[Biochemical findings in gestosis patients with pulmonary complications]

Lysosomal proteases from the granula of polymorphonuclear leucocytes play an important part in the development of the shock lung syndrome and its preliminary stages. If there is a local imbalance between the neutral proteinases (e.g. elastase) and its inhibitors, the interstitium consisting of collagenous fibres and glycosaminoglycanes is damaged. In 4 patients with gestosis and pulmonary complications it became evident that the plasma levels of the elastase-alpha 1-proteinase inhibitor complex correlate well with the clinical status and the x-ray findings. Significantly increased values are seen already prepartally; maximum values represent a severe interstitial oedema, and the drop of the values occurs parallel with the improvement of the clinical pattern. The increased consumption of inhibitors is expressed by the absence of the reactive increase of alpha 1-antitrypsin. By determining the elastase-alpha 1-PI complex it becomes possible to recognize the possible risk of development of an interstitial pulmonary oedema well in time, and the success of therapeutic measures is easily ascertained and controlled.