The treatment of multiple myeloma patients with monoclonal antibodies results in a visible and quantifiable M-protein that has the potential to falsely indicate poor response to therapy.
Diabetic dermopathy presents as well-demarcated, hyperpigmented, atrophic depressions, macules or papules located on the anterior surface of the lower legs of diabetic patients. The histopathology remains poorly defined which may in part be due to the fact that the lesions are rarely biopsied. An advantage of studying autopsy material is the ease of obtaining large biopsy specimens. To further define the histopathological features of this entity, we studied tissue taken from characteristic lesions at autopsy. Inclusion criteria included the presence of the lesions and diabetes-related nephroarteriolosclerosis at autopsy. Surprisingly, only four out of 14 skin biopsies showed moderate to severe wall thickening of arterioles or medium-sized arteries on periodic acid Schiff (PAS) stains. Only mild basement membrane thickening was noted in 11 of 14 which was highlighted by the PAS stain. Pigmented material was identified within the dermis of 13 cases. In 10 of the cases, the material was positive for Perl's iron stain. Ten cases had material staining positive for Fontana-Masson in the dermis. Nine cases had markedly increased epidermal melanin. The findings suggest that hemosiderin deposition in conjunction with the deposition of melanin contribute to the clinical features of diabetic dermopathy.
OBJECTIVE To assess whether the use of a lab test specific for intact human chorionic gonadotropin (hCG) would reduce the number of false-positive pregnancy cases. METHODS From 10/21/14 – 01/20/15 and 04/01/15 – 06/02/15, all serum samples sent for pregnancy screening at a large cancer center with a value of ≥5 mIU/mL total β-hCG were frozen and stored, then re-tested using intact hCG reagent. We compared the accuracy of total β-hCG and intact hCG results for the diagnosis of clinically confirmed pregnancy. A negative test was defined as ≤14 mIU/mL, our current institutional cutoff. We also assessed a cutoff of <5 mIU/mL, a historical cutoff to rule out pregnancy. RESULTS We performed intact hCG testing on 64 patient samples, of which 34 had originally resulted positive when tested for total β-hCG. These included 21 cases of clinically confirmed pregnancy, and 13 false positive cases. No women were pregnant when their intact hCG concentration was ≤14 mIU/mL, and all pregnancies were detected at and above this concentration. Intact hCG reduced the number of false positive pregnancy tests from 13 to 1, a 92% reduction [95% Confidence Interval (CI) 64–99%], corresponding to a reduction in the false-positive rate from 38% [95% CI 22–56%] to 3% [95% CI 1–15%]. CONCLUSION The use of intact hCG reagent in cancer patients reduces the rate of false positive pregnancy tests without increasing the rate of false negative tests.
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