Screening of Down syndrome using serum markers is based on statistic risk determination calculated from the results of markers. An increased risk of fetal Down syndrome is associated with high hCG levels and low AFP levels in maternal serum. In the daily practice, the use of these two markers also leads to observation of different analytical patterns. We reviewed these patterns according to published data and our own experience. Some patterns are well documented (neural tube defects or trisomy 18) some of them remain unexplored. Numerous difficulties are encountered in the clinical use of these markers patterns: lack of consensus for their analytical definition, problems in interpretation. lack of regular dispositions.

Screening of Down syndrome using serum markers is based on statistic risk determination calculated from the results of markers. An increased risk of fetal Down syndrome is associated with high hCG levels and low AFP levels in maternal serum. In the daily practice, the use of these two markers also leads to observation of different analytical patterns. We reviewed these patterns according to published data and our own experience. Some patterns are well documented (neural tube defects or trisomy 18) some of them remain unexplored. Numerous difficulties are encountered in the clinical use of these markers patterns: lack of consensus for their analytical definition, problems in interpretation, lack of regular dispositions.

Le fer est un element essentiel a la synthese de particules virales dans les cellules hotes infectees. Il potentialise l'activation du facteur nucleaire NF-kappaB induite par le TNFalpha. L'organisme se protege de l'infection virale en « retenant » le fer par differents mecanismes [1]. Ce processus s'accompagne d'une diminution du fer serique, de la saturation en fer de la transferrine et d'une augmentation de la ferritine serique : le tableau biologique est similaire a celui decrit dans le syndrome inflammatoire [2]. Une surcharge en fer altere ce mecanisme de defense et augmente les risques de l'infection virale. C'est dans cette optique physiopathologique que certains auteurs se sont interesses au dosage de la ferritine serique chez les patients infectes par le VIH [3-6]. Nous presentons notre propre experience a propos d'un bilan martial pratique chez 40 patients VIH-positifs.

Prenatal DiagnosisVolume 15, Issue 4 p. 388-390 Letters to the Editor ‘Faint-positive’ or ‘false-positive’ amniotic fluid acetylcholinesterase. A diagnostic dilemma Suzanne Guibaud, Suzanne Guibaud Central Laboratory, Hǒpital de la Croix-Rousse, F 69317 Lyon Cedex 04, FranceSearch for more papers by this authorAnnie Simplot, Annie Simplot Central Laboratory, Hǒpital de la Croix-Rousse, F 69317 Lyon Cedex 04, FranceSearch for more papers by this authorLaurent Guibaud, Laurent Guibaud Department of Radiology, Hǒpital Ste Justine, 3175 Chemin de la Cǒte Ste Catherine, Montréal, Quebec, Canada H3T 1C5Search for more papers by this author Suzanne Guibaud, Suzanne Guibaud Central Laboratory, Hǒpital de la Croix-Rousse, F 69317 Lyon Cedex 04, FranceSearch for more papers by this authorAnnie Simplot, Annie Simplot Central Laboratory, Hǒpital de la Croix-Rousse, F 69317 Lyon Cedex 04, FranceSearch for more papers by this authorLaurent Guibaud, Laurent Guibaud Department of Radiology, Hǒpital Ste Justine, 3175 Chemin de la Cǒte Ste Catherine, Montréal, Quebec, Canada H3T 1C5Search for more papers by this author First published: April 1995 https://doi.org/10.1002/pd.1970150419Citations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume15, Issue4April 1995Pages 388-390 RelatedInformation

Prenatal DiagnosisVolume 13, Issue 8 p. 772-773 Letter to the Editor Prenatal diagnosis of spina biflda aperta after first-trimester valproate exposure Suzanne Guibaud, Suzanne Guibaud Central Laboratory, Hôpital de la Croix-Rousse, F-69317 Lyon Cedex 04, FranceSearch for more papers by this authorElisabeth Robert, Elisabeth Robert Central-East/France Registry of Congenital Malformations, Institut Européen des Génomutations, 86 Rue Edmond Locard, F-69005 Lyon, FranceSearch for more papers by this authorAnnie Simplot, Annie Simplot Central Laboratory, Hôpital de la Croix-Rousse, F-69317 Lyon Cedex 04, FranceSearch for more papers by this authorCatherine Boisson, Catherine Boisson Central Laboratory, Hôpital de la Croix-Rousse, F-69317 Lyon Cedex 04, FranceSearch for more papers by this authorChristine Francannet, Christine Francannet Central-East/France Registry of Congenital Malformations, Institut Européen des Génomutations, 86 Rue Edmond Locard, F-69005 Lyon, FranceSearch for more papers by this authorMarie-Hélène Patouraux, Marie-Hélène Patouraux Central-East/France Registry of Congenital Malformations, Institut Européen des Génomutations, 86 Rue Edmond Locard, F-69005 Lyon, FranceSearch for more papers by this author Suzanne Guibaud, Suzanne Guibaud Central Laboratory, Hôpital de la Croix-Rousse, F-69317 Lyon Cedex 04, FranceSearch for more papers by this authorElisabeth Robert, Elisabeth Robert Central-East/France Registry of Congenital Malformations, Institut Européen des Génomutations, 86 Rue Edmond Locard, F-69005 Lyon, FranceSearch for more papers by this authorAnnie Simplot, Annie Simplot Central Laboratory, Hôpital de la Croix-Rousse, F-69317 Lyon Cedex 04, FranceSearch for more papers by this authorCatherine Boisson, Catherine Boisson Central Laboratory, Hôpital de la Croix-Rousse, F-69317 Lyon Cedex 04, FranceSearch for more papers by this authorChristine Francannet, Christine Francannet Central-East/France Registry of Congenital Malformations, Institut Européen des Génomutations, 86 Rue Edmond Locard, F-69005 Lyon, FranceSearch for more papers by this authorMarie-Hélène Patouraux, Marie-Hélène Patouraux Central-East/France Registry of Congenital Malformations, Institut Européen des Génomutations, 86 Rue Edmond Locard, F-69005 Lyon, FranceSearch for more papers by this author First published: August 1993 https://doi.org/10.1002/pd.1970130815Citations: 8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume13, Issue8August 1993Pages 772-773 RelatedInformation

Journal Article A Positive Control for Acetylcholinesterase Electrophoresis Get access A Simplot, A Simplot Search for other works by this author on: Oxford Academic Google Scholar S Guibaud S Guibaud Search for other works by this author on: Oxford Academic Google Scholar Clinical Chemistry, Volume 38, Issue 8, 1 August 1992, Pages 1511–1512, https://doi.org/10.1093/clinchem/38.8.1511 Published: 01 August 1992

A simple method for the separate determination of acetylcholinesterase and butyrylcholinesterase activities in amniotic fluid is reported. This determination is performed with an enzyme electrode involving an immobilized choline oxidase membrane associated with the amperometric detection of hydrogen peroxide. Acetylcholine or butyrylcholine, in the presence of samples containing acetylcholinesterase or butyrylcholinesterase are specifically hydrolyzed, the formation of choline being detected vs time by the sensor with no need for a selective inhibitor. The dynamic linear ranges for acetylcholinesterase and butyrylcholinesterase are respectively 100 microU to 10 mU and 30 microU to 3 mU per ml sample.

Polyacrylamide gel electrophoresis of cholinesterase from cerebrospinal fluid was performed in 22 patients with Guillain-Barré syndrome. Fifteen of these patients had an abnormal cerebrospinal fluid with emergence of a second electrophoretic migration band corresponding to non-specific cholinesterase. Among 182 patients with a variety of diseases who served as controls, only one presented with this abnormality. From these data the sensitivity and specificity of cerebrospinal fluid cholinesterase electrophoresis were calculated at 68 and 99 percent respectively. The second migration band seems to appear early in the course of the disease and disappears when the patient is cured. Moreover, the occurrence of this band is correlated with the severity of the condition, as shown by a greater number of patients under artificial ventilation and by a longer stay in intensive care unit. Cerebrospinal fluid electrophoresis could be used as a prognosis factor.

Pregnancy outcome was followed in 123 women showing maternal serum alpha-fetoprotein, less than or equal to 0.50 MOM. In 28 cases AFP was secondarily considered as normal either after ultrasonography and correction of gestation age or after a second sample normal result. In 95 cases AFP level was confirmed lowered; perinatal outcome was normal in 70 cases and abnormal in 25. Among these 25 cases, 3 autosomal trisomies occurred, 2 trisomies 18 and 1 trisomy 21; in the 22 other cases, we observed antepartum risk factors (10 cases with impending premature labor or premature labor, 9 cases with chronic hypertension, 2 cases with Ag HBs hepatitis and 1 case with diabetes).

In 31 affected pregnancies with Down syndrome, the median maternal serum alpha-fetoprotein value was lower than normal, 0.76 MoM, and median amniotic fluid value was quite normal, 0.98 MoM. Selecting an arbitrary cutoff-point of 0.5 MoM, 4.1 percent of normal gestations show values less than 0.5 MoM. Authors discuss problems about screening for fetal Down's syndrome by measuring maternal serum AFP levels.

Increasing number of amniocentesis done during the second half of gestation with indication "signe d'appel" made necessary for authors to study amniotic fluid markers in late pregnancy. Normal evolution curve must be established with samples obtained after 20 weeks gestation. Study reveals more false-negative results with AFP than before 20 weeks. AChE remains constantly positive in cases with NTD, band aspect being specific. For other malformations, AChE positivity seems inconstant, with a different aspect. Some normal gestation cases can be associated with faint AChE band.

The potential risk of spina bifida (SB) after fetal exposure to Valproate led the authors to apply the following protocol: in case of first trimester exposure to Valproate, prenatal diagnosis is offered and consists of both amniotic fluid examination and fetal ultrasound to detect open spina bifida. In the period 1983 to June, 1986, this program allowed early detection of three cases of SB and pregnancy termination. Another case escaped the programme: neural tube defect was detected lately and the child had to be operated upon. These four cases of SB underline the necessity of prenatal diagnosis with combined use and confrontation of ultrasound examination and biochemical amniotic fluid tests.

From 10 observations of trisomy 13, 3 presented an elevated amniotic fluid alpha-fetoprotein level considered as unusual in 2 cases, superior to cut-off level in the other case. Macroscopic examination of the three fetus could not reveal a cause of AFP elevation, neural tube defect or abdominal wall defect. The authors discuss the role of an undetected abnormality such as minor scalp defect with very thin membrane and for one case false-negative result of Kleihauer test.