Blood, 1957, Vol. 12, No. 6, pp. 493-506.
© 1957 American Society of Hematology, Inc.
Studies on the Serum Haptoglobin Level in Hemoglobinemia and Its Influence on Renal Excretion
of Hemoglobin
CARL-BERTIL LAURELL 1 and
MARGARETA NYMAN 1
1 Department of Clinical Chemistry, Malmö General Hospital, Malmö, Sweden.
A short survey is given of the literature on haptoglobin, the hemoglobin-binding serum protein, its properties and biologic variations. The principles of an
electrophoretic method for quantitative determination of the serum haptoglobin
are described.
Electrophoretic studies showed that haptoglobin has a high affinity for hemoglobin at physiologic pH and that every haptoglobin molecule can bind at least
2 hemoglobin molecules.
Observations made following the intravenous injection of hemoglobin showed:
that hemoglobin administered intravenously is bound by the haptoglobin;
that free hemoglobin is not demonstrable until more hemoglobin has been
injected than can be bound by the haptoglobin;
that the complex hemoglobin-haptoglobin is eliminated from the plasma after
intravascular hemolysis or intravenous administration of hemoglobin without
being excreted in the urine;
that the hemoglobin-haptoglobin complex is removed from the plasma at a
constant rate during the major part of the elimination period;
that the haptoglobin level will fall to nil within 24 hours, if the amount of
hemoglobin injected is sufficient to bind all the haptoglobin available. During
the following days the rate of formation of haptoglobin can be studied.
From the data available it can be concluded that hemoglobinuria cannot
appear until the amount of hemoglobin administered intravenously or the amount
liberated intravascularly exceeds the binding power of the haptoglobin and the
reabsorption capacity of the tubules. The variation observed by earlier authors
in the so-called renal threshold for hemoglobin on intravenous injection of hemoglobin can be explained among other things by the variation in the haptoglobin
content in one and the same subject, i.e., if the haptoglobin level is low, the
threshold value will also be low, and vice versa.
Submitted on August 21, 1956
Accepted on November 28, 1956
