Assuntos
Anticorpos/imunologia , Antígenos/imunologia , Eritrócitos/imunologia , Rejeição de Enxerto/imunologia , Sistema do Grupo Sanguíneo Kidd/imunologia , Transplante de Rim/métodos , Adulto , Biópsia , Feminino , Rejeição de Enxerto/sangue , Humanos , Nefropatias/terapia , Transplante de Rim/efeitos adversos , Antígenos de Histocompatibilidade Menor/químicaRESUMO
Plasma cell-rich acute cellular rejection of a transplanted kidney is described in association with the identification of serum antibody to the red cell Kidd antigen, Jk-b, which is also found in the kidney. This antibody was formed without a history of a recent blood transfusion or exposure to intravenous immunoglobulin. The role this antibody could have in the rejection of the transplant is discussed.
Assuntos
Rejeição de Enxerto/sangue , Sistema do Grupo Sanguíneo Kidd/imunologia , Transplante de Rim/imunologia , Plasmócitos/imunologia , Adulto , Anticorpos/análise , Biópsia , Feminino , Rejeição de Enxerto/patologia , Rejeição de Enxerto/cirurgia , Humanos , Transplante de Rim/patologia , NefrectomiaRESUMO
CONTEXT: Laboratory data are essential to the medical care of fetuses, infants, children, and adolescents. However, the performance and interpretation of laboratory tests on specimens from these patients, which may constitute a significant component of the workload in general hospitals and integrated health care systems as well as specialized perinatal or pediatric centers, present unique challenges to the clinical pathologist and the laboratory. Therefore, pathology residents should receive training in pediatric laboratory medicine. OBJECTIVE: Children's Health Improvement through Laboratory Diagnostics, a group of pathologists and laboratory scientists with interest and expertise in pediatric laboratory medicine, convened a task force to develop a list of curriculum topics, key resources, and training experiences in pediatric laboratory medicine for trainees in anatomic and clinical pathology or straight clinical pathology residency programs and in pediatric pathology fellowship programs. DATA SOURCES: Based on the experiences of 11 training programs, we have compiled a comprehensive list of pediatric topics in the areas of clinical chemistry, endocrinology, hematology, urinalysis, coagulation medicine, transfusion medicine, immunology, microbiology and virology, biochemical genetics, cytogenetics and molecular diagnostics, point of care testing, and laboratory management. This report also includes recommendations for training experiences and a list of key texts and other resources in pediatric laboratory medicine. CONCLUSIONS: Clinical pathologists should be trained to meet the laboratory medicine needs of pediatric patients and to assist the clinicians caring for these patients with the selection and interpretation of laboratory studies. This review helps program directors tailor their curricula to more effectively provide this training.
Assuntos
Currículo , Internato e Residência , Patologia Clínica/educação , Pediatria/educação , Ensino , Criança , Serviços de Saúde da Criança , Pré-Escolar , Humanos , Corpo Clínico HospitalarAssuntos
Reação em Cadeia da Polimerase/métodos , Kit de Reagentes para Diagnóstico , Colo do Útero/microbiologia , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/isolamento & purificação , Reações Falso-Negativas , Feminino , Gonorreia/diagnóstico , Gonorreia/microbiologia , Humanos , Masculino , Neisseria gonorrhoeae/isolamento & purificação , Sensibilidade e Especificidade , Uretra/microbiologiaRESUMO
The practice of pediatric laboratory medicine involves unique challenges related to development, nutrition, growth, and diseases during different periods of infancy, childhood, and adolescence. This article discusses key aspects of pediatric laboratory medicine faced by clinical pathologists, clinical laboratory scientists, and clinicians, including point-of-care testing, preanalytic variables, analytic factors, age-specific reference intervals, esoteric laboratory tests, clinical impact, andfuture opportunities. Although challenging, pediatric laboratory testing offers many opportunities for improved patient care, clinical- and laboratory-based research, and education.
Assuntos
Química Clínica/métodos , Patologia Clínica/métodos , Pediatria/métodos , Química Clínica/tendências , Criança , Pré-Escolar , Técnicas de Laboratório Clínico/tendências , Humanos , Lactente , Recém-Nascido , Patologia Clínica/tendências , Pediatria/tendênciasRESUMO
Exploiting the high sensitivity of the chemiluminescence phenomenon, an accurate and sensitive point-of-care test, called the ZstatFlu-II test (ZymeTx, Inc., Oklahoma City, Okla.), was developed to detect influenza virus infections. The ZstatFlu-II test takes 20 min and requires approximately 2 min of "hands-on" time for operational steps. The ZstatFlu-II test does not distinguish between infections with influenza virus types A and B. ZstatFlu-II test results are printed on Polaroid High-Speed Detector Film, allowing test results to be archived. A prototype version of the ZstatFlu-II test was evaluated during the 2000-to-2001 flu season with 300 nasal aspirate specimens from children at a pediatric hospital. Compared to culture, the ZstatFlu-II test had 88% sensitivity and 92% specificity. The Directigen test had a sensitivity of 75% and a specificity of 93%. The sensitivity of the ZstatFlu-II test was significantly higher than that of the Directigen test (P < 0.0574).