Official and Experts' Guidelines

Agence française de sécurité sanitaire des produits de santé (AFSSAPS)

• Anti vitamin K medicines (AVK) and prevention of medical iatrogenesis.
  An update on the correct use of AVK treatments (May 2009)

French National Authority for Health

Allergy & immunology

• Auto-antibody detection: diagnosis of coeliac disease and monitoring of compliance with a gluten-free diet
  This Report describes an evaluation of the efficacy of serological tests in the diagnosis of coeliac disease and the monitoring of compliance with a gluten-free diet, and the place of such testing in the overall care strategy.
• Detection of citrullinated antibodies directed against proteins
  This Report describes an evaluation of the efficacy of tests to detect antibodies directed against keratin and citrullinated cyclic peptides, how such tests are carried out and their place in the diagnosis and prognosis of rheumatoid arthritis.
• When to order specific IgE assays in the diagnosis and monitoring of allergic disease
  This text stipulates the indications for specific IgE assays in the diagnosis and monitoring of allergic disease, with a view to rationalising practices in the light of the great number of specific IgE assays ordered to investigate allergy coupled with the major inconsistency of methods used.

Physiology

• Detection of the 14-3-3 protein in CSF
  This Report evaluates the diagnostic efficacy of the 14-3-3 protein detection in cerebrospinal fluid (CSF) by manual Western Blot in suspected Creutzfeldt-Jakob disease (CJD). Since this test is one of the diagnostic criteria for CJD which must obligatorily be notified to the National Epidemological Surveillance Network, it must be carried out in the way stipulated in this Report.
• Detection of microdeletions in the Y chromosome
  The techniques of molecular biology are used to detect microdeletions in the Y chromosome in the investigation of major male infertility or for Medically Assisted Reproduction (MAR).
• Assaying for free immunoglobulin light chains in the serum
  The purpose of this Report is to assess the value of measuring the levels of free light chains in the serum, in the diagnosis and/or monitoring of clinical pictures associated with monoclonal immunoglobulinaemia (immunocyte-derived amyloidosis, myeloma, etc.).
• IFNg (gamma interferon) testing in the diagnosis of tuberculosis
  The purpose of this Report is to evaluate a new test for the diagnosis of tuberculosis by detecting the in vitro production of gamma interferon by T lymphocytes (isolated from the blood) in culture with specific M. tuberculosis antigens.
• Resistance to Activated Protein C; detection of Factor V Leiden; detection of the g.20210G>A mutation in the prothrombin gene
  The indications and place in therapeutic strategy of the molecular detection of the Factor V Leiden mutation and the Factor II 20210G>A mutation in an investigation of thrombophilia are defined in this text by seven recommendations based on experts' opinions.
• Complementary detection and identification of a lupus-like anticoagulant
  The main indications for detection of a lupus-like anticoagulant and its place in the treatment strategy for antiphospholipid syndrome (SAPL) are defined in this text.

Endocrinology

• Mild hypothyroidism in adults: diagnosis and management
  These guidelines clarify the concept of mild hypothyroidism and its relationship with the various symptoms or laboratory abnormalities that are commonly attributed to it; they rationalise ordering laboratory tests (TSH and T4L), evaluate the worth of screening and weigh up the pros and cons of treating the condition.

National Health Monitoring Institute (Institut national de veille sanitaire; INVS)

• Place of new vaccines and guidelines, notably immunisations that are recommended or obligatory for health care providers.