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ARTICLE |

The Predictive Value of Serum Haptoglobin in Hemolytic Disease FREE

Anthony Marchand, MD; Robert S. Galen, MD, MPH; Frederick Van Lente, PhD
[+] Author Affiliations

Reprint requests to Department of Pathology, Overlook Hospital, Summit, NJ 07901 (Dr Marchand).


JAMA. 1980;243(19):1909-1911. doi:10.1001/jama.1980.03300450023014
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Using a rapid, highly sensitive immunoprecipitin nephelometric technique, a retrospective study was undertaken to evaluate the clinical usefulness of determining serum haptoglobin in the diagnosis of hemolysis. Haptoglobin assays were performed shortly after admission in 100 patients with a variety of hematologic and nonhematologic conditions and the results correlated with the clinical diagnosis. An ad hoc boolean computer program allowed for the separation of hemolytic from nonhemolytic disorders with a haptoglobin limit of 25 mg/dL or less. The sensitivity and specificity of the test are high (83% and 96%, respectively), providing 87% probability of predicting hemolytic disease when the serum haptoglobin level falls below this limit. These data support the routine use of serum haptoglobin determinations in the diagnosis of hemolytic disease.

(JAMA 243:1909-1911, 1980)

REFERENCES

Nagel RL, Gibson QH:  The binding of hemoglobin to haptoglobin and its relation to subunit dissociation of hemoglobin . J Biol Chem 246:69-73, 1971;.
Keene WR, Jandl JH:  The sites of hemoglobin catabolism . Blood 26:705-719, 1965;.
Nyman M:  Serum haptoglobin: Methodological and clinical studies . Scan J Clin Lab Invest 11( (suppl 39) ):1-169, 1959;.
Statland BE, Winkel P, Killingsworth LM:  Factors contributing to intra-individual variation of serum constituents: 6. Physiological day-to-day variation in concentrations of ten specific proteins in sera of healthy subjects . Clin Chem 22:1635-1638, 1976;.
Javid J:  Human haptoglobins . Current Topics in Hematology 1:151-192, 1978;.
Khayam-Bashi H, Feldhammer D, Tyler G:  Determination of serum haptoglobin concentration by a laser-immunonephelometric procedure . Clin Chem 23:1137, 1977;.
Galen RS:  Beyond normality: An update , in Benson ES, Rubin M (eds): Logic and Economics of Clinical Laboratory Use . New York, Elsevier North-Holland Inc, 1978;, pp 103-112.
 Report of a WHO scientific group: Nutritional anemias . WHO Tech Rep Ser 405:1-9, 1968;.
Dash S, Das KC:  Serum haptoglobin concentrations in "pure" iron-deficiency anemia . Clin Chem 24:839-840, 1978;.
Brus I, Lewis SM:  The haptoglobin content of serum in haemolytic anemia . Br J Haematol 5:348-355, 1959;.
Nosslin BF, Nyman M:  Haptoglobin determinations in diagnosis of hemolytic diseases . Lancet 1:1000-1001, 1958;.
Laurell CB, Gronvall C:  Haptoglobin. Advances in . Clin Chem 5:135-166, 1962;.
Nyman M:  Haptoglobin in pernicious anemia . Scand J Clin Lab Invest 9:168, 1957;.
 Recommended methods for radioisotope red cell survival studies, International Committee for Standardization in Hematology . Blood 38:378-386, 1971;.

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Nagel RL, Gibson QH:  The binding of hemoglobin to haptoglobin and its relation to subunit dissociation of hemoglobin . J Biol Chem 246:69-73, 1971;.
Keene WR, Jandl JH:  The sites of hemoglobin catabolism . Blood 26:705-719, 1965;.
Nyman M:  Serum haptoglobin: Methodological and clinical studies . Scan J Clin Lab Invest 11( (suppl 39) ):1-169, 1959;.
Statland BE, Winkel P, Killingsworth LM:  Factors contributing to intra-individual variation of serum constituents: 6. Physiological day-to-day variation in concentrations of ten specific proteins in sera of healthy subjects . Clin Chem 22:1635-1638, 1976;.
Javid J:  Human haptoglobins . Current Topics in Hematology 1:151-192, 1978;.
Khayam-Bashi H, Feldhammer D, Tyler G:  Determination of serum haptoglobin concentration by a laser-immunonephelometric procedure . Clin Chem 23:1137, 1977;.
Galen RS:  Beyond normality: An update , in Benson ES, Rubin M (eds): Logic and Economics of Clinical Laboratory Use . New York, Elsevier North-Holland Inc, 1978;, pp 103-112.
 Report of a WHO scientific group: Nutritional anemias . WHO Tech Rep Ser 405:1-9, 1968;.
Dash S, Das KC:  Serum haptoglobin concentrations in "pure" iron-deficiency anemia . Clin Chem 24:839-840, 1978;.
Brus I, Lewis SM:  The haptoglobin content of serum in haemolytic anemia . Br J Haematol 5:348-355, 1959;.
Nosslin BF, Nyman M:  Haptoglobin determinations in diagnosis of hemolytic diseases . Lancet 1:1000-1001, 1958;.
Laurell CB, Gronvall C:  Haptoglobin. Advances in . Clin Chem 5:135-166, 1962;.
Nyman M:  Haptoglobin in pernicious anemia . Scand J Clin Lab Invest 9:168, 1957;.
 Recommended methods for radioisotope red cell survival studies, International Committee for Standardization in Hematology . Blood 38:378-386, 1971;.
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