Diagnostic accuracy of bone marrow blood evaluation in haemophagocytic lymphohistiocytosis paediatric patients.

Autor:	Caravaggi E; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.; Highly Specialized Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy., Serana F; Clinical Chemistry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy., Carini M; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.; Highly Specialized Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy., Ferrari F; Pediatrics, Mother's and Baby's Health Department, Poliambulanza Foundation Hospital Institute, Brescia, Italy., Tregambe D; Clinical Chemistry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy., Micheletti M; Clinical Chemistry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy., Martellosio G; Clinical Chemistry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy., Brugnoni D; Clinical Chemistry Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy., Bresciani R; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.; Highly Specialized Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy., Biasiotto G; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.; Highly Specialized Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy.
Jazyk:	angličtina
Zdroj:	Annals of clinical biochemistry [Ann Clin Biochem] 2024 Oct 24, pp. 45632241295694. Date of Electronic Publication: 2024 Oct 24.
DOI:	10.1177/00045632241295694
Abstrakt:	Introduction: Haemophagocytic lymphohistiocytosis (HLH) is a rare and serious immunological syndrome that involves a strong activation of cytotoxic T lymphocytes and macrophages. HLH determines a cytokine-mediated tissue injury with a contemporary multi-organ failure and a high fatality rate. Material and Methods: A retrospective study was performed considering the medical records of paediatric patients who underwent a bone marrow aspirate for suspect HLH. The biomarkers evaluated were among those included in the HLH-2004. Lactate dehydrogenase (LD) was also evaluated. Haemophagocytosis was evaluated in bone marrow blood smear slides. Results: Enrolled were 11 patients included in the HLH group and 8 patients as controls. Haemoglobin and fibrinogen resulted lower in HLH patients than in controls, while blood triglycerides, serum ferritin and LD resulted increased. Blood triglycerides and fibrinogen discriminated HLH cases perfectly, with a sensitivity and specificity of 100%. Ferritin had a sensitivity of 100% and a specificity of 83% (cut off ≥3,721 µg/L) and LD of 73% and of 100% (the cut off ≥1,903 U/L). Haemoglobin was found to have a sensitivity of 75% and a specificity of 100% (cut off ≤ 96 g/L). Total haemophagocytes cell counts were not different between patients and controls. Only the increased number of phagocytized nucleated red blood cells (NRBC) was found to be significantly increased in the patients. Erythrocytes phagocytosis (≥4/1,000 cells) only tended towards significance. Conclusions: The blood biomarkers showed better diagnostic performance than the morphological evaluation. Among the different cell lineages engulfed by haemophagocytes, the best diagnostic performance was obtained by phagocytosed mature erythrocytes and immature nucleated erythrocytes. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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