Abstract
Introduction. Haptoglobin binds the globin portion of free hemoglobin. Serum haptoglobin measurement is used as a laboratory marker for the diagnosis of hemolytic anemia. Since stored blood contains free hemoglobin, transfusion may affect haptoglobin levels. Study Objectives. The aim of the study was to evaluate whether serum haptoglobin could be measured to assess hemolysis in recently transfused patients. Patients and Methods. Twenty-one patients, receiving more than one unit of packed red blood cells (PRBCs) for presumed nonhemolytic indications, were enrolled. Serum haptoglobin levels were recorded before, immediately after, and 24 and 48 hours after transfusion. Observations and Results. Analysis of variance with a repeated measures was used to examine the serum haptoglobin levels at different time periods and no significant difference was found (P = .28). Conclusion. The results suggest that serum haptoglobin can be used in the diagnosis of hemolysis in patients receiving multiple units of PRBC.
Highlights
Haptoglobin, an alpha2 globulin, which functions to bind the globin portion of free hemoglobin in the blood, is an acute phase reactant
Serum haptoglobin levels can be increased in inflammatory conditions, of the two patients in our study who were admitted with acute respiratory failure neither was noted to have abnormally elevated baseline serum haptoglobin levels
For the twenty-one patients, serum haptoglobin levels taken at pretransfusion, immediately after, 24 hours and forty eight hours after transfusion were examined for significant differences using analysis of variance with repeated measures
Summary
Haptoglobin, an alpha globulin, which functions to bind the globin portion of free hemoglobin in the blood, is an acute phase reactant. The half-life of serum haptoglobin is approximately five days [1], but in the presence of free hemoglobin (e.g., intravascular hemolysis), the hemoglobinhaptoglobin complex which forms is rapidly cleared from the serum by the monocyte-macrophage system with resultant serum haptoglobin levels that are low or absent. An increased burden of free plasma hemoglobin rapidly causes a marked decrease in measured serum haptoglobin (normal levels 36–195 mg/dL). Studies have revealed the effect of prolonged storage on the amount of free hemoglobin in the stored blood. Nishiyama looked at the effect of blood transfusion on haptoglobin and free hemoglobin. The author noted that as the age of stored blood increased the detection rate of free hemoglobin went up [6]
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