Serum Haptoglobins in Hepatobiliary Disease

Abstract

HYPOPARATHYROIDISM evidence in this differentiation, although the usefulness of this test has been disputed (Milne, 1951 ;Dent, 1953 MacGregor and Whitehead, 1954).Of great interest, however, is the finding in our case of normal or high levels of calcium excretion in the urine. Reviews of published cases of idiopathic hypoparathyroidism (Lachmann, 1941; Steinberg and Waldron, 1952) are reticent on the matter of urinary calcium content. The records of most cases contain bare statements that the Sulkowitch test was either " negative " or "faintly positive "-findings which, according to Albright and Reifenstein (1948), indicate blood calcium levels of "below 7.5 mg. per 100 ml." They further admit, however, that certain individuals apparently have a low renal threshold for calcium excretion, and mention, without further details, three patients with hypoparathyroidism who excreted large amounts of calcium in the urine at low levels of serum calcium. In our own case the absence of other urinary abnormality, together with the increase in urinary calcium excretion parallel with elevation of the serum calcium, suggests an abnormality of renal threshold for calcium, an "idiopathic hypercalciuria." There is no evidence of osteoporosis, and the radiological abnormalities typical of hypoparathyroidism suggest that the hypercalciuria is no more than an incidental unassociated abnormality. SummaryA case of idiopathic hypoparathyroidism presenting with epilepsy is described.Restoration of normal serum levels of calcium and phosphate was achieved with calciferol in high dosage.The unusual finding of a high normal daily calcium excretion in the urine before treatment is discussed.Our thanks are due to Mr. W. M. Nichols for permission to publish this case and for his continued encouragement, to Dr. M. MacLeod for his advice and criticism, and to Mr. Topp for the photographs. We are particularly indebted to Dr. F. A. Macrae, Kyle of Lochalsh, for his unfailing help in the follow-up of the case.

A Simple Method for the Determination of Serum Haptoglobins

“…The method described here for the estimation of serum haptoglobins gives more precise values than the simple electrophoretic methods used by Laurell and Nyman (1957) and by Owen et al (1959) and is quicker than the electrophoretic method described by Lathem and Worley (1959). The procedure described by Jayle (1951) gives precise values but involves a titration carried out with very careful timing and utilizes a reagent (ethyl hydroperoxide) which is potentially explosive (Baeyer and Villiger, 1901 ;Tobolsky and Mesrobian, 1954).…”

“…(Jayle and Boussier, 1955;Laurell and Nyman, 1957;Nyman, 1958;Owen et al, 1959). Thus, approximately 0.025 ml.…”

The determination of haptoglobins in normal human serum

“…Electrophoretic analyses. Paper electrophoresis was carried out as described by Owen, Mackay & Got (1959). Starch-gel electrophoresis was carried out essentially as described by Smithies (1955).…”

The Effect of Surgery on Serum Haptogloglobins

“…Earlier studies (Owen, Mackay & Got, 1959) have led to the conclusion that serum haptoglobins are formed in the liver. Plasma fibrinogen, also thought to be formed in the liver, has been found to increase after "stress" (Gilchrist & Tulloch, 1952) and it is relevant that the increase in fibrinogen following surgery or coronary thrombosis roughly The use of the initials of chemical names and prefixes to provide convenient abbreviations has been hallowed by tradition.…”