Hot Topic Archives - Insights
Millions of Americans suffer from allergies with peanut allergies being of particular interest. For the patient’s welfare, it’s important to understand when that allergy is actually allergic disease or sensitization as a result of exposures. These 2 clinical pictures can be differentiated using laboratory testing, in addition to the clinical history, to identify the presence of allergen-specific IgE.
Diagnosis of chronic granulomatous disease (CGD) is complex, as there are five genes and two different inheritance patterns involved. The DHR/Dihydrorhodamine (DHR) Flow Cytometric Test, Blood assay is the most commonly used assay for diagnosis of CGD. Accurate assessment of the NADPH oxidase activity is highly dependent on having a high-quality specimen that is received within 24 hours of collection.
Clostridium difficile is an important cause of health-care-associated infections. C. difficile infections (CDI) present with a wide range of symptoms, from diarrhea to toxic megacolon. Accurate and rapid diagnosis is important to begin therapy with an appropriate antimicrobial agent and discontinue antimicrobial agents that may be predisposing the patient to CDI. This Hot Topic covers several methods for diagnosing CDI, including molecular NAATs, EIAs, and culture.
Increasing complaints about heel bruising in infants following blood-spot collection raised concerns about the best option for collecting blood from infants. A team from Mayo Clinic evaluated the practice of warming the heel prior to puncture, using venipuncture instead of heel puncture, and infant distress as a result of either heel puncture or venipuncture.
Programmed cell death ligand 1 (PD-L1) is a protein that can be expressed on tumor cells and immune cells. Anja Roden, M.D., discusses the role of PD-1 – PD-L1 interaction in the immune system and the challenges of PD-L1 testing.
Knowing which test is the correct test can be difficult. Ordering the wrong test can provide misleading results and increase costs to the patient. In this case review, Sarah Kerr, M.D., explains similarities and differences between mismatched repair defects and microsatellite instability when screening patients for Lynch syndrome.
Because many patients with lung cancer are not surgical candidates, the biopsy specimen or cytology preparation will be the only specimen available for diagnosis and molecular testing in these patients. In this Hot Topic, Anja Roden, M.D., covers a new classification of small biopsies and cytology in the 2015 WHO classification of lung adenocarcinoma.
In this Hot Topic, Nancy Wengenack, Ph.D., provides an overview of the current standards for antifungal drug-susceptibility testing of yeast and the development of species-specific breakpoints and epidemiological cutoff values.
The amount of tumor tissue in a specimen and the percent tumor nuclei are the foundation for selecting the right specimen for molecular testing. Once you’ve correctly identified the target, the requirements for the specific type of test come into play.
Coagulation testing is complex. This case-based presentation introduces the diagnostic considerations for prolonged activated partial thromboplastin time and/or prothrombin time, including pathophysiologic classification (“SICKFAIL”) and laboratory and clinical approaches for evaluation.
Neuromyelitis optica is now recognized as a spectrum of autoimmunity (termed NMO spectrum disorders or NMOSD). Many patients with NMOSD are misdiagnosed as having multiple sclerosis, however, the prognosis and optimal treatments for the two diseases differ. Therefore, early diagnosis and initiation of NMO-appropriate immunosuppressant treatment is important to optimize the clinical outcome by preventing further attacks and reducing disability.