to a bilirubin concentration of 342 µmol/L. Many hepatology patients have bilirubin levels much higher than this limit, and laboratories are unable to release creatinine results on these complex patients. This is particularly challenging for patient management, as creatinine is a key test and is a prerequisite for many procedures, imaging studies and treatments.MethodsTwo spiking studies were carried out, the first to define the interference effect of bilirubin on enzymatic creatinine measurement, and the second to see if this interference could be mitigated via dilution. Serum samples (n = 50) were spiked with a concentrated bilirubin solution. Indices, bilirubin and creatinine were measured using the Roche Cobas 8000 c702 automated analyser according to manufacturer instructions.ResultsThe spiking study found a negative linear relationship and as bilirubin concentrations increased, the measured creatinine concentration decreased (R2 = 0.7828, y = -0.0597x + 15.603). Samples with a bilirubin concentration over 246 µmol/L demonstrated an average 1.48% drop in creatinine concentration per 25 µmol/L increase in bilirubin.ConclusionsA service improvement was applied where creatinine results can be released on samples with a bilirubin concentration up to 550 µmol/L, with an appropriate comment, upon request by the clinician.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251337619"},"PeriodicalIF":2.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of inadequate drying of blood spots on newborn screening analyte concentrations. 血斑干燥不足对新生儿筛查分析物浓度的影响。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-04-12 DOI: 10.1177/00045632251337608

Stuart J Moat, Melissa Levi, Margaret Birch, Nadia Worlock, Chandra Sundas, Lucy Woodcock, Jude Kay, Sikha de Souza, Annabel Rodham

{"title":"The effect of inadequate drying of blood spots on newborn screening analyte concentrations.","authors":"Stuart J Moat, Melissa Levi, Margaret Birch, Nadia Worlock, Chandra Sundas, Lucy Woodcock, Jude Kay, Sikha de Souza, Annabel Rodham","doi":"10.1177/00045632251337608","DOIUrl":"https://doi.org/10.1177/00045632251337608","url":null,"abstract":"BackgroundA critical pre-analytical phase of newborn screening (NBS) testing involves the drying of blood applied to the blood collection devices to form the dried blood spots (DBS). Guidance states that blood applied should be air-dried for a minimum of 3 h. A recent survey highlighted that a number of DBS specimens routinely received into laboratories have a 'crinkled' appearance and that DBS specimens collected in a hospital setting are transported to the laboratory in sealed plastic bags. To date no scientific studies have evaluated aspects of blood drying on DBS NBS analyte concentrations.MethodsWe undertook experiments to recreate 'crinkled' DBS specimens in the laboratory and assess the impact on analyte concentrations. We also assessed the impact of storing collection devices following blood application in hermetically sealed plastic bags to impede the drying process. Experiments were performed using whole blood enriched with thyroid stimulating hormone, immunoreactive trypsinogen, phenylalanine, tyrosine, leucine, methionine, octanoyl-carnitine, decanoyl-carnitine, isovaleryl-carnitine and glutaryl-carnitine to pathophysiological concentrations.Results'Crinkled' DBS specimens produced significantly lower results (mean -15.5%, range -25.1 to -4.7%) for all analytes measured versus air-dried DBS specimens (P < .05). Analyte concentrations obtained from DBS specimens following storage in plastic bags before drying were significantly lower (mean -41.6%, range -60.0 to -27.6%) for all analytes measured (P < .05) versus air-dried DBS specimens.ConclusionResults from this study demonstrate that all DBS specimens with a crinkled appearance and those received in plastic specimen bags should be rejected and a repeat specimen collected to prevent erroneous screening results.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251337608"},"PeriodicalIF":2.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thyroid reference ranges in pregnancy utilizing an Abbott Alinity platform in a multi-ethnic population in the UK. 利用雅培血统平台在英国多民族人群中妊娠甲状腺参考范围。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-28 DOI: 10.1177/00045632251333286

R V Scott, M Abdel-Malek, J Zhu, J Tan, D Thayabaran, R Valaiyapathi, P Padam, E Jackson, S C Barnes, H Fourie, M Al-Memar, C Kyriacou, M Nimura, T Bourne, N G Martin, R Agha-Jaffar, B Jones, B Khoo, Tm-M Tan

{"title":"Thyroid reference ranges in pregnancy utilizing an Abbott Alinity platform in a multi-ethnic population in the UK.","authors":"R V Scott, M Abdel-Malek, J Zhu, J Tan, D Thayabaran, R Valaiyapathi, P Padam, E Jackson, S C Barnes, H Fourie, M Al-Memar, C Kyriacou, M Nimura, T Bourne, N G Martin, R Agha-Jaffar, B Jones, B Khoo, Tm-M Tan","doi":"10.1177/00045632251333286","DOIUrl":"10.1177/00045632251333286","url":null,"abstract":"BackgroundMaternal thyroid function significantly affects fetal development. However, thyroid hormone concentrations change dynamically throughout pregnancy rendering non-pregnancy reference ranges inaccurate. We aimed to establish the trimester-, population-, and assay-specific reference ranges for thyroid hormones in pregnancy using the recently introduced Abbott Alinity thyroid function test, according to American Thyroid Association 2017 Guidelines for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.MethodsThis study of 663, iodine-replete and thyroid peroxidase (TPO)-antibody negative female determined trimester-specific reference ranges for thyroid stimulating hormone (TSH), free thyroxine (fT4), and free tri-iodothyronine (fT3) using Abbott Alinity assays in accordance with ATA guidelines. Study participants were drawn from a multi-ethnic population with 49% non-white participants.ResultsFirst trimester reference ranges were TSH 0.06-2.73 mIU/l, fT4 9.9-15.3 pmol/l, and fT3 3.4-5.6 pmol/l. Second trimester reference ranges were TSH 0.02-2.47 mIU/l, fT4 8.5-14.4 pmol/l, and fT3 3.3-5.5 pmol/l. In the third trimester, TSH ranges were 0.41-2.80 mIU/l, fT4 7.6-12.3 pmol/l, and fT3 3.1-5.0 pmol/l. There were no significant differences in any trimester-specific analyte reference ranges when white and non-white populations were compared.ConclusionsThese reference ranges support the clinical care of female from diverse backgrounds with thyroid dysfunction in pregnancy using the thyroid function tests available on the Abbott Alinity platform.Study registrationISRCTN17018939.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251333286"},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Underreporting of synthetic cathinone poisoning with clinical immunoassays: An experimental and observational study. 临床免疫分析中合成卡西酮中毒的漏报：一项实验和观察性研究。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-21 DOI: 10.1177/00045632251331404

Théo Willeman, Mathis Laudet, Bruno Revol, Coralie Boudin, Hélène Eysseric-Guerin, Virginie Scolan, Françoise Stanke-Labesque

{"title":"Underreporting of synthetic cathinone poisoning with clinical immunoassays: An experimental and observational study.","authors":"Théo Willeman, Mathis Laudet, Bruno Revol, Coralie Boudin, Hélène Eysseric-Guerin, Virginie Scolan, Françoise Stanke-Labesque","doi":"10.1177/00045632251331404","DOIUrl":"10.1177/00045632251331404","url":null,"abstract":"BackgroundThere is an increasing global concern about the use of synthetic cathinones (SCs). Detecting these drugs in human urine samples can be difficult, particularly in emergency settings. Cross-reactivity has been described for several immunoassays. We evaluated the analytical interference caused by common SCs in MDMA and amphetamine assays that use the EMIT® Atellica CH (Siemens Healthineers) with both clinical and in vitro experimental data.MethodsDrug-free urine samples were spiked with various concentrations (5 to 100 µg/mL) of 2-methylmethcathinone (MMC), 3-MMC, 4-MMC, 3-chloromethcathinone (CMC), methylone and alpha-PHP and tested using EMIT® assays. The percentage of false-positive results was determined in urine samples from patients above 18 years of age admitted to the ICU or emergency department who underwent routine toxicology screening and urine immunoassays over a 4-year period. Confirmatory analyses of SC were performed by mass spectrometry techniques.ResultsFalse-positive results occurred for the MDMA assay with methylone (10 µg/mL) and 3-CMC (100 µg/mL) and for the amphetamine test with 2-MMC (50 µg/mL). We studied 2033 urine samples from 1812 patients (mean age 39 years, 61.8% male), of which 49 tested positive for amphetamine and 76 for MDMA. SCs were responsible for a false-positive rate of 16.3% for the amphetamine tests and 17.1% for the MDMA tests. Most of the false-positive tests occurred among young male patients (mean age 38 years, 92.8% male).ConclusionsThis study demonstrates that SC intoxication may be underreported in immunoassay toxicology testing. Due to a lack of specificity of screening immunoassay methods, positive results for amphetamine-type stimulants should be confirmed by specific MS methods.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251331404"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A five-year retrospective analysis of a national external quality assessment program for urinary organic acid analysis in newborn screening for inherited metabolic disorders in China. 中国新生儿遗传代谢疾病筛查尿有机酸分析国家外部质量评价项目的五年回顾性分析

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-21 DOI: 10.1177/00045632251332460

Yuxuan Du, Wei Wang, Yanling Yang, Zhiguo Wang

{"title":"A five-year retrospective analysis of a national external quality assessment program for urinary organic acid analysis in newborn screening for inherited metabolic disorders in China.","authors":"Yuxuan Du, Wei Wang, Yanling Yang, Zhiguo Wang","doi":"10.1177/00045632251332460","DOIUrl":"10.1177/00045632251332460","url":null,"abstract":"ObjectivesUrinary organic acid analysis is crucial for diagnosing inherited metabolic disorders (IMDs). This study assesses the impact of an external quality assessment (EQA) scheme on standardizing urinary organic acid detection in China from 2019 to 2023.MethodsThis retrospective longitudinal study analysed data from the NCCL-E-25 EQA scheme for urinary organic acid analysis using gas chromatography-mass spectrometry (GC-MS). Ten batches of EQA data over 5 years were included, focussing on eight key organic acid metabolites. Robust statistical methods were used to evaluate laboratory performance, including regional variations, sample preparation methods, and laboratory types.ResultsParticipating laboratories increased from 43 in 2019 to 76 in 2023, with high participation rates (median 94.74%). All eight target compounds showed significant reductions in robust coefficient of variation (CV) over time. Regional performance disparities narrowed, converging by 2022-2023. Extraction preparation methods generally outperformed non-extraction methods. Newborn Screening Centers (NBSCs) demonstrated lower robust CVs compared to non-NBSCs.ConclusionsThe EQA scheme effectively improved and standardized laboratory testing quality nationwide, particularly benefiting central and western regions. The study highlights the importance of standardized protocols and continuous improvement in enhancing IMD diagnostic accuracy. Future efforts should focus on encouraging wider participation, especially from underrepresented regions, and integrating quantitative and diagnostic capability assessments to comprehensively evaluate laboratory performance.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251332460"},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Importance of the preanalytical phase: Elevation of protein levels in cerebrospinal fluid samples due to inappropriate containers. 分析前阶段的重要性：由于容器不合适，脑脊液样品中蛋白质水平升高。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-14 DOI: 10.1177/00045632251330749

Alberto Izquierdo-Martínez, Carmen Sánchez-Palacios

引用次数: 0

A simpler and more sensitive modified catalytic (bleomycin detectable) iron assay. 一种更简单、更灵敏的改良催化（博来霉素可检测）铁测定法。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-14 DOI: 10.1177/00045632251330176

Mohan M Rajapurkar, Banibrata Mukhopadhyay, Suhas S Lele, Sudhir V Shah

{"title":"A simpler and more sensitive modified catalytic (bleomycin detectable) iron assay.","authors":"Mohan M Rajapurkar, Banibrata Mukhopadhyay, Suhas S Lele, Sudhir V Shah","doi":"10.1177/00045632251330176","DOIUrl":"10.1177/00045632251330176","url":null,"abstract":"BackgroundIron is ubiquitously distributed in biology, only a miniscule amount exists as free is capable of catalysing production of highly toxic reactive hydroxyl radicle. This free iron also called; labile iron, non-transferrin bound iron or catalytic iron (CI). CI is measured by bleomycin detectable iron assay. The assay as described originally was difficult to perform accurately and reproducibly due to variations of pH in the assay mixture and due to the lack of properly diluted iron standards.MethodsIn our laboratory we modified the assay for serum/plasma so that the variations of pH in assay medium were constantly between 7.4 and 7.6 using acid diluted iron standards by multiple treatments of Chelex resin which is alkaline.ResultsIntra assay CV for low, medium, and high levels of catalytic iron was 0.05%, 0.61% and 0.68% whereas the interassay CV was 0.06%, 0.96% and 0.28% respectively. The modified assay is highly sensitive being able to detect levels as low as 0.1 μmoles/l. In patients on maintenance haemodialysis CI measured by the original assay failed to detect any catalytic iron in almost all of these samples whereas by modified method it was measurable in all patients with a mean of 0.66 ± 0.10 μmoles/l. Normal values for catalytic iron in subjects having no comorbidities measured by modified method is 0.11 ± 0.06 μmoles/l.ConclusionsThe modified assay is reproducible and more sensitive than original assay and has been validated in several clinical studies.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251330176"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sigma metrics for assessing the analytical performance of 14 biochemical analytes in Mansoura university children's hospital laboratories (MUCHLs) using CLIA LIMITS 1988 & 2024. 曼苏拉大学儿童医院实验室（MUCHLs） 14种生化分析物分析性能的Sigma指标使用CLIA LIMITS 1988和2024。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-14 DOI: 10.1177/00045632251330163

Nada Karam, Reham M El-Farahaty, Abdel-Hady El-Gilany, Nessma A Nosser

{"title":"Sigma metrics for assessing the analytical performance of 14 biochemical analytes in Mansoura university children's hospital laboratories (MUCHLs) using CLIA LIMITS 1988 & 2024.","authors":"Nada Karam, Reham M El-Farahaty, Abdel-Hady El-Gilany, Nessma A Nosser","doi":"10.1177/00045632251330163","DOIUrl":"10.1177/00045632251330163","url":null,"abstract":"IntroductionAnalytical quality is a crucial prerequisite for best practice in medical laboratory. Six-Sigma Methodology (SM) is a quality measurement tool used to evaluate laboratory performance. This study aims to assess the analytical phase baseline performance using SM and compare results using TEa of CLIA 1988 and CLIA 2024.Materials and methodsCoefficient of variation and bias were determined for 14 analytes. The sigma level for each parameter was calculated using total allowable error (TEa) for CLIA 1988 and CLIA 2024. The quality goal index ratio was calculated for analytes with Sigma less than 3. Normalized method decision Charts were plotted for level 1 and 2 Bio-Rad internal quality control for both CLIA 1988 and 2024.ResultsUsing CLIA TEa 1988, HDL-C, triglycerides & uric acid for level 1 and ALT, AST, HDL-C, calcium, triglycerides & uric acid for level 2 had six Sigma world class performance, meanwhile, only BUN for level 1 and 2 performed less than 3. Using CLIA TEa 2024, HDL-C, GGT, and triglycerides for level 1 and ALT, AST, calcium, GGT, and triglycerides for level 2 had world class quality performance. Meanwhile, creatinine, glucose, BUN for level 1 and BUN and creatinine for level 2 performed less than 3.ConclusionEvaluation of baseline analytical performance using SM revealed lower sigma values with stringent CLIA TEa 2024 versus tolerant CLIA TEa 1988. Improvement in the methodology of analytes with poor performance on some assay platforms with stringent quality control regimes is recommended.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632251330163"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of a laboratory reflex testing protocol to detect hypopituitarism in primary care presenting as hypothyroxinaemia. 评估用于检测初级保健中表现为甲状腺功能减退症的垂体功能减退症的实验室反射测试方案。

IF 2.1 4区医学

Annals of Clinical Biochemistry Pub Date : 2025-03-01 Epub Date: 2024-11-11 DOI: 10.1177/00045632241298891

Colleen Flannery, Ana Rakovac, Gerard Boran

{"title":"Evaluation of a laboratory reflex testing protocol to detect hypopituitarism in primary care presenting as hypothyroxinaemia.","authors":"Colleen Flannery, Ana Rakovac, Gerard Boran","doi":"10.1177/00045632241298891","DOIUrl":"10.1177/00045632241298891","url":null,"abstract":"BackgroundThyroid function tests (TFTs) are routinely requested by general practitioners (GPs) in the clinical biochemistry laboratory. Hypothyroxinaemia (low fT4) accompanied by TSH within the reference interval (RI) is a discordant pattern which is seen commonly in non-thyroidal illness and also as result of medications. Hypopituitarism is a lot rarer, but a serious condition the laboratory does not want to miss.MethodsAll thyroid hormone samples from primary care meeting the discordant case definition under investigation [fT4<10 pmol/L and TSH within RI (0.3-4.2 mU/L)] had partial anterior pituitary profiles [PAPP (cortisol, oestradiol/testosterone, prolactin, gonadotrophins)] added as reflex tests and results interpreted by a chemical pathologist. From January to June 2023, we conducted structured interviews with the requesting GPs, and, where indicated, requested repeat samples for full anterior pituitary profile [FAPP (PAPP, growth hormone (GH) and insulin-like growth factor 1 (IGF-1)]. We also reviewed the laboratory records of patients with previously known hypopituitarism to determine their fT4 and TSH values at diagnosis.ResultsOver the 6 months 41,487 GP TFTs were requested; 54 (0.13%) fitted the discordant case definition and had PAPP reflexed. 13 FAPPs were requested. We identified 3 cases of hypopituitarism. The number of additional tests required to diagnose 1 case of hypopituitarism was 129. In 74% of reflex-tested cases, there was a plausible explanation for the TFT pattern (medications, known thyroid dysfunction, non-thyroidal illness, pregnancy).ConclusionThis study highlights the importance of medical liaison and early intervention in a biochemistry laboratory in identifying cases of unsuspected hypopituitarism.","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"118-125"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0