[Hemoglobinopathy. Laboratory diagnosis]. / Hémoglobinopathies. Diagnostic au laboratoire.

Hemoglobinopathies are the most common genetic diseases in the world. They are most frequent in areas where malaria is endemic. Sickle cell disease and severe thalassemia require prompt diagnosis. The purpose of this article is to describe first-line techniques for diagnosis in non-specialized laboratories with special emphasis on the pitfalls of interpreting results.

[Colchicine poisoning: a case report]. / A propos d'une intoxication létale à la colchicine.

Colchicine is a drug commonly used for treatment of acute and chronic gout. Poisoning is a rare but always serious event. The purpose of this report is to describe the case of a 16-year-old girl who ingested an unknown amount of colchicine in a suicide attempt. At the time of admission she presented with gastrointestinal manifestations and reduced consciousness. After ten days in the intensive care unit she died due to multiple organ failure. This case provides the opportunity not only to review the clinical course and prognostic factors associated with colchicine poisoning but also to underline the difficulty of its management due to the absence of a specific antidote and of emergency pharmacologic doses.

[Congenital hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency]. / Anémie hémolytique congénitale par déficit en Glucose-6-Phosphate Déshydrogénase.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common enzyme defect with a wide range of clinical manifestations that can be severe. A variety of factors including many medications can induce hemolytic episodes. Screening for G6PD deficiency is required before use of some drugs especially primaquine or dapsone.

[New use of primaquine for malaria]. / Le nouvel âge de la primaquine contre le paludisme.

Primaquine is the only available drug to treat Plasmodium vivax liver stages (hypnozoites). It has been used for more than five decades and is now included in an increasing number of clinical guidelines. The major concern is induced hemolysis when administered to glucose-6-phosphate-dehydrogenase deficient patients. Primaquine could be used for causal prophylaxis during and after exposure or for presumptive antirelapse therapy (PART) in case of high exposure to P. vivax. A radical cure is used to avoid relapse for patients with a confirmed bloodstream infection with P. vivax or P. ovale. In France, primaquine is not approved for prevention and treatment and its use requires a specific temporary authorization.

[Analytical interference caused by monoclonal immunoglobulin M with cryoglobulin effect: a case report]. / IgM monoclonale cryoprécipitante: un piège au laboratoire.

In biochemistry laboratory, monoclonal immunoglobulins are frequently found. They can lead to analytical interferences which are difficult to anticipate. In this case reports, a monoclonal immunoglobulin M with cryoglobulin effect has been responsible of false result of protein electrophoresis because of the whole precipitation of the monoclonal immunoglobulin. This case report allows us to remember the interferences caused by monoclonal immunoglobulins and that clinicians should be aware of these aspects of paraproteins and contacting the laboratory when encountering unexpected results.

[Cryoglobulins: detection, type determination and quantitation. A study of healthy subjects and patients with chronic hepatitis C]. / Cryoglobuline: recherche, typage et quantification. Etude chez le sujet sain et chez des patients atteints d'une hépatite C chronique.

Cryoglobulins are immunoglobulins or immune complexes which precipitate at a temperature lower than 37 degrees C and re-dissolve when rewarmed. So their collection and processing are critical. We describe the methodology used in the biochemical laboratory of Military hospital Laveran (Marseille) for detection determination of type and quantitation of cryoglobulins. In this study, we have found cryoglobulins in 53% of healthy subjects and in 77% of patients with chronic hepatitis C.

[Cryoglobulinemia]. / Les cryoglobulinémies.

Cryoglobulins are immunoglobulins or immune complexes which precipitate at a temperature lower than 37 degrees C and redissolve when rewarmed. Cryoglobulins can be asymptomatic. When not, clinical features are in most cases cutaneous, renal or neurological. Cryoglobulinemia are associated with malignant haematological disorder, connective tissue disease or infection process especially infection with hepatitis C virus. In some case, no aetiology can be found, in theses cases cryoglobulinemia are called primary or essential cryoglobulinemia. For the last ten years it has been widely demonstrated that virus C infection causes the most part of essential cryoglobulinemia.