The formation and rapid clearance of a truncated albumin species in a critically ill patient

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• 作者：David Bar-Or ; Leonard T. Rael ; Raphael Bar-Or ; Denetta S. Slone and Michael L. Craun
• 刊名：Clinica Chimica Acta
• 出版年：2006
• 出版时间：March 2006
• 年：2006
• 卷：365
• 期：1-2
• 页码：346-349
• 全文大小：105 K

文摘

Introduction

Hypoalbuminemia is known to occur in critically ill patients and is associated with increased mortality. We observed a potentially novel, partial explanation for the hypoalbuminemia noticed in a severely traumatized patient.

Case report

We report of a severely, multi-system traumatized patient in whom hypoalbuminemia was present (1–2 g/dl). The plasma albumin (HSA) was analyzed by liquid chromatography/positive electrospray ionization mass spectrometry. A high percentage of a truncated albumin that lost its carboxy terminal amino acid leucine (HSA-L) associated with a 10-fold increase in plasma carboxypeptidase A (CPA) activity (R² = 0.994) were found. We estimated the half life of this truncated albumin species to be < 80 h.

Conclusions

The increased CPA activity encountered following a traumatic event and subsequent rapid clearance of the resulting HSA-L from plasma might be a contributing factor to the hypoalbuminemia observed in the critically ill patients.