[Chronic lymphocytic leukemia: flow cytometry contribution]

Chronic lymphocytic leukemia is a part of B lympho-proliferative diseases. Clinically, it is an indolent disease thought it has a variable evolution. Our aim is to focus on the importance of flow cytometry in the diagnosis of chronic lymphocytic leukemia. This is a prospective survey conducted in 2005/2006, concerned 13 cases of chronic lymphocytic leukaemia from 42 B-cell chronic lymphoproliferative syndromes. The clinical features were summarized in the data file filled by the practicians. Chronic lymphocytic leukemia is studied in our laboratory by different means such as: hemogramm with a morphological aspects of peripheral lymphocytes, osteomedulhary biopsy myelogram, and immunophenotyping by FC500 [Trade Mark] cytometer[Beckman Coulter]. Within the 13 cases of chronic lymphocytic leukemia, there were 9 male and 4 female having a mean age of 68.5 years old with extremes from 45 to 80 years old. The most important signs found were: polyadenopathy, splenomegaly or cytopenia. In our patients, lmphocytosis was ranged from 5,6 a 136 g/l. The marrow was infiltrated by small lymphocytes in some cases. The cytometric analysis was based on Matutes score. In most cases, the chronic lymphocytic leukemia diagnosis seems to be easy based on the hemogram and immunophenotyping. Actually, treatment of patient with chronic lymphocytic leukemia depends on Rai or Binet classifications; still, it is important to have more a other accurate markers dae to its variable evolution. Flow cytometry is of real help in the diagnosis and the monitoring of residual disease in chronic lymphocyte leukemia

[Neonatal hyperbilirubinemia]

Hyperbilirubinemia is frequently encountered in neonatology. This disorder causes mucocutaneous jaundice, often transient and mild. It is due to the physiological characteristics of the newborn as hepatic immaturity and fragile red blood cells with polycythemia. Sometimes it reaches levels to much high that exceed the control capacity of the organism and thus causes kernicterus with severe neurological sequelae. This is an exhaustive retrospective study on a series of cases of newborn infants with hyperbilirubinemia and registered in the service of biochemistry. We have profiled the types, etiology and assessment of risk of kernicterus in order to better situate the ideal model that ensures optimal management of neonatal jaundice. The neonatal hyperbilirubinemia were all with unconjugated bilirubin. The majority of them were due to physiological origin, but the maternal-fetal blood incompatibility and neonatal infection are not negligible. All are likely to expose to serious neurological complications. Newborns, especially premature babies with jaundice of the integument must be screened for potentially severe jaundice. The prevention of alarming levels of bilirubin not bound to albumin must be realized through a monitoring including total bilirubin and albumin, or failing that, the serum protein. The best adaptation of albumin to bilirubin becomes possible by the prompt initiation of therapy, minimally invasive, such as phototherapy or the infusion of albumin. It is imperative to integrate this action in a global screening and to implement an algorithm taking into account all risk factors

Digitalis intoxication during a maintenance treatment

Digitalis is the most common drug of choice used in cases of heart failure and atrial fibrillation. Long-term utilisation of this drug may cause an intoxication as its therapeutic index is short. Visual and digestive signs are classical as the rhythmic and combative troubles which may interfere with the vital prognosis. The aim of this review is to analyse the characteristic clinical and therapeutic findings of this intoxication