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The complement system is a critical component of both the innate and adaptive immune systems that augments the function of antibodies and phagocytes. Antigen-antibody immune complexes, lectin binding, and accelerated C3 tick-over can activate this well-coordinated and carefully regulated process. The importance of this system is highlighted by the disorders that arise when complement components or regulators are deficient or dysregulated. This article describes the pathways involved in complement activation and function, the regulation of these various pathways, and the interpretation of laboratory testing performed for the diagnosis of diseases of complement deficiency, exuberant complement activation, and complement dysregulation.

The discovery of antineutrophil cytoplasmic antibodies (ANCA) helped establish ANCA-associated vasculitis as a separate and well-defined clinical entity. Its progressive incorporation into the clinical diagnosis algorithms has made ANCA testing a cornerstone immunoassay embedded in the management of ANCA-associated vasculitis. After its description by indirect immunofluorescence, proteinase-3 and myeloperoxidase were identified as principal ANCA targets. ANCA, and proteinase-3 and myeloperoxidase immunoassessment, have undergone iterative rounds of improvement in sensitivity and specificity. This article traces landmarks in the development of ANCA tests, describes common pitfalls arising during ANCA interpretation, and discusses new technologies to improve the future of ANCA testing.

Accurate diagnosis of inflammatory arthritides remains a challenge because of substantial clinical overlap. To achieve a granular classification for informing clinical decisions, numerous potential serologic biomarkers have been identified. Rheumatologists have settled on rheumatoid factor and anti–citrullinated protein antibodies for the diagnosis of rheumatoid arthritis (RA) based on specificity and sensitivity and their ability to be integrated into clinical algorithms. These biomarkers should be interpreted in their specific clinical context. This article discusses the serologic basis for the diagnosis of RA, how these biomarkers have framed conceptualization of the pathogenesis of RA, and the inherent limitations in their use.

Red blood cell width, routinely available in full blood counts, is associated with likelihood of hip fracture and could offer a good way to identify high risk patients at no cost, say researchers.
Medscape Medical News

If the settlement is ratified, 85,000 union workers will stay on the job in six states and the District of Columbia; the union gets sweetened terms after hard bargaining.
Medscape Medical News

The U.S. Preventive Services Task Force (USPSTF) continues to recommend screening for asymptomatic bacteriuria in pregnant women with urine culture and discourage such screening in nonpregnant adults, based on an updated systematic review of the evidence.
Reuters Health Information

The promise of serum neurofilament light chain to diagnose multiple sclerosis continues to evolve, with new evidence supporting a role in identifying presymptomatic disease.
Medscape Medical News

Multimodal balance training with rhythmic cues improved balance and freezing of gait with persistent benefit in Parkinson's patients, a well-controlled study has shown.
Medscape Medical News

Dr Bishal Gyawali shares what he has learned about empathy and culture in medicine through his experiences of delivering difficult news to cancer patients around the world.
Medscape Oncology

A beloved physician and researcher who fought the status quo to foster antibiotic stewardship, Levy dedicated his life to warning the world about the dangers of misuse.
Medscape Medical News

Global commitments to fight antibiotic resistance have come from governments, pharmaceutical and health insurance companies, medical professionals, healthcare systems, and the food industry.
Medscape Medical News

The most common adult leukemia has seen a rush of new evidence in recent years. Here are some of the highlights.
Medscape Oncology