Serum Proteins in Pulmonary Tuberculosis

Abstract

In two large controlled studies of corticosteroid-supplemented therapy in advanced pulmonary tuberculosis, mutual confirmation of the serum protein abnormalities of the disease was possible. Initially, albumin was depressed and α-1, α-2 and γ-globulins were increased. Total proteins and β-globulins were slightly increased in the study characterized by less extensive disease, but were normal in the other. Initial abnormalities of the serum proteins were related to various clinical background factors. Fever was the most notable with respect to albumin, α-1 and α-2 globulin and race was the major factor related to γ-globulin. During conventional treatment, β-globulin (if elevated) was restored to normal first, followed by α-1 and α-2 in that order. In these patients with advanced tuberculosis, albumin and γ-globulin averages improved, but failed to return to normal during eight months of observation. Corticosteroid therapy produced more rapid normalization of albumin and α-1 globulin, but these proteins and α-2 were transiently more abnormal than controls following withdrawal. The most striking effect was the reduction of elevated γ-globulin values to normal in two months without a later “rebound.” Normal Negroes have lower albumin and higher γ-globulin than whites. In tuberculosis, albumin values were the same in both races throughout treatment. However, γ-globulin was consistently higher in the Negro. The effect of corticosteroids on serum proteins was the same in the two races.