Abstract
Twenty-two patients with alcoholic hepatic disease were studied in order to determine the reliability of results of common laboratory tests as indicators of hemolytic disease in patients with chronic hepatic disease. Erythrocyte survival was compared with hemoglobin level, reticulocyte count, serum bilirubin, serum lactic acid dehydrogenase, and serum haptoglobin. Individual studies which had good reliability in indicating hemolytic disease in such patients were the indirect: total bilirubin ratio (r = –0.82) and serum haptoglobin levels (r = 0.60). A stepwise regression analysis disclosed (1) the indirect: total bilirubin ratio, (2) total bilirubin, and (3) haptoglobin values to be a reliable combination of studies to evaluate for the identification of hemolytic disease (multiple r = 0.92). Serum haptoglobin levels did not correlate with other measurements of hepatic protein synthesis (albumin, fibrinogen, prothrombin times—initial and mean). This study suggests that haptoglobin synthesis can remain intact in patients with chronic hepatic disease and that serum levels are a reliable guide to the recognition of hemolytic conditions in such patients.
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