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BC: Articoli scritti da F. Di Serio

Il contributo della misura delle catene leggere libere plasmatiche alla diagnostica della malattia da deposito delle catene leggere
The contribution of the plasma free light chains determination to the diagnosis of the Light Chain Deposition Disease
<p>The contribution of the plasma free light chains determination to the diagnosis of the Light Chain Deposition Disease. Light Chain Deposition Disease (LCDD) is a clinical condition characterized by renal deposition of monoclonal free light chains, produced by B-cells or plasma cell clone. In LCDD, non-organized monoclonal immunoglobulin deposits along the glomerular and tubular basement membranes are composed of monoclonal light chains (kappa isotype in 92% of cases). These deposits differ from amyloidosis deposits because they do not show the typical affinity for Congo Red and do not have a fibrillar organization. We described a 64 years male patient with hypertension, proteinuria and nephrotic syndrome. Plasma cell dyscrasias diagnostic work-up evidenced only an abnormal kappa/lambda ratio and increased plasma concentrations of kappa free light chains. Serum and urine immunofixation did not demonstrated the presence on monoclonal immunoglobulin. Kidney biopsy showed a membranoproliferative glomerulonephritis pattern and renal immunofluorescence demonstrated the parietal diffuse linear staining of kappa monoclonal light chain along basement membranes. Ultrastructural appearance confirms the diagnosis of LCDD.</p>
Biochimica Clinica ; 42(4) e53-e55
Casi Clinici - Case Report
 
Appropriatezza della richiesta di esami ed esiti clinici: il caso delle malattie renali, tiroidee e della celiachia
Appropriateness of test request and clinical outcome: the example of kidney, thyroid and coeliac disease
<p>This document analyzes the topic of appropriateness of test request. It is organized in 4 parts. The first deals with the theme of appropriateness, the consequences of insufficient or excessive test request and the need to balance guideline indications with the clinical need of a single patient. The other 3 parts present the cases of thyroid, chronic kidney and coeliac disease. With regard to the thyroid function, population screening, excluding neonates, is not recommended; on the contrary, it is highly recommended to evaluate the thyroid function in any individual with even only a minimal clinical suspect. The thyrotropin (TSH) is the test of choice with reflex free T4 and free T3, according to specific algorithms. The contemporaneous measurement of free FT3, free FT4 and TSH, except for specific cases, should be discouraged due to the high frequency of unjustified abnormal findings. Anti-thyroperoxidase antibodies are the test of choice for autoimmune thyroid diseases. In chronic kidney disease (CKD), the estimated glomerular filtration rate (eGFR) based on serum creatinine in most cases is the best indicator of renal function, provided that creatinine is measured with the accurate enzymatic method. In borderline situations, a confirmatory eGFR calculation based on cystatin C is recommended. Urinary albumin, expressed as albumin/creatinine ratio, is an essential complement for CKD staging. The diagnosis of coeliac disease requires integration between clinical, histological and serological data. The anti-transglutaminase IgA is the test of choice; only when an IgA deficit is present, the test to be used is IgG antigliadin deamidate peptides. The genetic HLA DQ2/DQ8 test is indicated for screening of subjects at risk: if negative, coeliac disease can be excluded.</p>
Biochimica Clinica ; 41(3) 266-285
Documenti - Documents
 
Raccomandazioni per l'implementazione e la gestione del "point-of-care testing" (POCT)
Recommendations for the implementation and management of the point-of-care testing (POCT)
Biochimica Clinica ; 35(3) 242
DOCUMENTI SIBioC - DOCUMENTI SIBioC