ABSTRACT
BACKGROUND: Free fatty acids are well known as an energy source. However, theoretically it could be destructive through oxygen free radical chain reactions unless they are bound to albumin in blood. Recently, the toxicity of oxidative agents in several diseases, and additionally the behavior of antioxidants including albumin against this have been suggested. Therefore, we investigated the relationship between free fatty acid/albumin molar ratio and erythrocyte injury in this study. METHODS: Free fatty acid and albumin were analysed in thirty-eight hypoalbuminemia patients and fifty-six healthy controls. To measure the erythrocyte injury, hemoglobin, absolute and relative reticulocyte counts, and lactate dehydrogenase (LD) were also examined. In addition, glutathione peroxidase (GPX) and superoxide dismutase (SOD) were determined in both fifteen patients and fifteen controls, respectively. RESULTS: The albumin levels in study group (3.06+/-0.28 g/dL) were significantly lower than those of control group (4.94+/-0.21 g/dL). The hemoglobin, reticulocyte counts, and LD levels in study group were significantly different from those of control group (P<0.01), but the free fatty acid concentrations showed no difference between two groups. The free fatty acid/albumin molar ratio in study group was significantly higher than control values. In study group, there were significant correlations between the free fatty acid/albumin molar ratio and (a) LD (r=0.43, P< 0.05), (b) relative reticulocyte count (r=0.39, P<0.05), and (c) hemoglobin (r=-0.31, P<0.01), respectively. The GPX and SOD activities in study group were not statistically different from the control values. There was an inverse correlation between albumin and GPX concentrations in study group (r=-0.36, P<0.01). CONCLUSIONS: These results suggest that toxic effect of unbound free fatty acid with decreased albumin activity as antioxidant may be involved in the cellular injury in hypoalbuminemia patients. Further studies for the correlation of free fatty acid/albumin molar ratio with individual antioxidant status are needed.
Subject(s)
Humans , Antioxidants , Erythrocytes , Fatty Acids, Nonesterified , Glutathione Peroxidase , Hypoalbuminemia , L-Lactate Dehydrogenase , Molar , Oxygen , Reticulocyte Count , Superoxide DismutaseABSTRACT
Autoimmune hemolytic anemia due to antibody formation against the A or B antigen in renal transplant recipients has been reported on rare occasions. We experienced a case of autoimmune hemolytic anemia which developed 11 days after renal transplantation during CsA and prednisolone administration as immunosuppressive agents. The patient was a 46 year old male, blood group was Rh(+) A, who had received a kidney from his Rh(+) O, HLA haploty'pe identical elder brother. He was transfused with three units of Rh(+) A RBCs preoperatively and his hemoglobin level was 9.2g/dl 1 day after transplantation. After 11 to 12 days posttransplantation, the hemoglobin level dropped to 3.8g/dl. A peripheral blood smear showed marked spherocytosis and polychromatophilia. The reticulocyte count was increased to 4.2%, and total bilirubin was increased to 2.91mg/dl. The LDH was raised to 561 IU/L and the plasma Hb level was 6.Smg/dl. Blood bank tests confirmed that the autoantibody cause hemolytic anemia was anti-A. If transplant recipients of blood groups A, B, or AB, who recieve organs from blood group 0 donors, have hemolytic anemia and ABO discrepancy, the possibility of AIHA due to anti-A or anti-B should be considered.
Subject(s)
Humans , Male , Middle Aged , Anemia, Hemolytic , Anemia, Hemolytic, Autoimmune , Antibody Formation , Bilirubin , Blood Banks , Blood Group Antigens , Immunosuppressive Agents , Kidney , Kidney Transplantation , Plasma , Prednisolone , Reticulocyte Count , Siblings , Tissue Donors , TransplantationABSTRACT
No abstract available.