Paediatric reference intervals for plasma anti-Müllerian hormone: comparison of data from the Roche Elecsys assay and the Beckman Coulter Access assay using the same cohort of samples.

Background: Autoanalyser methods for the measurement of anti-Müllerian hormone have been introduced into clinical laboratories but few reports of paediatric reference intervals using these new assays have been published.

Methods: After prior evaluation of the Roche Elecsys anti-Müllerian hormone assay against the Beckman Coulter modified second generation anti-Müllerian Hormone enzyme-linked immunosorbent assay using samples from adult females, a cohort of paediatric samples which had previously been assessed using the Beckman Coulter Access anti-Müllerian hormone assay was analysed using the Roche Elecsys anti-Müllerian hormone assay.

Results: The Roche Elecsys anti-Müllerian hormone assay measured significantly lower than the Beckman Coulter modified second generation anti-Müllerian Hormone enzyme-linked immunosorbent assay.

Paediatric Anti-Müllerian Hormone measurement: Male and female reference intervals established using the automated Beckman Coulter Access AMH assay.

Objective: Anti-Müllerian Hormone (AMH) concentration is high at birth in males, demonstrating the presence of functional testicular tissue in the prepubertal period, and acting as a useful marker in the investigation of paediatric reproductive disorders. AMH also provides a tool in the investigation of female virilization, premature ovarian failure and polycystic ovarian syndrome in childhood. Robust, assay-specific paediatric AMH reference intervals are therefore required for clinical interpretation of results.

A national survey of specimen contamination in the UK.

Background: Specimen contamination that goes unnoticed can have many adverse consequences for patients including inappropriate investigations or treatment decisions based on erroneous results. Little is known about UK laboratory practices relating to specimen contamination; therefore, this national survey aimed to gather valuable baseline data.

Methods: An electronic survey consisting of 26 questions was designed to obtain key information relating to specimen contamination including its frequency, how it is identified by laboratories and actions taken in event of confirmed contamination.

Does lactate measurement performed on admission predict clinical outcome on the intensive care unit? A concise systematic review.

Background: There is a need for practical, efficient and effective prognostic markers for patients admitted to the intensive care unit (ICU) with sepsis, to identify patients at highest risk and guide and monitor treatment. Although many biomarkers and scoring systems have been advocated, none have yet achieved this elusive combination. Most ICUs already use blood lactate concentrations to monitor patients but the evidence base for this application is unclear.

Reverse iontophoresis of urea in health and chronic kidney disease: a potential diagnostic and monitoring tool?

Background: Patients with chronic kidney disease (CKD) need regular monitoring, usually by blood urea and creatinine measurements, needing venepuncture, frequent attendances and a healthcare professional, with significant inconvenience. Noninvasive monitoring will potentially simplify and improve monitoring. We tested the potential of transdermal reverse iontophoresis of urea in patients with CKD and healthy controls.

Pseudohyperkalaemia associated with leukaemic cell lysis during pneumatic tube transport of blood samples.

Background: Pseudohyperkalaemia is relatively uncommon in children, but needs to be considered in cases where extreme hyperkalaemia is associated with normal renal function.

Case: A previously well 12 year-old boy presented with new onset T cell acute lymphoblastic leukaemia associated with a high peripheral blood white cell count. Plasma biochemistry tests on a blood sample sent to the laboratory using a pneumatic tube system showed a high plasma potassium level of 16.

Acute pancreatitis in Soweto, South Africa: relationship between trypsinogen load, trypsinogen activation, and fibrinolysis.

Objective: It is not known why acute pancreatitis in Soweto, South Africa, pursues an aggressive course. We sought clues from circulating trypsinogen load at admission as marker of initial acinar injury, trypsinogen activation using the carboxypeptidase B activation peptide as surrogate, proteinase inhibitors, the coagulation-fibrinolysis axis, indicators of inflammation, oxidative stress markers, and antioxidant status. This article reports on the first four aspects.