Abnormalities of Albumin Metabolism in Patients with Hypogammaglobulinemia*

Waldmann, Thomas A.; Laster, Leonard

doi:10.1172/jci104986

Cited by 59 publications

(7 citation statements)

References 21 publications

(6 reference statements)

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“…We felt that the primary disorder in these two patients was a defect in gamma globulin synthesis but that there was a secondary disorder of the intestinal mucosa with consequent general enteric loss of serum proteins. The presence of secondary gastrointestinal protein loss in patients with deficient production of antibodies has been previously observed (24,36,42) and may be a possible explanation for the occasional short gamma globulin survivals previously reported in some patients with agammaglobulinemia.…”

Section: Discussionmentioning

confidence: 51%

“…In contrast, the nine patients with regional enteritis and ulcerative colitis and gastrointestinal protein loss had serum gamma globulin concentrations from 0.8 to 1.7 g per 100 ml. In general, loss of proteins from (36).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the patients with hypogammaglobulinemia secondary to excessive gastrointestinal protein loss, these patients with nonproductive hypogammaglobulinemia had a markedly reduced ability to synthesize specific antibodies in response to antigenic challenge, had negligible isohemagglutinin titers, and had a decrease or absence of plasma cells (39). Many of the patients with defective gamma globulin synthesis have recurrent infections and associated chronic sinusitis, bronchitis, bronchiectasis, arthritis, and in 15 to 40%o of the cases unexplained gastrointestinal tract disorders resembling sprue or ileocolitis (36,41). Two of the nine patients with defective gamma globulin synthesis, in the present study, had associated gastrointestinal disorders with associated loss of proteins into the intestinal tract.…”

Section: Discussionmentioning

confidence: 99%

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IgG (7 S Gamma Globulin) Metabolism in Hypogammaglobulinemia: Studies in Patients with Defective Gamma Globulin Synthesis, Gastrointestinal Protein Loss, or Both*

Waldmann¹,

Schwab²

1965

J. Clin. Invest.

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The factors that control the rates of gamma globulin synthesis and catabolism and thus regulate the body pool of gamma globulin are not well understood. Although antigenic stimulation is a major factor regulating the synthesis of immunoglobulins by plasma cells (1-3), other factors such as the metabolic rate (4) and the serum concentration of gamma globulin (5-11) modify gamma globulin metabolism.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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IgG (7 S Gamma Globulin) Metabolism in Hypogammaglobulinemia: Studies in Patients with Defective Gamma Globulin Synthesis, Gastrointestinal Protein Loss, or Both*

Waldmann¹,

Schwab²

1965

J. Clin. Invest.

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“…Because of the relative constancy of the concentration of albumin in the serum during each study, the patients were regarded as being in a steady state, and the value for albumin turnover was considered equal to the value for the rate of albumin synthesis. Detailed descriptions of the calculations have been presented previously (8). Results Whipple's disease in relapse.…”

Section: Methodsmentioning

confidence: 99%

Albumin metabolism in patients with Whipple's disease.

Laster¹,

Waldmann²,

Fenster³

et al. 1966

J. Clin. Invest.

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When malabsorption develops during the course of Whipple's intestinal lipodystrophy, it is often accompanied by hypoalbuminemia. Among 53 case reports published between 1951 and 1964 for which values of the concentration of albumin in the serum were presented, there were 43 values below 3.5 g per 100 ml (Figure 1).A decrease in the concentration of albumin in the serum may be due to dilution or to a decrease in the size of the body's total exchangeable pool of albumin. A reduction in the albumin pool size may result from decreased synthesis, from increased catabolism or loss, or from both causes. To explore the factors responsible for the hypoalbuminemia of Whipple's disease, we studied the albumin metabolism of seven patients with this disorder. Albumin labeled with 131I or with 125I was used to measure the total exchangeable pool of albumin and the rates of albumin catabolism and synthesis. Albumin-51Cr was used to measure loss of albumin into the gastrointestinal tract. The patients were studied when their disease was in relapse and again when therapy had induced marked improvement. The data suggest that abnormal exudation of serum protein into the gastrointestinal tract is an important factor in causing the hypoalbuminemia of Whipple's disease, that treatment of the disease can reverse this exudative enteropathy relatively rapidly, and that impairment of al-

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“…In patients with very severe immunodeficiency involving, virtually, loss of both T cell and B cell immunity (i.e., patients with various forms of severe combined immunodeficiency), this usually takes the form of a major GI infection that overshadows any secondary problems such as PLE; thus, in these patients PLE may be present but is not recognizable. On the other hand, in patients with less severe immunodeficiency such as common variable immunodeficiency (CVID) and in those with selective IgA deficiency, more chronic GI difficulties are present, and in these patients PLE not only can be found with appropriate study but also in some cases is severe enough to complicate the clinical picture (Waldmann and Laster et al, 1964).…”

Section: Immunodeficiency States (Common Variable Immunodeficiency Anmentioning

confidence: 99%