This study was in part supported by Grant 10991 from the Österreichische Nationalbank (G.F.K.).
Influence of clinical factors on the haemolysis marker haptoglobin
Article first published online: 27 FEB 2006
European Journal of Clinical Investigation
Volume 36, Issue 3, pages 202–209, March 2006
How to Cite
Körmöczi, G. F., Säemann, M. D., Buchta, C., Peck-Radosavljevic, M., Mayr, W. R., Schwartz, D. W. M., Dunkler, D., Spitzauer, S. and Panzer, S. (2006), Influence of clinical factors on the haemolysis marker haptoglobin. European Journal of Clinical Investigation, 36: 202–209. doi: 10.1111/j.1365-2362.2006.01617.x
Department of Blood Group Serology and Transfusion Medicine (G. F. Körmöczi, C. Buchta, W. R. Mayr, D. W. M. Schwartz, S. Panzer); Department of Internal Medicine III, Division of Nephrology and Dialysis (M. D. Säemann); Department of Internal Medicine IV, Division of Gastroenterology and Hepatology (M. Peck-Radosavljevic); Core Unit for Medical Statistics and Informatics (D. Dunkler); Institute of Medical and Chemical Laboratory Diagnostics (S. Spitzauer), Medical University of Vienna, Vienna, Austria.
- Issue published online: 27 FEB 2006
- Article first published online: 27 FEB 2006
- Received 17 October 2005; accepted 17 January 2006
- Acute-phase response;
- extracorporeal circuit;
- liver cirrhosis
Background Plasma haptoglobin determination is clinically used as parameter for haemolysis. To date, however, the influence of the mode of haemolysis (extravascular vs. intravascular) and of nonhaemolytic conditions on haptoglobin concentration and its reliability as a haemolysis marker remain poorly defined.
Materials and methods In a total of 479 individuals, the influence of haemolytic and nonhaemolytic conditions on plasma haptoglobin levels was investigated.
Results All studied types of haemolytic disease (n = 16) were associated with markedly decreased plasma haptoglobin levels, without significant differences between intravascular vs. predominantly extravascular haemolysis. Diminished haptoglobin values were also observed in patients with liver cirrhosis, which normalized after liver transplantation. In contrast, markedly increased haptoglobin levels were found in patients with inflammation. In patients with haemolysis and a concomitant acute-phase response, however, haemolysis-dependent haptoglobin depletion was not attenuated. Interestingly, patients with a strongly positive direct antiglobulin test or high cold agglutinin titre but no further evidence for haemolysis had normal haptoglobin values. Likewise, anaemia owing to bone marrow failure, acute gastrointestinal or chronic diffuse blood loss, and end-stage kidney disease were associated with normal haptoglobin levels.
Conclusions Plasma haptoglobin depletion is a reliable marker for the instant diagnosis of accelerated red cell destruction irrespective of the site of haemolysis or the presence of inflammation. The capacity of this parameter to predict haemolysis appears to be limited in patients with liver cirrhosis and decreased haptoglobin production only.