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PubMedDate not supplied

Laboratory diagnosis of ophthalmic sarcoidosis.

Because the eye is involved in about 25% of patients with active sarcoid, the ophthalmologist is often the first physician to see these patients. Although clinical findings may suggest sarcoid, laboratory tests (e.g., x-ray, skin tests, blood chemistries, etc.) may be normal or inconclusive. Thus, it is important that the ophthalmologist be aware of the availability and limitations of the various biochemical, immunological, radiological, and histopathological tests that contribute to the early diagnosis of sarcoidosis. The authors review diagnostic procedures and present a flowchart detailing indications for each.

Antigen-Antibody Complex↗

PubMed2005

[Congenital toxoplasmosis: possibilities for laboratory diagnosis].

A case history and the steps taken in diagnosing congenital toxoplasmosis in a child whose mother experienced asymptomatic infection with the protozoon Toxoplasma gondii are presented. At pregnancy week 35, amniocentesis was performed because of fetal hydrops, ascites, hepatosplenomegaly and dilated left lateral brain ventricle on sonography. Laboratory tests showed high titers of IgM, IgE and IgA antibodies (acute infection markers) against Toxoplasma gondii in serum of the pregnant woman. Congenital toxoplasmosis in the new-born spontaneously delivered at week 41 was confirmed by detection of Toxoplasma gondii DNA in blood, acute infection markers in serum and hydrocephalus and calcifications on brain sonography. The woman received intensive treatment for toxoplasmosis during the last pregnancy trimester and her new-born child's treatment started immediately after delivery. The accurate diagnosis and early institution of therapy in both the pregnant woman and her child led to progressive normalization of laboratory tests (decreased titers of antibodies and Toxoplasma gondii DNA negativity) and significant regression of the brain lesions in the child.

Adult↗

PubMedDate not supplied

Laboratory diagnosis of vaginal infections.

Vaginal discomfort and/or odor are a common complaint in primary care visits by female patients. This is especially true among sexually active women of childbearing age. Because treatment varies depending upon which syndrome is present, effective treatment depends upon accurate diagnosis. The microscopic exams for diagnosing vaginal complaints are most frequently done in primary care sites. Because of this, few clinical laboratory scientists (CLSs) have the opportunity to become familiar with microscopy on this specimen type. In addition, literature on the subject is only gradually becoming available. This paper will attempt to briefly review the clinical and microscopic features of the common syndromes associated with vaginal discomfort.

Female↗

PubMed1976

[The laboratory diagnosis of von Willebrand's disease (author's transl)].

This investigation was undertaken in order to determine the most suitable methods for diagnosing von Willebrand's disease (v. W. d.), with particular reference to "mild" cases. 50 healthy persons, 21 patients with "severe" v.W.d. (verified according to all hitherto-established criteria) and 39 persons suffering from "mild" v.W.d. were examined. Even though - as far as the latter group is concerned - some of the characteristic laboratory findings were absent, the fact that these persons are related to the patients with "severe" v.W.d. made verification of the diagnosis nevertheless possible. In the group with "mild" v.W.d. 85% had decreased functional factor VIII activity and 82% showed reduced platelet adhesiveness; a prolonged bleeding time according to Borchgrevink was recorded in 72% of the cases and 64% had pathological values for the Ristocetin-induced platelet aggregation were pathological in less than 50% of the group. There was a close relation between the diagnostic significance and reproducibility of the various methods; in regard to the group of patients with "mild" v.W.d., the methods yielding the greatest number of pathological findings (functional factor VIII and platelet adhesiveness) were the ones with the lowest variation coefficients, i.e. 3.1 and 2.1%, respectively. The consideration of a time-dependent rise in the aggregation capability of washed platelets with Ristocetin was of decisive importance in the reproducibility of the rather sophisticated technique of determining the Ristocetin cofactor. The addition of EDTA largely inhabited this effect. Even in the group of patients with "severe" v.W.d., part of the findings obtained with screening tests of the intrinsic coagulation system remained within the normal range. There was no statistical correlation between the individual laboratory findings in the group of healthy persons. In the group with "mild" v.W.d., there was a significant correlation between platelet adhesiveness and Ristocetin-induced platelet aggregation on the one hand, and platelet adhesiveness and the Ristocetin cofactor on the other. In addition, a verified correlation was found to exist between Ristocetin-induced platelet aggregation and Ristocetin cofactor and between functional factor VIII and factor VIII-related antigen. In the group of "severe" v.W.d., only platelet adhesiveness and functional factor VIII were not significantly correlated, whilst all other correlations were of statistical significance. Further problems involved in the diagnosis of v.W.d., such as the variablility of laboratory findings, the existence of subgroups, as well as the difficulties involved in the statistical evaluation of individual cases suffering from v.W.d. are discussed.

Factor VIII↗

PubMed1957