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BC: Articoli scritti da L. Cerutti

Utilità della determinazione della frazione delle piastrine immature nella diagnostica delle trombocitopenie autoimmuni
Role of the determination of immature platelet fraction in the diagnosis of autoimmune thrombocytopenia
<p>A 34 years old woman presented progressive severe thrombocytopenia, without major bleeding. The diagnostic tests for systemic lupus erythematosus, HIV infection and HCV infection, were negative. The platelet count was 9x10<sup>9</sup>/L, with elevated immature platelet fraction (IPF). Bone marrow aspirate was normal; the final diagnosis was immune thrombocytopenia (ITP). ITP is an autoimmune disease characterized by low platelet count in the absence of other causes of thrombocytopenia. IPF is a parameter of Sysmex hematological analyzers that measures young platelets in peripheral blood. It is elevated in peripheral platelet destruction and it is low in hypoproliferative thrombocytopenias, making it useful in differential diagnosis. This case report demonstrates the utility of IPF in diagnosis, management and follow up of ITP.</p>
Biochimica Clinica ; 42(3) e40-e42
Casi clinici - Case report
Conteggio e contenuto di emoglobina reticolocitario in un caso di grave anemia
Reticulocyte count and hemoglobin content in a case of severe anemia
<p>A 4 years old child from Sry Lanka was admitted in our hospital after several blood transfusions for severe anemia in her country. Very low hemoglobin (65 g/L) and ferritin (&lt;1 ng/mL) concentrations were detected, consistent with iron deficiency anemia. The reticulocyte count and the hemoglobin content (Ret-He) were low (49,20x10<sup>9</sup>/L and 13.7 pg respectively). An important number of causes of iron deficiency anemia were excluded. The patient was treated with iron infusion for two weeks, with good recovery of hemoglobin levels iron stores, Ret-He and reticulocyte number. The patient was then treated with oral iron supplementation, but a considerable decrease of Ret-He and reticulocyte count was observed, so the infusive therapy was reintroduced. Diagnosis and treatment were optimized by the synergy between the clinical laboratory and pediatricians, utilizing these hematological parameters. The blood transfusions could thus be stopped and the bone marrow biopsy could be avoided. This case demonstrates the importance of the reticulocyte count and the Ret-He in the management of iron deficiency anemia.</p>
Biochimica Clinica ; 41(2) e09-e12
Casi clinici - Case report
Adrenomedullina e peptidi correlati: dalla fisiologia alla diagnostica
Adrenomedullin and related peptides: from physiology to diagnostics
<p>Adrenomedullin (ADM) and related peptides have important physiologic effects on cardiovascular system, including a potent and powerful hypotensive activity caused by dilatation of resistance vessels. Other roles are played in endocrine and nervous systems. The plasma concentrations of ADM are increased in several cardiac diseases, raising the possibility of a role as a biomarker of heart failure. The actions of ADM are generally protective and beneficial to organs and tissues (e.g., vasodilation, natriuresis and anti-inflammation) and suggest that increased ADM expression or activity could act as a compensatory response to end-organ injury. The investigations on the possible applications of ADM in clinical studies have increased since the introduction of an assay measuring mid-regional proadrenomedullin (MR-proADM), a peptide derived from proadrenomedullin characterized by a high stability in plasma. Recent studies suggest that MRproADM could be a marker of adverse prognostic effects after myocardial infarction or during acute cardiac dyspnea. Recently, our group showed that MR-proADM is a powerful prognostic marker in AL (light-chain) amyloidosis, which may not only reflect cardiac dysfunction, but also widespread systemic disease, and can be combined with cardiac troponin for detecting patients at risk of early death. However, further studies are required in order to recommend the assay of MR-proADM in the clinical laboratory; in particular, there is a lack of information about: 1) kinetics of MRproADM release after acute events and 2) the specific contribution given by MR-proADM assay in addition to the wellestablished determination of natriuretic peptides.</p>
Biochimica Clinica ; 37(2) 086-090
Rassegne - Reviews