Serum proteins in the haemolytic uraemic syndrome

In 122 patients with the haemolytic uraemic syndrome (HUS), serum proteins were analysed in the acute phase of the disease (n = 122) and 6 weeks (n = 57) and 6 months (n = 84) later. Total serum protein levels were significantly lower on admission than 6 weeks and 6 months later (P < 0.0001). The same was true for median values of serum albumin (P < 0.0001), alpha 2-globulins (P < 0.0001) and gamma-globulins (P < 0.001). There was no difference in beta-globulins, whereas the alpha 1-globulins were significantly higher in the acute phase (P < 0.0001). There was a significant positive correlation between age and total protein and gamma-globulin levels. Serum total protein and albumin levels displayed a significant positive correlation with serum sodium levels and a significant negative correlation with urinary protein excretion. Patients with oligoanuria had significantly lower serum albumin and significantly higher alpha 1-globulin levels than those with preserved urine production. Marked differences were observed between patients with (D+) and patients without (D-) prodromal diarrhoea. In D(-) HUS, only albumin and total protein levels were lower on admission, but to a lesser degree than in D(+) HUS. Serum alpha 1-globulin levels were significantly higher and alpha 2-globulin levels significantly lower in D(+) HUS than D(-) HUS. In the D(+) subgroup of patients, by far the largest, there was a significant positive correlation between serum albumin and total protein on the one hand and the duration of the prodrome on the other.(ABSTRACT TRUNCATED AT 250 WORDS)