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The article informs about interference of ceftriaxone in serum protein capillary electrophoresis, leading to the appearance of a distinct peak at the anodal site of prealbumin fraction. Topics include the principles of capillary zone electrophoresis, reported interferences from substances such as contrast agents and antibiotics, and a case study illustrating the interference of ceftriaxone, with subsequent confirmation through control blood samples after discontinuation of antibiotic therapy.

La procalcitonine (PCT) est un marqueur de gravité du sepsis, dont la valeur absolue et la cinétique sont corrélées à la sévérité de l'infection. On rapporte le cas d'un patient qui présente une PCT très élevée sans relation avec un sepsis. Il s'agit d'un homme âgé de 55 ans, admis en rhumatologie pour des lombosciatalgies hyperalgiques fébriles. Le bilan biologique a montré une hyperleucocytose à 15000 élément/mm3 à prédominance neutrophile, associée à une CRP et une PCT sériques, respectivement à 305 mg/l et 2,5ng/ml. Devant ce tableau évocateur de sepsis, des hémocultures étaient réalisées et un traitement antibiotique probabiliste était instauré. L'absence d'évolution favorable du malade ainsi que la discordance entre les chiffres de la PCT demeurant très élevés et les hémocultures négatives, une IRM dorso-lombaire était réalisée. Elle a objectivé une arthrite de la hanche droite, associée à des lésions osseuses multiples secondaires du squelette axial évoquant une origine néoplasique. Une TDM thoraco-abdomino-pelvienne a montré la présence d'une masse pulmonaire gauche. La biopsie pulmonaire a révélé un adénocarcinome infiltrant.

Background: Hyperthyroidism can lead to diverse hematological disorders, such as microcytosis and a mild increase in hemoglobin A2 fraction., Methods: This study reported a 31-year-old woman of Moroccan origin recently diagnosed with Graves' disease. Her blood tests revealed microcytosis, hypochromia, and a normal ferritin level. A phenotypic analysis of hemo-globin was performed using two techniques: capillary electrophoresis and reversed-phase high performance liquid chromatography., Results: Both techniques indicated a slight increase in hemoglobin A2 level. These results initially suggested het-erozygous beta-thalassemia, eventually correlating with the concurrent presence of Graves' disease, as evidenced by the normalization of hemoglobin A2 level following treatment., Conclusions: This case highlights the importance of having clinical, biological, and therapeutic data for a relevant interpretation of a phenotypic hemoglobin study.

Background: Monoclonal gammopathies are a group of disorders associated with clonal proliferation of plasma cells that produces a monoclonal protein., Aims: The main objective of this study was to describe the epidemiological and immunochemical characteristics of monoclonal gammopathies diagnosed during 19 years in a Moroccan teaching hospital., Materials and Results: This retrospective study enrolled 443 Moroccan patients with monoclonal gammopathy, patients meeting the inclusion and exclusion criteria in at the biochemistry department of Military Hospital in Rabat, the capital of Morocco, from January 2000 to August 2019. Of the 443 enrolled patients, 320 (72.23%) were men and 123 (27.77%) were women. All patients were of Caucasian origin, from 12 Moroccan regions. The patient's samples were collected and subjected to serum protein electrophoresis and serum immunofixation electrophoresis to further characterize the monoclonal protein. The mean ± SD age of the 443 participants was 62.24 ± 13.14 years. Reasons for being admitted to the hospital were as follows, bone pain (41.60%), renal failure (19.08%), alteration of the general condition (12.21%), and anemia (10.69). Plasma cell proliferative disorders in our study were as follows, multiple myeloma (MM) (45.65%), Monoclonal gammopathies of undetermined significance (MGUS) (39.05%), Waldenstrom's macroglobulinemia (5.58%), Lymphoma (2.27% + 1.2%), Chronic Lymphocytic Leukemia (2.48%), Plasma cell leukemia (1.86%), Plasmacytoma (0.62%), POEMS syndrome (0.41%), and Amyloidosis (0.84%). The most frequent isotypes in MM were the IgGκ (62) 36.5%, IgGλ (52) 30.6%, IgAκ (27) 15.9%, and the IgAλ (19) 11.2%. It is also worth noting that Free light chain MM represents 20% of all cases of MM., Conclusions: We found that monoclonal gammopathies are age-related and affects men more than women, also the results of this study point to the delayed diagnosis of monoclonal gammopathies, since most of our patients were diagnosed at the MM stage. The most frequent isotypes were the IgGκ and IgGλ in MM and MGUS, in Waldenström macroglobulinemia were IgMκ and IgMλ and the oligoclonal profile represented only 3.70%., (© 2023 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

Background: We report a case of a multiple myeloma with light polymerized kappa chains, a phenomenon rarely described., Methods: Capillary electrophoresis of serum proteins (Capillarys 2 Flex Piercing Sebia ®) revealed the presence of two migrant monoclonal peaks in the gamma globulin area and identified by immunosubtraction (IS) as light chain (LC) κ. These results suggest either the presence of a LCκ monoclonal IgD or IgE or the presence of a biclonal gammopathy or finally a LCκ polymerization. Serum immunofixation (IF) was carried out, after serum depolymerization with beta mercaptoethanol (BME), using as antiserum anti IgD, anti IgE and anti LCκ total and free LC κ. Capillary electrophoresis and IS were also repeated after serum treatment with BME., Results: The depolymerization of our patient's serum showed the transformation of the two serum peaks into a single peak at the level of the κ light chains on both capillary electrophoresis and immunotyping techniques (IF and IS)., Conclusions: Polymerization of kappa light chains is a rare phenomenon which can cause difficulty in the interpretation of the serum protein electrophoresis and immunotyping.

Introduction: This prospective study was conducted at the Laboratoy of Biochemistry of the HMIMV, Rabat, over a period of 1 year. It aimed to analyse the kinetics of troponin lc (cTnl) after on-pump cardiac surgery in order to establish threshold values for the diagnosis of perioperative myocardial infarction., Methods: The study included 58 patients who had undergone on-pump valvular surgery or on-pump coronary artery bypass surgery. These patients were separated into 3 groups according to their clinical and electrical evolution as well as their laboratory tests (cTnI) during the immediate post-operative period. We batched and followed the kinetics of cTnl using immuno-enzymatic technique, CTNI Flex ® reagent, before and after on-pump cardiac surgery, at H0, H3, H6, H12, H21, H24 and H72 using automatic SIEMENS Dimension Xpand Plus., Results: The results were higher than in cardiology, even among the group of patients without postoperative cardiac complications, with an average cTnl rate of approximately 2.5 times higher than the threshold value in cardiology. The kinetics of release differed significantly among the 3 groups (p‹ 0.05)., Conclusion: The threshold value that we propose to confirm the diagnosis of perioperative myocardial infarction is 13ng/ml obtained between H12 and H24. We recommend to collect 1-2 samples at H12 and then between H20 and H24.

Composite S/C sickle cell disease accounts for 20%-30% of major sickle cell syndromes. We report a case of fortuitous detection of composite heterozygous S/C sickle cell disease in the context of retinal detachment. The patient had been hospitalized in the Department of Ophthalmology for treatment-resistant decreased visual acuity detected 06 months before. The patient's clinical history was marked by total hip replacement (THR) twelve years before. Our study highlights the wide clinical variability of sickle cell disease underlying the importance of early screening and adapted clinical monitoring of patients at-risk, in order to avoid its evolution toward irreversible organic sequelae such as sickle cell retinopathy.

Background: The retinopathy is an uncommon complication in individuals with sickle cell trait except for the cases of sickle cell trait associated with systemic arterial hypertension, diabetes mellitus, syphilis, tuberculosis and sarcoidosis., Case Presentation: A retinopathy in a 16 year-old child with no history of consanguinity in the parents revealed a sickle S trait associated to heterozygous alpha thalassemia. His mother has Sickle cell anaemia (Hb SS) and his father is a carrier of heterozygous alpha-thalassemia status that it was unknown before., Conclusion: This case report describes a proliferative retinopathy in a 16 year-old patient with co-inheritance of heterozygous alpha + -thalassemia and sickle trait.

Unlabelled: This study aimed to compare the vitamin D status in healthy Moroccan men and women aged 50 years and older. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. We found in this study a high prevalence of hypovitaminosis D with no difference between men and women., Purpose: The main purpose of this study was to describe and compare the vitamin D status, parathormone, calcium, and phosphate of healthy Moroccan men and women aged 50 years and older., Methods: We conducted two cross-sectional studies, in postmenopausal women from October 2008 to November 2009 and in men over 50 years old, from December 2009 to August 2010. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. For the definition of hypovitaminosis D, the preferred level for 25-hydroxyvitamin D (25(OH)D) insufficiency, which is now recommended by many experts, is 30 ng/mL (75 nmol/L), and the levels below 10 ng/ml (25 nmol/L) indicate deficiency., Results: The prevalence of vitamin D deficiency in men and women was 4.4 and 8.6 %, respectively, and the prevalence of vitamin D(25(OH) D) insufficiency in men and women were 85.2 and 77.4 %, respectively. In men and women, no correlations were found between intact parathormone (PTHi) and 25(OH) D (r = 0.056)., Conclusions: Despite a sunny environment, we found in this study a high prevalence of hypovitaminosis D (insufficiency + deficiency) in Moroccan men over 50 years old and postmenopausal women.

Background: Vertebral Fractures (VFs) are associated with bone loss that occurs before menopause but is accelerated at menopause as a result of sex hormone deficiency. To determine the association of sex hormones, bone remodeling markers and vitamin D levels with bone mineral density (BMD) and asymptomatic VFs prevalence using vertebral fracture assessment (VFA) in a cohort of Moroccan menopausal women., Methods: This was a cross-sectional study conducted from October 2012 to April 2013 with menopausal women aged 50 years old and over. A total of 207 women who had no previous diagnosis of osteoporosis were enrolled in this cross-sectional study. Women were recruited prospectively from our laboratory department. VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. Serum levels of estradiol, dehydroepiandrosterone sulfate, Sex hormone binding globulin, vitamin D, Osteocalcin, Crosslaps, intact parathormone were measured by Electrochemiluminescent immunoassay technique., Results: Among the 207 women, 18.3 % (n = 38) had densitometric osteoporosis. On VFA, VFs were detected in 134 (62.3 %), including 96 (44.6 %) grade 1 and 38 (17.6 %) grade 2/3. There was no difference in the plasma levels of sex steroids, bone remodeling markers and vitamin D in the group of women with VFs (grade 1 and grade 2/3) and without VFs. The combination of variables that best predicted grade 2/3 VFs included the number of years since menopause and the lumbar spine T-score., Conclusion: These data confirm the importance of postmenopausal estrogen and SHBG concentrations in the bone loss and the pathogenesis of osteoporosis in elderly women, but not in the occurrence of the VFs.

Unlabelled: Bisalbuminemia whether hereditary or acquired, is a rare electrophoretic abnormality of albumin, characterized by a duplication of the albumin fraction on the electrophoretic trace of the serum proteins. This duplication reflects the presence in the same individual normal plasma albumin and a modified albumin., Observation: This is a patient of 62 years hospitalized at the Internal Medicine Department of HMIMV for liver metastases of gastrointestinal adenocarcinoma and including serum protein electrophoresis (EP) performed on capillary (Capillarys society Sebia) reveals bisalbuminemia. The family investigation has ruled that inheritance of acquired bisalbuminemia to retain appearance., Comment: Bisalbuminemia acquired outside treatment with high doses of beta-lactam antibiotics, chronic pancreatitis with pseudocyst rupture or fixing a monoclonal immunoglobulin on albumin in the myeloma subjects is an exceptional event. The pathophysiologic mechanism in the reported cases remains unexplained as is also the case of acquired bisalbuminemias associated with other pathological contexts (Alzheimer's disease nephrotic syndrome)., Conclusion: To the best of our knowledge, the bisalbuminemia in the gastrointestinal adenocarcinoma liver metastases has not been reported to date, hence the importance of the reported cases.

Objectives: We wanted to measure the impact of going from a two-step screening for gestational diabetes mellitus (50g oral glucose tolerance test then 100g OGTT) to a one-step screening 75g OGTT (WHO's recommendations)., Patients and Methods: A prospective study was carried out among patients who consulted between July 1st, 2008 and October 31st, 2009. The screening was performed in the first trimester if risk factors were identified and between 24 and 28 weeks of gestation (WG)., Results: During our period of study of 15 months, 706 pregnant women were included. The prescription of a screening test was performed in 403 women, i.e. 57% of cases. Out of the 403-screened women, 33 had gestational diabetes mellitus (GDM) i.e. a 8.2% prevalence rate. In univariate analysis, the following are considered to be risk factors: age, diabetes family history and macrosomia history in a previous pregnancy. Between 24 and 28 WG, 34.34% of the screening tests were achieved. The 75g OGTT is prescribed in 96.2% of cases as a screening test of GDM but fasting blood glucose is still prescribed in 3.8% of cases. Also, before 12 WG, 75g OGTT represent 64.7% of the prescribed tests., Discussion: Despite the simplification of the GDM screening procedure, our work shows no significant difference of the screening rate and prevalence of GDM between our present study and the first work done in the same service (57% versus 61%, P=0.7 and 8.2% versus 7.7%, P=0.9). The GDM risk factors found are also identical between the two studies: age, type 2 diabetes family history and macrosomia history. Moreover, there is a statistically significant improvement in the screening age (23±6.7 versus 20.9 WG±6.8 in the first half of 2008, P<0.001) and the number of tests ordered during the period between 24 and 28 WG (34.34% versus 23.9% in the first half of 2008, P<0.001). For the GDM screening tests between 24 and 28 WG, 75g OGTT replaced the 50g OGTT (test used in the first study), but fasting blood glucose is prescribed in 3.8% of cases knowing that normal fasting blood glucose alone done between 24 and 28 WG has a poor sensitivity and do not exclude the diagnosis of GDM (Cosson, 2006) [11]. Also, before 12 WG, 75g OGTT represents 64.7% of the prescribed tests. However, there is to date no data to validate load testing before 24 WG., Conclusion: Our comparative study revealed maintenance of low implementation of universal screening of GDM despite the simplification of the protocol. Between 24 and 28 WG, 75g OGTT replaced the 50g OGTT, but fasting blood glucose was still prescribed. A sensitization meeting involving all intervening persons is to be organized with proposals for corrective actions. The final objective is the systematic screening of gestational diabetes mellitus with the use of fasting blood glucose in the first trimester and the 75g OGTT between 24 and 28 weeks of gestation., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Unlabelled: The aim of the study is to find the correlation between bone turnover markers and bone mineral density in a cohort of Moroccan postmenopausal women., Patients and Methods: A cross-sectional study, conducted over a period of 12 months from October 2008 to November 2009. Five hundred Moroccan postmenopausal women volunteers participated in this study and we included only 185., Results: In this cohort of 185 women, average age 60 years, the percentage of osteoporotic women was 35.7%, they were older 62.09 (9.13) years and they had an average of the body mass index (BMI), the lowest 29.58 (4.45). The values of the bone mineral density (BMD) measured at the lumbar spine correlated positively and significantly with BMI (P<0.001), serum calcium (P=0.026), negatively with age (P<0.001) and osteocalcin (OC) (P=0.0033). As for the results of BMD measured at the femoral neck, they show a negative and highly significant correlation with age (P<0.001) and osteocalcin. Looking for an association between the biochemical markers of bone remodeling, a weak positive correlation was found between the calcium (Ca) and alkaline phosphatase (PAL) on the one hand and Ca and intact parathyroid hormone (PTHi) in the other hand. And a significant positive correlation was found between PTHi and PAL, and between PTHi and OC. Finally, a significant positive correlation was found between the cross-laps (β-CTX) and Ca and between PAL and OC., Conclusion: Our results are in agree to some international studies and disagree to others., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

This transversal case study aimed at drawing the biological profile of sensitized patients consulting for respiratory allergies at Mohamed V Military Hospital-Rabat. One hundred four patients were included in the case study, who have benefitted from specialized medical consultation and those who came to the biochemistry laboratory holding a medical check-up prescription for allergy (NFS and biochemical check-up). The biochemical analysis were made up of TMA Phadiatop(®), correct proportioning of specific IgE serum, and complete IgE. The different anamnestic and clinical parameters acting upon the sensitization to respiratory allergens have been collected through a multiple choice question survey. Statistical analysis has been performed by a SPSS software version 13.0. The Phadiatop(®) was positive at 54.8% of our patients with a masculine predominance (H/F sex-ratio = 1.4). The recurring symptoms were the rhinitis (36.8%) and the asthma (10.5%). The allergen d1 Dermatophagoides pteronyssinus was the most incriminated pneumallergens (59.6%). For 19.3% of the patients sensitized, a polysensitization (superior to three) was noted, due to dust mite, cockroaches, pollen and animals. 93.6% of the Phadiatop(®) positive patient had a hypereosinophilia (p &#60; 0.001). The complete IgE had been prescribed to 29 patients and had been increased among 19 patients in 66% of the cases. Among the patients having a rate of elevated complete IgE, 8 (42.1%) had a negative Phadiatop(®) (p = 0.019). Our survey showed the strong prevalence of the respiratory sensitization at our population. The allergen d1 is the most incriminated. It also put in evidence the weak diagnostic value of the dosage of the complete IgE in the respiratory allergy.

Introduction: Patients with end-stage renal disease (ESRD) receiving chronic hemodialysis show a high incidence and prevalence of cardiovascular disease of multifactorial etiology and an association between dyslipidemia and accelerated atherosclerosis., Objective: Our aim was to study lipid profiles in ESRD patients receiving dialysis regularly at our hospital (Morocco).Subjects and methods : The patient population consisted of 30 ESRD patients on maintenance haemodialysis. Matched control subjects were recruited among healthy normolipidemic patients. Concentrations of triglycerides (TG), total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C) and low-density-lipoprotein cholesterol (LDL-C) were measured. The atherogenic index (AI = TC/HDL-C ratio) was calculated., Results: The TG, the HDL-C levels and atherogenic index were significantly higher in groups of hemodialysis patients. We saw no increase in the levels of TC and LDL-C. The prevalence of dyslipidemia in hemodialysis group was high (80%). The most frequent lipid alterations were decreased HDL-C (70%), increased TG (33,3%) and increased LDL-C (23,3%); 50% of ESRD patients have more than two different dyslipidemic findings. AI was higher (≥ 5) in 33,3% of cases., Conclusion: The prevalence of dyslipidemia is higher than normal in ESRD patients on maintenance hemodialysis. Classically, these patients have had low levels of HDL-C and elevated TG levels. Strict control of dyslipidemia should be part of the cardiovascular risk prevention strategy in this population.

Our study has for aim to describe the practices of screening of the gestational diabetes mellitus. Screening test was realised at 61% of the women included in the study. The HGPO in 50 g was prescribed in 47% of the cases, a single fasting blood glucose in 28% of the cases; 13,4% of the detected women had a glycaemia included between 1,30 and 2 g/L one hour after a load of 50 g of glucose. Among these patients, 52,63% did not realize test HGPO in 100 g. Gestational diabetes mellitus complicates about 7,7% of pregnancies in our study. In statistical analysis united varied, are considered as risk factors: the age, the family history of diabetes and the histories of macrocosmic during previous pregnancy.

Allergic diseases are ranked fourth considering the world health organization classification of diseases. The consequences linked to these ailments are huge for public health economics and the diagnosis is awkward due to clinical polymorphism and multifactorial aetiologies. The allergologic diagnosis is the result of weighing in clinical and biological findings. The biological assessment is made of qualitative specific and multiple-allergen serum IgE test, which once positive drives to skin test and each allergen-specific IgE level determination to conclude. Our study aims at displaying biological analysis results of incoming patients with clinical allergy conditions. We carried out a nine months retrospective study, from June 2007 to March 2008, with 200 outwards patients involved. Blood samples were collected using dry tubes and as recommended we first did screening tests for respiratory (Pharmacia Phadiatop) and food (fx 5) allergens, then for positive samples we proceeded to serum specific IgE assay (UniCap, Phadia). We also realized the total IgE assay on 46 patients using Roche Elecsys 2010 technology. 49% of patients enrolled in the study were positive to aerollergens, d1 Dermatophagoides pteronyssinus being the most incriminated (96.4%), and 2.5% to food allergens. On 13% of patients, we noticed a double sensitization to d1 and g6 (pollen of grasses). Concerning the total IgE dosage, we found 50% of patients tested with normal values, 28% of whom having a positive allergologic screening test. Further studies matching clinical data, skin tests to serum IgE assay are necessary to draw the profile of respiratory and dermatological allergies for our patients.

We report the case of a 70 years old patient hospitalized for renal insufficiency and deterioration of the general state. The electrophoresis of serum proteins on freezing of agarose reveals the presence of a discrete peak of monoclonal pace on the level of the gammaglobulines identified by serum immunofixation like IgM of the kappa type. The research of the cryoglobulinemia carried out in a laboratory of city was made positive and typified like a monoclonal cryoglobulinemia IgM kappa, thus directing the diagnosis towards a disease of Waldenström. However, the result of the biopsy medullary made exclude any lymphoprolifératif syndrome. The positivity of the serology of hepatitis B justified a second request for study of the cryoglobulinemia, carried out within our laboratory. The cryoglobuline was typified like mixed (IgM kappa monoclonal and IgG polyclonales). This result associated with the immunological assessment and the renal biopsy made retain for our patient the diagnosis of a kidney vasculitis connected to an infection chronicle by the virus of hepatitis B. This observation points out the interest of the preanalytic, analytic and post analytic phases in the study of the cryoglobulinemias. A good technical control is today the only guarantee of the quality of the result of this examination which has large importance in internal medicine in the etiologic assistance with the diagnosis of certain clinical demonstrations.

The removal organ in order to transplantation is realized often for patient deceased. It was regulation activity that passes in urgency context where laboratory play an important role. The biochemistry, immunology, haematology, toxicology and microbiology analysis allows the validation of the donors, the supervision of the functional quality of organ and the definition of the best couple donor-recipient.