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The relationship between the erythrocyte sedimentation rate (ESR) and plasma proteins in clinical materials and models
Authors:Ingebrigt Talstad  Hans Fredrik Haugen
Affiliation:1. Medical Department A and Department of Clinical Chemistry, Rikshospitalet, National Hospital of Norway, University of Oslo, Norway;2. Medical Department B, Haematological Division, Haukeland Hospital, University of Bergen, Norway
Abstract:The relationship between the erythrocyte sedimentation rate (ESR) and plasma proteins was studied within homogenous clinical material and in in vitro models. In acute phase reactions, fibrinogen was the likely cause of the ESR-elevation, but there were significant associations between the ESR and the concentrations of α1-antitrypsin, C3, haptoglobin and albumin. In chronic diseases, the ESR-elevation was probably caused by fibrinogen, mono- or polyclonal increase of IgG, IgA, IgM alone or in combinations. In multiple myeloma of the IgG and IgA subtypes, significant correlations were found between the ESR and the monoclonal proteins or between the ESR and the percentage of plasma cells in bone marrow. Model studies showed that the ESR increased linearly with the concentrations of fibrinogen or gammaglobulin (IgG) when these exceeded normal thresholds. The ESR was slightly decreased by increasing concentrations of albumin. Albumin had a synergistic effect on the ESR together with gammaglobulin, but not together with fibrinogen.
Keywords:albumin  disease  erythrocyte sedimentation rate  y-globulin  model studies
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