Annals of clinical and laboratory science最新文献

{"title":"Resolution of a False-Positive Fourth-Generation HIV Screening Test by Polyethylene Glycol Precipitation: A Case Report.","authors":"Mel-Marie Datka, Whitney Fuller, Hennessy Williams, Liyun Cao","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fourth generation human immunodeficiency virus (HIV) antigen/antibody (Ag/Ab) combination assays are highly sensitive and enable early detection of HIV infection; however, rare false positive results due to immunoassay interference may occur. We report a case of discordant HIV testing characterized by a reactive ARCHITECT HIV Ag/Ab Combo screening assay with negative HIV 1/HIV 2 antibody differentiation and negative HIV 1/HIV 2 qualitative nucleic acid testing. To investigate the mechanism of reactivity, polyethylene glycol (PEG6000) precipitation was performed. Following PEG treatment, the patient's specimen converted to non reactive on repeat screening; comparatively, a confirmed HIV positive control specimen remained strongly reactive, despite partial signal reduction. These findings support the presence of PEG-precipitable immune interference as a likely contributor to false reactivity and highlight PEG precipitation as a useful problem solving tool in selected cases of discordant HIV serologic results.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"341-343"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576910","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}

{"title":"Hepatoid Adenocarcinoma of the Stomach with Liver Metastasis Misdiagnosed as Hepatocellular Carcinoma: A Case Report and Literature Review.","authors":"Yan-Yan Zhu, Jia-Rong Zhao, Chun-Li Xu, Li-Pei Wu, Zhao-Ying Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatoid adenocarcinoma of the stomach (HAS) is a rare, highly aggressive gastric cancer subtype with a poor prognosis. Herein, we report a 61-year-old male initially misdiagnosed with multifocal hepatocellular carcinoma (HCC) at another hospital in December 2025, based on multiple hepatic nodules on MRI and elevated serum AFP. Admitted to our hospital in January 2026 for worsening fatigue and anorexia, he had severe anemia, a family history of gastric cancer and progressively rising AFP. Gastroscopy and histopathology confirmed HAS with multiple liver and lymph node metastases. After one cycle of XE-LOX plus cadonilimab palliative chemotherapy, the disease progressed rapidly with sharply elevated AFP and new metastases, and the patient refused further treatment. This case shows HAS is easily misdiagnosed as HCC, especially with occult gastric lesions and liver metastasis. Imaging and tumor markers have limited diagnostic value, while gastroscopy and histopathology are the gold standard. Comprehensive clinical evaluation is essential to reduce misdiagnosis. HAS is characterized by rapid disease progression and poor therapeutic response. Nevertheless, as a novel biomarker, the diagnostic and therapeutic value of CLDN18.2 in this disease remains to be further validated by large scale clinical data.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"359-364"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576827","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}

{"title":"Analysis of the Effect of <i>in vitro</i> Hemolysis Test in the Treatment of Patients with Autoimmune Hemolytic Anemia.","authors":"Weiwei Gan, Weiwei Lin, Hongyu Cai, Conghai Tang, Dongqing Zhan, Yanxue Huang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of the in vitro hemolysis test in the treatment of patients with autoimmune hemolytic anemia (AIHA).</p><p><strong>Methods: </strong>This retrospective study analyzed data from AIHA patients treated at our hospital. Patients were categorized into two groups based on the blood-matching method recorded in their records: a control group and a research group. In the control group, the microcolumn gel method was applied for blood allocation and transfusion. In the research group, blood allocation and transfusion were guided by the in vitro hemolysis test.</p><p><strong>Results: </strong>After transfusion, hematological indices (RBC, TBil, Hb, Ret) improved in both groups compared to pre-transfusion values. The research group showed higher RBC and Hb levels, and lower TBil and Ret levels than the control group (<i>P</i><0.05). Coagulation parameters (PT, APTT, FIB) also improved after transfusion. The research group had lower PT and APTT, and higher FIB than the control group (<i>P</i><0.05). The total effective rate was higher in the research group (86.0% vs 66.7%, <i>P</i><0.05).</p><p><strong>Conclusions: </strong>The <i>in vitro</i> hemolysis assay for blood matching can improve hematological and coagulation parameters in AIHA patients and enhance transfusion efficacy, demonstrating significant clinical value.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"331-338"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576765","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}

{"title":"Serum Progranulin as a Potential Marker for Disease Activity and Thrombotic Events in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.","authors":"Yue Zhong, Wen-Lu Yu, Tie-Gang Lv, Li-Ping Xu, Jian Hao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Progranulin (PGRN) is a secreted glycoprotein that can have pro-inflammatory or anti-inflammatory effects, depending on the disease. The serum and urinary levels and mechanism of action of PGRN in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are unclear.</p><p><strong>Methods: </strong>Thirty patients with active AAV were enrolled from May 2022 to May 2024; 28 were myeloperoxidase-positive, and two were proteinase 3-positive. A healthy control cohort consisted of five male and five female volunteers. Age, gender, AAV subtype, and laboratory data were collected. Using an enzyme-linked immunosorbent assay, Whole blood and urine samples were collected for measurements of PGRN.</p><p><strong>Results: </strong>The median patient age was 69.0 years (range: 58.8-75.5); 56.7% of them were female, and 94.3% of them were MPO-ANCA-positive. Compared with healthy controls, the AAV patients had higher serum PGRN levels (52.0±30.9 vs. 3.3±1.7 ng/mL, <i>P</i><0.05) and lower urinary PGRN levels. The serum PGRN level also had a positive correlation with the Birmingham vasculitis activity score (r=0.776, <i>P</i><0.001), and moderate positive correlations with coagulation-related parameters (activated partial thromboplastin time, fibrin degradation products, and D-dimer). Patients who subsequently developed thrombotic events had higher serum PGRN levels than those without thrombotic events.</p><p><strong>Conclusion: </strong>The serum PGRN level was associated with disease activity and coagulation abnormalities in patients with active AAV, particularly in those with MPO-ANCA positivity. Although serum PGRN had a positive association with thrombotic events, its elevation may be influenced by renal dysfunction and systemic inflammation. Therefore, serum PGRN may serve as an activity-related biomarker rather than a disease-specific marker in AAV.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"295-302"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576902","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}

{"title":"<i>Technical Note:</i> Implementation of Point of Care High Sensitivity Troponin I on the i-STAT Device and Comparative Analysis with a Beckman DxI 800 Laboratory-Based Assay.","authors":"Melody Nelson, John Kummer, Kristine Zinn, Amitava Dasgupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>High sensitivity troponin I (hs-TnI) is a sensitive biomarker for the diagnosis of myocardial infarction. Recently, the FDA has approved a point of care (POC) hs-TnI assay on the i-STAT device (Abbott Laboratories, Abbott Park, IL). We evaluated concordance of this assay with a laboratory based hs-TnI assay using the DXI 800 analyzer (Beckman, Brea, CA).</p><p><strong>Methods: </strong>i-STAT device precision for hs-TnI was studied using two controls provided by the manufacturer across all i-STAT analyzers (n=68) to be used at our health system. For initial concordance study, 40 plasma specimens were analyzed using the DXI 800 hs-TnI assay and i-STAT hs-TnI assay. Then, for further evaluation, in 20 plasma specimens (10 males and 10 females), hs-TnI concentrations were determined by using two DXI analyzers (each measurement in duplicate) and 17 i-STAT devices (each run in duplicate). For overall reproducibility of results using i-STAT devices, all 68 analyzers were assessed side-by-side using a large plasma pool. Moreover, in four patients, i-STAT hs-TnI whole blood values were compared with plasma hs-TnI values using the DXI 800.</p><p><strong>Results: </strong>Both short- and long-term precision of hs-TnI controls demonstrated acceptability. When the mean hs-TnI concentrations obtained by the DXI 800 were plotted in the x-axis (reference method) and corresponding mean values obtained by i-STAT were plotted in the y-axis, we observed the following regression equation: y=1.06x+2.72, r=0.97, (r=0.98). When all 68 i-STAT analyzers were compared with each other using pooled plasma specimens, we observed acceptable results. Additionally, in 20 plasma specimens, where hs-TnI obtained by two DXI 800 analyzers (mean value) were plotted in the x-axis and the corresponding overall mean of hs-TnI results obtained using 17 i-Stat analyzers were plotted in the y-axis, we observed the following regression equation: y=0.97x+2.36 (r=0.98). We also observed concordance between whole blood hs-TnI and plasma-based TnI in four patients.</p><p><strong>Conclusions: </strong>We observed good concordance in hs-TnI values obtained by i-STAT and DXI 800; however, due to different analytical cut-offs, assay design, and lack of a TnI standard, this concordance should not be interpreted as equivalent performance.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"378-381"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576584","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}

{"title":"A Heterozygous IFIH1-Δ14 Polymorphism that Causes Severe Systemic Inflammatory Reactions Resembling Hemophagocytic Lymphohistiocytosis.","authors":"Ina Jeong, Seong-Eun Ryu, Hyun Ji Lee, Sun Min Lee, In Suk Kim, Chulhun L Chang, Seung Hwan Oh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Type I interferon signaling is central to antiviral innate immunity, and disruption of this pathway may contribute to unusually severe illness during otherwise common viral infections in children. We report a previously healthy 12-month-old girl who presented with a fever for two weeks, followed by a generalized skin rash. She then subsequently developed a persistent fever, pancytopenia, splenomegaly, elevated soluble IL-2 receptor, and hypofibrinogenemia, fulfilling diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). Because an underlying immune disorder was suspected, targeted panel sequencing was performed, followed by Sanger confirmation and RNA transcript analysis; this identified a heterozygous <i>IFIH1</i> splice-site variant (NM_022168.4:c.2807+1G>A (rs35732034)). Reverse transcription-polymerase chain reaction and transcript sequencing demonstrated exon 14 skipping (Δ14) in patient RNA, providing direct confirmation of the predicted splicing abnormality and aligning with the prior report by Asgari et al. regarding this same variant in children with severe viral illness. Although these findings support the biological relevance of the variant in this clinical setting, they do not establish a causal relationship or indicate that the variant was the sole cause of the inflammatory syndrome. As a single case report, this observation should therefore be interpreted cautiously; however, it suggests that <i>IFIH1</i> abnormalities may be associated with infection-related hyperinflammation or an HLH-like presentation in some patients and highlights the value of RNA-based validation when interpreting candidate splice-site variants in innate immune genes.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"354-358"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576571","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}

{"title":"Morphological and Severity Patterns of Anemia among Children in Taif City, Saudi Arabia.","authors":"Rana Ghazi Zaini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Anaemia remains a common public health concern among children and may adversely affect growth, cognitive development, immune function, and overall health. This study aimed to assess the morphological and severity patterns of anaemia among children in Taif City, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted among pediatric patients attending two government hospitals in Taif City between March and June 2026. Children aged 2-12 years without a previous diagnosis of anaemia or chronic disease affecting red blood cell production were included. Demographic and clinical data were collected, and complete blood counts were performed using an Abbott hematology analyzer. Anaemia was diagnosed using age-specific haemoglobin thresholds and classified according to morphology and severity based on World Health Organization criteria.</p><p><strong>Results: </strong>A total of 242 children were included, with a mean age of 6.2±2.9 years. Anaemia was identified in 30 children, yielding a prevalence of 12.4%. Mean haemoglobin levels were significantly lower among anaemic children than non-anaemic children (10.17±0.90 vs. 13.11±0.93 g/dL; <i>p</i><0.001). Most anaemic cases occurred among children aged 2-6 years (83.3%). Microcytic anaemia was the predominant morphological pattern (66.7%), and mild anaemia was the most common severity category (73.3%).</p><p><strong>Conclusion: </strong>Anaemia among children in Taif City was predominantly mild and microcytic, highlighting the importance of routine screening and early detection.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"324-330"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576841","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}

{"title":"The Prevalence of Kidd, Lutheran, and Duffy Antigens and Phenotypes Among Blood Donors in Al-Qurayyat, Al-Jouf, Saudi Arabia: A Cross-Sectional Study.","authors":"Fehaid Alanazi, Wael Alzahrani, Shiny K Kajal, Ezeldine K Abdalhabib, Alneil Hamza, Fahd A Kuriri, Fawaz Alenazy, Abdulmajeed M M Alanazi, Marzouq H M Albalawi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Blood group antigen frequencies vary across populations and influence transfusion compatibility and alloimmunization risk; data on minor systems in northern Saudi Arabia are limited. This study determined Kidd (Jk), Lutheran (Lu), and Duffy (Fy) antigen and phenotype frequencies among Al-Qurayyat blood donors and compared them with other populations.</p><p><strong>Methods: </strong>In this cross-sectional study, 240 healthy blood donors were serologically typed for Kidd (Jk^a, Jk^b), Lutheran (Lu^a, Lu^b), and Duffy (Fy^a, Fy^b) antigens. Using the chi-square test, Phenotype frequencies were compared with published.</p><p><strong>Results: </strong>Jk^a and Jk^b antigens were observed in 94.2% and 50.8%, respectively. Kidd phenotypes were predominantly Jk(a⁺b^-) (49.2%), followed by Jk(a⁺b⁺) (45.0%). Lu^b was the predominant Lutheran specificity (99.2%), and Lu^a was rare (0.8%). The main Lutheran phenotype was Lu(a^-b⁺) (99.2%). Duffy antigens Fy^a and Fy^b were found in 38.3% and 45.0%, respectively. Duffy phenotypes were predominantly Fy(a^-b⁺) (35.0%), followed by Fy(a⁺b^-) (28.3%), Fy(a^-b^-) (26.7%), and Fy(a⁺b⁺) (10.0%). Duffy distribution differed significantly from Caucasian, Asian, and other regional populations (<i>p</i><0.001).</p><p><strong>Conclusions: </strong>This first profile of the Kidd, Lutheran, and Duffy systems in Al-Qurayyat reveals wide regional differences, especially for Duffy; this underscores the value of population-based databases to guide transfusion practice and directed searches for compatible donors.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"270-278"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576866","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}

{"title":"<i>In Memoriam</i>: Clive R. Hamlin, PhD, FACSc (1941 - 2026).","authors":"Charles D Hawker","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 1","pages":"3-5"},"PeriodicalIF":1.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607517","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}

{"title":"Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Variation Among Normoglycemia, Prediabetes, and Diabetes.","authors":"Ayed A Dera, Gaffar Sarwar Zaman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The association between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and mortality among individuals with diabetes or prediabetes has not been clearly established. The aim of the present study was to compare the HALP score of individuals with disglycemic status in a tertiary care hospital.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 3,545 participants (2022-2024) from the Future Lab Pioneer database. Participants were classified as type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), or normoglycemic. HALP was calculated and compared by Mann-Whitney U or Kruskal-Wallis tests. Linear regression assessed group differences and correlations with glycemic and metabolic indicators, while principal component analysis (PCA) explored key laboratory contributors to glycemic variation.</p><p><strong>Results: </strong>HALP scores varied by age and sex, with males showing higher values (<i>p</i><0.0001). Higher HALP correlated inversely with HbA1c (<i>p</i><0.0001) but not fasting blood glucose. Participants in the highest HALP quartile had higher hemoglobin, albumin, and lymphocyte counts and lower platelet and WBC counts. PCA highlighted inflammation-related markers, particularly WBC and neutrophils, as major contributors to glycemic variability, emphasizing systemic inflammation's role in dysglycemia.</p><p><strong>Conclusion: </strong>HALP reflects immunonutritional status and systemic inflammatory burden and shows associations with long-term glycemic status. Owing to its simplicity, low cost, and derivation from routine laboratory parameters, HALP may serve as a complementary index for characterizing metabolic and inflammatory profiles across glycemic categories, particularly in younger males. However, prospective longitudinal studies are required to determine whether HALP has independent predictive value for dysglycemia in clinical practice.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 1","pages":"10-22"},"PeriodicalIF":0.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607755","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}