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Maria Stella Graziani

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Martina Zaninotto

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Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
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Magdalena Krintus Poland
Giuseppe Lippi Italy
☩Howard Morris Australia
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Sverre Sandberg Norway
Ana-Maria Simundic Croatia
☩Jill Tate Australia
Tommaso Trenti Italy
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Maria Willrich USA
Paul Yip Canada


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Giuseppe Agosta

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email: biochimica.clinica@sibioc.it



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BC: Articoli scritti da I. Cataldo

L’analisi del liquido cefalorachidiano
Cerebrospinal fluid (CSF) analysis
<p>The laboratory investigation of CSF has been developed over the years as a&nbsp;diagnostic tool for many neurological diseases. Although minimally invasive, CSF is obtained with a traumatic&nbsp;procedure; therefore, the whole laboratory process should be established to maximize the analytical performance.&nbsp;Based on the review of international guidelines and on the experience developed by members of the SIBioC Working&nbsp;Group, the present document provides practical information for laboratory professionals to better address the CSF&nbsp;analysis in different diagnostic situations. The report faces the pathophysiologic meaning of the determination of&nbsp;biochemical parameters, such as glucose, lactate, albumin, immunoglobulins, <span style="font-family:symbol">b</span>-amyloid, tau protein, and the cellular&nbsp;content, providing also evidence on the proper methodological approach. Quantitative and qualitative CSF parameters&nbsp;useful to diagnose an inflammatory process of the central nervous system are discussed, particularly with reference to&nbsp;multiple sclerosis. Indications on how laboratory data should be presented to meet international recommendations are&nbsp;also included.</p>
Biochimica Clinica ; 38(3) 238-254
Documenti - Documents
 
Il contributo della diagnostica proteica nella gestione delle gammopatie monoclonali
Protein diagnostics in the management of monoclonal gammopathies
<p>This document examines laboratory tests&nbsp;to be used for the management of monoclonal gammopathies in different clinical scenarios, from screening to&nbsp;monitoring and assessment of the response to therapy. The content is based on international recommendations and&nbsp;guidelines currently available. It includes sections on the analytical aspects of different tests&nbsp;(serum&nbsp;protein&nbsp;electrophoresis, typing and quantification of monoclonal components, Bence Jones protein determination and free&nbsp;light chain measurement) and on their clinical significance as well. Different clinical settings are examined: screening,&nbsp;diagnosis, risk stratification, monitoring and response assessment. For each of those, laboratory tests to be used are&nbsp;indicated. Aim of the document is to help clinical laboratories avoiding unnecessary tests, ensuring in the meantime&nbsp;that all the investigations required for a optimal patient management are carried out.</p>
Biochimica Clinica ; 38(1) 47-53
Documenti SIBioC - SIBioC Documents
 
La determinazione delle catene leggere libere nel liquido cefalorachidiano: l’esperienza di due laboratori italiani
Quantitation of immunoglobulin free light chains in cerebrospinal fluid: the experience of two Italian laboratories
<p>The detection of oligoclonal IgG bands in cerebrospinal fluid (CSF) by isoelectricfocusing and&nbsp;immunodetection is the current &ldquo;gold standard&rdquo; method to detect an inflammatory process in central nervous system.&nbsp;However, as this test is time consuming and subjective, some authors have tested the measurement of free light&nbsp;chains (FLC) in CSF using a specific automated polyclonal antibody-based assay (Freelite, The Binding Site) with&nbsp;promising results. Recently, another automated nephelometric monoclonal antibody-based assay for FLC has been&nbsp;made available (N Latex FLC, Siemens). In our laboratories, we tested FLC<span style="font-family:symbol">k</span> and <span style="font-family:symbol">l</span> in CSF and serum using both&nbsp;assays. To test sensitivity and specificity, multiple sclerosis (MS) patients and non inflammatory neurological disease&nbsp;(NIND) patients as controls were selected. Both laboratories found statistically significant (P &lt;0.05) difference&nbsp;between results in two groups. Using Freelite, the first laboratory defined the best cut-offs to discriminate between&nbsp;MS and NIND by ROC curves: i.e., 0.56 mg/L for FLC<span style="font-family:symbol">k</span>, 7.82 for FLC<span style="font-family:symbol">k</span> index, 0.31 mg/L for FLC<span style="font-family:symbol">l</span> and 4.36 for FLC<span style="font-family:symbol">l</span>&nbsp;index. Using N Latex FLC, the second laboratory estimated cut-offs by means of the NIND patients highest&nbsp;interquartile value, resulting in 0.22 mg/L for FLC<span style="font-family:symbol">k</span>, 2.72 for FLC<span style="font-family:symbol">k</span> index, 0.15 mg/L for FLC<span style="font-family:symbol">l</span> and 2.07 for FLC<span style="font-family:symbol">l</span> index.&nbsp;Sensitivities found with Freelite assay were 95% for FLC<span style="font-family:symbol">k</span> index, 83% for FLC<span style="font-family:symbol">l</span> index and 100% when both tests were&nbsp;considered. With N Latex FLC assay sensitivities were 100% for FLC<span style="font-family:symbol">k</span> index and 93% for FLC<span style="font-family:symbol">l</span> index. In both&nbsp;centers, isoelectricfocusing had 97% global sensitivity for MS. Our results show that, with both evaluated methods,&nbsp;CSF FLC can support or even replace isoelectricfocusing in clinical laboratories.</p>
Biochimica Clinica ; 37(5) 389-394
Contributi Scientifici - Scientific Papers