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Objectives: Whereas antinuclear antibodies (ANAs) detected by indirect immunofluorescence (IIF) have diagnostic significance, the dense fine speckled (DFS) pattern on HEp-2 cells may be an exclusionary marker for ANA-associated rheumatic disease (AARD). The aim of this study was to evaluate a new algorithm considering anti-DFS70 antibodies for routine ANA testing.Method: From ANA requested sequential 10 528 sera, 181 sera samples showing the DFS pattern were additionally tested for anti-DFS70 antibodies by an enzyme-linked immunosorbent assay (ELISA-DFS70) and for specific-ANAs. Specific-ANAs(+)/IIF-DFS(-) control sera samples (n = 50) were also tested.Results: Of the 181 IIF-DFS-positive sera samples, 82.9% (n = 150) were from non-AARD patients and 112 (61.9%) patients had non-rheumatic diseases (NRD), including the most common clinical feature of dermatitis (18.2%). The ELISA-DFS70 was positive in 109 (60.2%) sera and was negative in all control sera. Specific-ANAs were similarly detected as 25.7% (28/109) and 22.2% (16/72) of ELISA-DFS70(+) and ELISA-DFS70(+) patients, respectively (p > 0.05). The prevalence of non-AARD was 95.1% and 25.1% in the ELISA-DFS70(+)/specific-ANAs(-) and ELISA-DFS70(-)/specific-ANAs (+) groups, respectively.Conclusions: In patients with a HEp-2 DFS pattern, the additional ELISA-DFS70 and specific-ANAs test could improve the efficiency of diagnosing AARD. The detection of anti-DFS70 antibodies should be included in test algorithms for ANA testing. [ABSTRACT FROM AUTHOR]

We determined the utility of leukocyte cell population data (CPD) for the screening of sepsis and fungemia. Blood culture-positive CBC samples, 117 bacteremia and 27 fungemia, and 134 CBC samples from healthy controls were analyzed using the DxH800 and CPD of neutrophils, lymphocytes, and monocytes were analyzed. Immature granulocytes (IG) were counted using Sysmex XE-2100. The neutrophils and monocytes volume were increased significantly, and the neutrophils light scattering values were reduced significantly in the sepsis samples. ROC curves evidenced excellent sensitivity in the lymphocyte SD parameters (sensitivity 78-89%, specificity 78-87%), monocytes volume (at 177.5, sensitivity 88.2% specificity 87.3%), and monocytes volume SD (at 22.16, sensitivity 93.1% specificity 91.0%) for sepsis. The IG value was significantly higher in sepsis and the ROC curve evidenced a sensitivity of 82.8% and a specificity of 90.8% for sepsis. Only lower angle light scatter of lymphocytes SD value evidenced good sensitivity and specificity in the discrimination of fungemia from bacteremia (sensitivity 74.1%, specificity 72.4% at 12.6). Many of the leukocyte CPD have been identified as useful parameters of sepsis. Hopefully, these parameters can ultimately be incorporated into a decision rule for the screening of sepsis samples and to discriminate fungemia from bacteremia. [ABSTRACT FROM AUTHOR]

We present a case of Epstein–Barr virus (EBV)‐associated haemophagocytic syndrome in a patient with Behçet's disease. A 43‐year‐old man, who had been receiving treatment under the diagnosis of Behçet's disease for recurrent oral ulcers, genital ulcer, ileal ulcer, and arthritis, had been admitted for fever, headache, and nausea developed 3 days ago. Laboratory data showed pancytopaenia, an increase in liver enzymes, lactate dehydrogenase (LDH) and ferritin. Haemophagocytic syndrome was diagnosed from histiocytosis and haemophagocytosis by macrophages, shown in the bone marrow aspiration and biopsy, and in situ hybridization for EBV showed a positive finding. The patient recovered rapidly after steroid therapy. This is the first report of EBV‐associated haemophagocytic syndrome developed in a patient with Behçet's disease. [ABSTRACT FROM AUTHOR]