The modern landscape of transfusion-related iatrogenic Creutzfeldt–Jakob disease and blood screening tests

2004 ◽  
Vol 11 (5) ◽  
pp. 351-356 ◽  
Author(s):  
Paul Brown ◽  
Larisa Cervenakova
2021 ◽  
Vol 32 (3) ◽  
pp. 181-190
Author(s):  
Dong Hee Seo ◽  
Hyoung Ju Yoon ◽  
Jae Chan Ahn ◽  
Yoo-Sung Hwang

Blood ◽  
1970 ◽  
Vol 35 (4) ◽  
pp. 462-475 ◽  
Author(s):  
ROBERT C. HARTMANN ◽  
DAVID E. JENKINS ◽  
ANITA B. ARNOLD

Abstract The diagnostic specificity of the various modifications of the sucrose hemolysis test for PNH was examined in detail. In whole blood screening tests the greatest specificity was achieved using citrated or oxalated blood and room temperature incubation (23°). Defibrinated whole blood should not be used since "false positive" hemolysis may occur in blood disorders other than PNH. Mechanisms were suggested for this phenomenon. The validity of the confirmatory sucrose hemolysis test employing normal serum was further reported. Because of the clear, colorless character of serum-sucrose mixtures, an insignificant degree of hemolysis (i.e., less than 5%) is more readily visible than in other PNH hemolytic tests employing undiluted serum. Definitive instructions and criteria for interpretation were given for both the whole blood screening test and the confirmatory sucrose hemolysis test.


PEDIATRICS ◽  
1966 ◽  
Vol 37 (1) ◽  
pp. 102-106
Author(s):  
Helen K. Berry ◽  
Betty S. Sutherland ◽  
Barbara Umbarger

THE American Academy of Pediatrics Committee on Fetus and Newborn recently recommended that a blood test for elevated concentration of phenylalanine be performed for all newborn infants prior to discharge. As results become available from wide application of blood screening tests, a number of questions have arisen regarding the interpretation of positive findings of elevated blood phenylalanine levels. Some reports suggest that diagnosis of phenylketonuria is determined by elevation of blood phenylalanine. The conclusion may be erroneously drawn that such a finding in an infant calls for immediate treatment with a low-phenylalanine diet. There are instances in which children were fed a phenylalanine restricted diet for periods up to 18 months and subsequently were proven not to have phenylketonuria. In another study plasma phenylalanine levels up to 40 mg/100 ml in a premature infant, accompanied by elevation of tyrosine, were shown not to result from phenylketonuria. Some investigators urge that tests for urinary metabolites characteristic of phenylketonuria be a necessary part of the diagnosis, while others consider urine testing of little value. The cause for the mental defect in phenylketonuria has not been established with certainty. No satisfactory explanations have been proposed to account for the rare individuals with normal intelligence and biochemical phenylketonuria. It is not known whether elevation of phenylalanine from disorders other than phenylketonuria might result in mental impairment. We have carried on a broad-scale urinescreening program since 1958 and a bloodscreening program since 1961. At the same time we have accumulated 70 patient years of experience in treatment of phenylketonuria.


2017 ◽  
Vol 41 (S1) ◽  
pp. S162-S162
Author(s):  
N. De Uribe-viloria ◽  
M. De Lera Alfonso ◽  
L. Rodriguez Fernandez ◽  
G. Zapico Aldea ◽  
C. Laserna Del Gallego ◽  
...  

IntroductionNeurocognitive disorders are the only psychiatric disorders which underlying pathogeny can potentially be determined. This has important implications, for it makes possible the use of biomarkers in order to gain better diagnosis, and opens a door to more accurate treatments. Nonetheless, as biomarkers are not exclusive of a single disorder, the lengths of its utility are still unknown.Objectives and aimsTo understand the values and limitations of biomarkers in differential diagnosis of dementias.MethodsWe present three cases followed in the Neurology ward of our hospital, in which they were admitted for diagnosis and treatment of a subacute form of dementia. Medical history, core symptoms, screening tests for cognitive impairment, MRI, EEG and biomarkers in cerebrospinal fluid were used for diagnosis.ResultsTwo cases had consistent clinical features and complementary explorations, and they were respectively diagnosed as Creutzfeldt-Jakob Disease and Lewy Body Dementia; however, the last case showed contradictory results between clinic and complementary explorations, particularly 14-3-3 protein, which was positive and led to the initial diagnosis as Creutzfeldt-Jakob Disease, which was proven wrong once necropsy was practiced.ConclusionsAlthough complementary explorations, and biomarkers in particular, are of invaluable utility in the accurate diagnosis of multiple psychiatric diseases, they must always be considered within a context given by biography and clinical features, because, when failing to do so, they can lead to misdiagnosis and delay of correct treatment.


2016 ◽  
Vol 44 (3) ◽  
pp. 187-191 ◽  
Author(s):  
Marcel Verweij ◽  
Koen Kramer

Some screening tests for donor blood that are used by blood services to prevent transfusion-transmission of infectious diseases offer relatively few health benefits for the resources spent on them. Can good ethical arguments be provided for employing these tests nonetheless? This paper discusses—and ultimately rejects—three such arguments. According to the ‘rule of rescue’ argument, general standards for cost-effectiveness in healthcare may be ignored when rescuing identifiable individuals. The argument fails in this context, however, because we cannot identify beforehand who will benefit from additional blood screening tests. On the ‘imposed risk’ argument, general cost-effectiveness standards do not apply when healthcare interventions impose risks on patients. This argument ignores the fact that imposing risks on patients is inevitable in healthcare and that these risks can be countered only within reasonable limits. Finally, the ‘manufacturing standard’ argument premises that general cost-effectiveness standards do not apply to procedures preventing the contamination of manufactured medical products. We contend that while this argument seems reasonable insofar as commercially manufactured medical products are concerned, publicly funded blood screening tests should respect the standards for general healthcare. We conclude that these particular arguments are unpersuasive, and we offer directions to advance the debate.


2016 ◽  
Vol 102 (6) ◽  
pp. 556-558 ◽  
Author(s):  
Revanth Baineni ◽  
Reena Gulati ◽  
CG Kumar Delhi

A 4-year-old boy presented with severe bone pains, refusal to walk, diffuse bony swelling of forelimbs, skin changes and abdominal pain, with symptoms evolving over 6 weeks. Blood screening tests were normal except for raised aspartate aminotransferase (AST). Radiographs revealed thickened periosteum, widening of the diaphyses of long bones and lifted periosteum in mid-shaft of ulnae and right femur. Skeletal scintigraphy showed a high uptake of radionuclide at clinically affected and unaffected sites, suggestive of multifocal osteoblastic skeletal lesions. After repeated enquiries, his parents admitted to giving him massive doses of preformed vitamin A for over 3 months as ‘health tablets’. Surprisingly, he did not have overt liver disease typically found with much smaller doses, although the dermal changes and musculoskeletal pathology were florid. He made a full clinical recovery within 2 months of cessation of vitamin A.


Transfusion ◽  
2011 ◽  
Vol 52 (3) ◽  
pp. 478-488 ◽  
Author(s):  
Barbara A. Borkent-Raven ◽  
Mart P. Janssen ◽  
Cees L. van der Poel ◽  
Gouke J. Bonsel ◽  
Ben A. van Hout

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