Causes of hypoamylasaemia in a hospital population.

AIMS: We noted serum amylase activity results in our laboratory that fell below the lower reference limit, although there was no obvious explanation for this and the literature on this topic is relatively sparse. METHODS: We studied hospital laboratory requests and reports of individuals showing hypoamylasaemia over a one-year period. RESULTS: We report one of the few studies to look at hypoamylasaemia in a hospital population. We found that 5.4% of the hospital serum amylase activity results were below the reference range quoted by our laboratory. CONCLUSIONS: Some of the associations we observed with hypoamylasaemia were diabetes mellitus, cystic fibrosis, hypertriglyceridaemia and use of the antibiotic gentamicin. We suggest that clinicians and laboratories should be aware of the causes of hypoamylasaemia to aid interpretation of abnormally low amylase activity in their patients.

[Aetiological spectrum of hyperferritinemia]. / Spectre étiologique des hyperferritinémies.

UNLABELLED: Serum ferritin levels may be increased in many conditions: renal diseases, liver diseases, human immunodeficiency virus infection. The purpose of this study was to assess the aetiological spectrum of high serum ferritin levels in a 1200-bed university hospital, to compare our results with the data already published and to assess a potential association between aetiology and ferritin levels. PATIENTS AND METHODS: Patients with a serum ferritin level higher than 600 microg/l were retrospectively included between 15 November 2003 and 15 January 2004, and their medical records were reviewed. RESULTS: Ninety-eight patients (38 women and 60 men; median age: 59,5 years [19-92]) were recruited in departments of hepatology and gastroenterology (22%), haematology (14%) and internal medicine (18%). Diagnosis performed were: non-HIV systemic infections (23,8%), haematological diseases (16,1%), alcoholism (11,2%) and malignancies (9,8%). Dialysed chronic renal failure, liver diseases, haemochromatosis and systemic inflammatory diseases counted for 4.2 to 5.2% of cases. Serum ferritin level lied between 600 and 1000 microg/l for 50 patients, between 1000 and 1500 microg/l for 24, and over 1500 microg/l for 24. There was no significant difference between the three groups as regards the etiological distribution. DISCUSSION: In our study, chronic renal failure was not a major cause of high ferritin level: this is probably due to the current use of erythropoietin, which has decreased the use of blood transfusions. The two major aetiology of hyperferritinemia were non-HIV infections and malignancies.

[Dysalbuminemia]. / Les dysalbuminémies.

Albumin is the major circulating protein. It plays a fundamental role maintaining intra-vascular oncotic pressure and carrying many endogenous and exogenous substances. Variations of plasma albumin levels can be physiologic or pathologic and both qualitative and quantitative (more frequent) disorders are regrouped under the name "dysalbuminemia". Although hypoalbuminemia are frequent, analbuminemia exists but is a rare disease. Qualitative disorders, mainly bisalbuminemia, are benign. Detected fortuitously on sera protein electrophoresis, bisalbuminemia could be genetically transmitted, it will then be permanent, or acquired and then be transient. This article proposes to review main kind of dysalbuminemia usually encountered in clinical biology laboratories.

[Blood rheology in patients with gastric cancer]. / Reologicheskie svoistva krovi u bol'nykh rakom zheludka.

Blood rheology was examined in 163 patients with gastric cancer. The 4th stage of the disease was detected in 51 of them. The following changes of blood rheology were found: changes of a blood and plasma viscosity and red blood cells hyperaggregation. These changes lead to hypo- and dysproteinaemia, erythron system disorders, endogenous intoxication, hemostasis disorders which correlated in severity with the disease stage. These patients need correction of rheological disorders.

Effect of platelet phospholipid exposure on activated protein C resistance: implications for thrombophilia screening.

The effect of platelet contamination and freeze-thawing on the activated protein C sensitivity ratio (APCsr) was determined. With increasing platelet count there was a progressive reduction in the ratio. Filtration of samples through a 0.2 microm filter before or after freeze-thawing abolished the development of resistance to the addition of activated protein C indicating that the phenomenon is due to the presence of a particulate factor. Contamination of normal plasma with platelets from a patient with homozygous factor V (FV) deficiency was also associated with the same development of resistance to activated protein C, indicating that the phenomenon was not due to exposure of platelet-derived factor V that might be inaccessible to APC. 82% (96/117) of FVQ506 and 32% (138/430) of FVR506 individuals had APC resistance on analysis of unfiltered plasma. However, 85% (42/50) of FVQ506 individuals had APC resistance on analysis of filtered plasma, whilst only 1/50 FV R506 individuals had APC resistance after filtration. For the purpose of identifying individuals at increased risk of venous thromboembolism due to the presence of the FVQ506 and associated APC resistance a PCR-based genotypic analysis is recommended.

[The cryopathies]. / Kryopatier.

The term cryopathies includes conditions in which abnormal sensitivity to cold is a prominent feature and includes the cold agglutinin syndrome, the cold hemolysin syndrome, the cold urticarias, the cryoglobulinemias, and cryofibrinogenemia. The cryopathies may be secondary to lymphoproliferative, autoimmune, and infectious diseases, but in many patients no underlying disease can be found (essential cryopathy). Avoidance of cold is of prime importance in all patients. Underlying disease should be treated, if possible. Severe therapeutic problems may arise in patients with essential cryopathies.

Hyperproteinaemia in dracunculiasis.

The study of biochemical changes induced by dracunculiasis show that hyperproteinaemia is present even in patients three months post infection. The hyperproteinaemia is due to increase in serum globulin content of patients.

[Urologically silent Grawitz tumor. General framework of paraneoplastic syndromes and personal experiences]. / Tumore di Grawitz urologicamente silente. Inquadramento generale delle sindromi paraneoplastiche ed esperienze personali.

The symptomatological triad of Grawitz tumour (haematuria, renal mass, lumbar pain) is rarely observed, whereas clinical signs and symptoms indicative of an internist pathology. An account is given of the more common paraneoplastic syndromes that may be associated with renal adenocarcinoma. If correctly evaluated, these permit early diagnosis and resolutive surgery. Reference is made to personal experience in emphasising that there are extremely few diagnostic features in cases of urologically silent Grawitz tumour.