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1. A case of inter-assay HbA1c discrepancy due to Hemoglobin G-Copenhagen

Author

Stéphanie Badiou, Anne-Marie Dupuy, Séverine Cunat, Agnès Delay, Stéphanie Alcaraz, Patricia Aguilar-Martinez, Jean-Paul Cristol, and Florence Galtier

Subjects
Biochemistry (medical), Clinical Biochemistry, General Medicine, Biochemistry
Abstract

A clinician was intrigued about HbA1c upper 9% (75 mmol/mol) in a 76 year-old women with normal glycemia. Further explorations were performed in order to understand this discordance.First HbA1c test was performed on a HLC -723 G11 apparatus (Tosoh Bioscience) and thereafter compared to the HLC-723-G8 (Tosoh Bioscience), the Capillaris 3 Tera (Sebia) and the DCA Vantage point of care testing (POCT) (Siemens) apparatus. In addition, study of Hemoglobin (Hb) fraction and mutation analysis of HBB gene was realized due to the suspicion of an Hb variant.Twice high results of HbA1c (9.3%, 78 mmol/mol and 10%, 86 mmol/mol) on the HLC-723 G11 was not confirmed with other instruments. HbA1c result for the same sample was 5.2% (33 mmol/mol) for the HLC-723 G8, 5.3% (34 mmol/mol) for the Capillaris and 6.2% (44 mmol/mol) for the DCA Vantage POCT. The subject had normal glycemia and none signs of diabetes mellitus. An abnormal Hb fraction was visualized on the graphs for the HLC-723 G11 and Capillaris but not for the HLC-723 G8 analyzer. Study of Hb fraction confirmed the presence of an abnormal Hb fraction that was identifed as an Hb G-Copenhagen through mutation analysis of HBB gene.This case evidenced an interference on HbA1c test in presence of Hb G-Copenhagen depending to the analyzer used. This report help to alert of such possibility and to remain that a discordance between HbA1c and glycemia can be due to an Hb variant.

Published
2022

2. Prospective analysis of 61 cases of enteroviral meningitis: interest of systematic genome detection in cerebrospinal fluid irrespective of cytologic examination results

Author

Stéphanie Alcaraz, Hélène Peigue-Lafeuille, Christophe de Champs, André Labbé, F. Charbonné, Christine Archimbaud, Martine Chambon, Cécile Henquell, and Jean-Luc Bailly

Subjects
Virus Cultivation, Adolescent, Neutrophils, medicine.disease_cause, Polymerase Chain Reaction, Virus, law.invention, Central nervous system disease, Leukocyte Count, Cerebrospinal fluid, law, Virology, Enterovirus Infections, medicine, Viral meningitis, Humans, Lymphocyte Count, Prospective Studies, Child, Prospective cohort study, Polymerase chain reaction, Enterovirus, business.industry, Infant, medicine.disease, Meningitis, Viral, Infectious Diseases, Child, Preschool, Immunology, RNA, Viral, business, Meningitis
Abstract

Background: Enteroviruses are the most commonly identified cause of viral meningitis. Detection of the enterovirus genome in cerebrospinal fluid (CSF) using reverse-transcription polymerase chain reaction (PCR) has proved to be useful in diagnosis and is more rapid and sensitive than viral cultures. In routine practice, cytologic examination results of CSF are obtained swiftly and PCR indication is performed as a second step. Objectives: The aim of this study was to determine, by analysis of complete data from CSF results for 61 cases of proven enteroviral meningitis, whether cytologic CSF findings can be used to establish viral etiology and to indicate if PCR assay should be performed. Study design: From a prospective study of children admitted during 1997 for suspected enterovirus meningitis in which PCR and viral cultures of CSF were systematically performed, we selected 61 patients with proven enterovirus meningitis. We compared global white cell count (WCC), relative percentage of lymphocytes/neutrophils, PCR and culture for enterovirus, patient age, and clinical data. Results: 92% of patients (56/61) had positive PCR in CSF and in 48% (29/61) enterovirus was isolated in CSF. Nine patients (14.75%) had WCC 3 ; eight of them had positive PCR and two had positive culture. There were comparable numbers of CSF with a predominance of lymphocytes ( n =25) and CSF with a predominance of neutrophils ( n =22), and of positive PCR and positive cultures of CSF in the two groups. Results were not influenced by the age of the patients. Conclusion: Irrespective of other CSF parameters, it seems difficult to dispense with PCR assay for enterovirus genome detection. It should be introduced as a true rapid routine test. Early reporting of a positive PCR result could result in a considerable saving in health resources.

Published
2001
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3. Myocardial injury in coronavirus disease 19 (Covid-19): main pathophysiological mechanisms and clinical utility of cardiac biomarkers

Author

Kamel, Saïd, Raynor, Alexandre, Zozor, Samuel, Lacape, Geneviève, Brunel, Valéry, Nivet-Antoine, Valérie, Collin-Chavagnac, Delphine, Peoc’h, Katell, Cohen, Ariel, Lassoued, Amin Ben, Chévrier, Marc, Alemann, Mathieu, Lessinger, Jean-Marc, Bérard, Annie, Sapin, Vincent, Beauvieux, Marie-Christine, Levy, Pacifique, Lehmann, Sylvain, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Bordeaux [Bordeaux], CHU Rouen, Normandie Université (NU), Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Tenon [AP-HP], Thrombose, atherothrombose et pharmacologie appliquée, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Clermont-Ferrand, Génétique, Reproduction et Développement (GReD), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Centre de résonance magnétique des systèmes biologiques (CRMSB), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Pour le Groupe de Travail de la SFBC « Marqueurs Biochimiques de la pathologie Covid-19 »: Isabelle Aimone-Gastin, Stéphanie Alcaraz, Stéphane Allouche, Malika Balduyck, Françoise Barbé, Yann Barguil, Jean-Philippe Bastard, Jean-Louis Beaudeux, Marie-Christine Beauvieux, Amin Ben Lassoued, Isabelle Benz de Bretagne, Annie Bérard, Laurent Bermont, Edith Bigot-Corbel, Muriel Bost, Valery Bourbonneux, Valery Brunel, Jean-Luc Carré, Camille Chenevier-Gobeaux, Marc Chevrier, Giulia Chinetti, Delphine Collin-Chavagnac, Hervé Delacour, Delphine Delevallée, François Desroys du Roure, Patrice Faure, Jean-Philippe Galhaud, Anne Galinier, Thierry Hauet, Carine Helj, Emilie Jolly, Said Kamel, Sylvain Lehmann, Aline Leroy, Jean-Marc Lessenger, Pacifique Levy, Anne-Marie Lorec-Penet, Samir Mesli, Dagui Monnet, Caroline Moreau, Laurence Mouly, Valérie Nivet-Antoine, Nathalie Oueidat, Mathieu Pecquet, Katell Peoc’h, Laurence Piéroni, Carole Poupon, Martine Roubille, Benoit Rucheton, Medhi Sakka, Vincent Sapin, Vincent Saunier, Florian Scherrer, François Schmitt, Sabine Zaepfel, Samuel Zozor

Subjects
myocardite, peptides natriurétiques, SARS-CoV-2, myocarde, [SDV]Life Sciences [q-bio], troponine, Covid-19
Abstract

International audience; Pour citer cet article : Atteintes myocardiques au cours de la maladie à coronavirus 19 (Covid-19) : principaux mécanismes physiopathologiques et utilité clinique des biomarqueurs cardiaques.

Published
2021
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4. Atteintes myocardiques au cours de la maladie à coronavirus 19 (Covid-19) : principaux mécanismes physiopathologiques et utilité clinique des biomarqueurs cardiaques

Author

Kamel, Saïd, Raynor, Alexandre, Zozor, Samuel, Lacape, Geneviève, Brunel, Valéry, Nivet-Antoine, Valérie, Collin-Chavagnac, Delphine, Peoc’h, Katell, Cohen, Ariel, Lassoued, Amin Ben, Chévrier, Marc, Alemann, Mathieu, Lessinger, Jean-Marc, Bérard, Annie, Sapin, Vincent, Beauvieux, Marie-Christine, Levy, Pacifique, Lehmann, Sylvain, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Bordeaux [Bordeaux], Université de Bordeaux (UB), Laboratoire de biochimie générale [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Innovations thérapeutiques en hémostase (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), CHU Necker - Enfants Malades [AP-HP], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Saint-Antoine [AP-HP], Thrombose, atherothrombose et pharmacologie appliquée, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Hôpital de la Timone [CHU - APHM] (TIMONE), Hospices Civils de Lyon (HCL), Nouvel Hôpital Civil de Strasbourg, Les Hôpitaux Universitaires de Strasbourg (HUS), Génétique, Reproduction et Développement (GReD), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Centre de résonance magnétique des systèmes biologiques (CRMSB), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU), Pour le Groupe de Travail de la SFBC « Marqueurs Biochimiques de la pathologie Covid-19 »: Isabelle Aimone-Gastin, Stéphanie Alcaraz, Stéphane Allouche, Malika Balduyck, Françoise Barbé, Yann Barguil, Jean-Philippe Bastard, Jean-Louis Beaudeux, Marie-Christine Beauvieux, Amin Ben Lassoued, Isabelle Benz de Bretagne, Annie Bérard, Laurent Bermont, Edith Bigot-Corbel, Muriel Bost, Valery Bourbonneux, Valery Brunel, Jean-Luc Carré, Camille Chenevier-Gobeaux, Marc Chevrier, Giulia Chinetti, Delphine Collin-Chavagnac, Hervé Delacour, Delphine Delevallée, François Desroys du Roure, Patrice Faure, Jean-Philippe Galhaud, Anne Galinier, Thierry Hauet, Carine Helj, Emilie Jolly, Said Kamel, Sylvain Lehmann, Aline Leroy, Jean-Marc Lessenger, Pacifique Levy, Anne-Marie Lorec-Penet, Samir Mesli, Dagui Monnet, Caroline Moreau, Laurence Mouly, Valérie Nivet-Antoine, Nathalie Oueidat, Mathieu Pecquet, Katell Peoc’h, Laurence Piéroni, Carole Poupon, Martine Roubille, Benoit Rucheton, Medhi Sakka, Vincent Sapin, Vincent Saunier, Florian Scherrer, François Schmitt, Sabine Zaepfel, Samuel Zozor, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Clermont-Ferrand, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), VIAUD, Karine, Normandie Université (NU)-Centre hospitalier universitaire de Rouen, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB)

Subjects
Adult, Male, medicine.medical_specialty, Myocarditis, [SDV]Life Sciences [q-bio], Myocardial Infarction, troponine, Disease, Systemic inflammation, Predictive Value of Tests, Internal medicine, myocarde, Coagulopathy, medicine, myocardium, Humans, Hospital Mortality, Myocardial infarction, Pandemics, Aged, Aged, 80 and over, Endocarditis, biology, business.industry, SARS-CoV-2, troponin, Heart, General Medicine, Middle Aged, Prognosis, medicine.disease, Troponin, Pathophysiology, 3. Good health, myocardite, [SDV] Life Sciences [q-bio], peptides natriurétiques, biology.protein, Cardiology, Female, France, Myocardial infarction diagnosis, medicine.symptom, myocarditis, business, Covid-19, natriuretic peptides, Biomarkers
Abstract

International audience; Covid-19 is responsible for myocardial injury in many infected patients, which is associated with severe disease and critical illness. The mechanisms by which SARS-CoV-2 may cause myocardial damage involve direct effect of the virus in cardiac cells and indirect effect due to the clinical consequences of Covid-19. Cardiomyocytes are well known to express Angiotensin-Converting Enzyme-2 receptors (ACE-2) to facilitate the virus cell entry, which could explain the occurrence of myocarditis, functional alterations in the myocardium, and more rarely, myocardial infarction. Myocardial injury may also be secondary to systemic inflammation or coagulopathy due to complicated Covid-19. The existence of a cardio-intestinal axis with alteration of tryptophan metabolism in the small bowel leading first to colitis and then to systemic inflammation has also been evoked to explain the myocardial injury. Morphological and metabolic disturbances of the heart during the Covid-19 are associated with elevated concentrations of cardiac blood biomarkers, mainly troponins and natriuretic peptides. The determination of these biomarkers has proven to be very useful for diagnosis, prognosis, and risk stratification. Indeed, recent data demonstrated that about 20% of infected patients admitted to the hospital have elevated troponin or BNP levels, and Covid-19 patients with elevated troponin concentrations beyond the diagnostic threshold (99th percentile) were associated with a higher risk of in-hospital mortality. In conclusion, after more than a year of a unique global pandemic, it is now clearly established that myocardial injury during Covid-19 is frequent and strongly contributes to the severity of the disease. Cardiac alterations secondary to direct infection of cardiac cells by SARS-CoV-2 or to the clinical consequences of Covid-19 are associated with elevated levels of cardiac biomarkers in blood, whose measurement is crucial in clinical decision making.

Published
2021
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