Hepatic dysfunction in human trypanosomiasis: II. Serum proteins in Trypanosoma rhodesiense infections and observations on the alterations found after treatment and during convalescence

Abstract

1. 1) The results of the analysis of serum proteins by electrophoresis are described in 26 early cases and 10 late cases of T. rhodesiense infection in man. 2. 2) In early cases in the acute febrile stage there is a reduction in total protein and serum albumin. This reduction precedes any rise in γ-globulin and is corrected during treatment and subsequently. 3. 3) Individual early cases may show an increase in serum γ-globulin on admission, which declines on treatment and subsequently. 4. 4) Some early cases show a rise in γ-globulin after treatment, which declines subsequently. 5. 5) Other disorders of hepatic function are described in a very early case with a trypanosome chancre. The associated serum protein alterations are also described. The abnormalities of the hippuric acid synthesis test, the bromsulphthalein tolerance test and serum bilirubin are described; these tests became normal before the serum proteins. 6. 6) In late cases the serum albumin is low and the serum γ-globulin is high. Very high γ-globulin levels are found characteristically in the chronic “tolerant” late case. The “intolerant” very wasted case showed marked reduction in serum albumin and very low total protein. 7. 7) Seroflocculation tests improve concurrently with serum proteins and reflect the “balance” of these proteins but a quantitative relationship could not be determined. 8. 8) The pathogenesis of serum protein changes is discussed.