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HAPTOGLOBIN
Message"Avoid exercise prior to collection and hemolysis from traumatic venipuncture
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Test Code
1628
CPT Codes
83010
Preferred Specimen
"Serum (preferred) or plasma
2 mL
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2 mL
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Instructions
"Separate serum or plasma from cells
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Transport Container
"Red-top tube, gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube
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Transport Temperature
Room temp
Specimen Stability
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Room temperature
14 days
Refrigerated
14 days
Frozen
14 days
Freeze/thaw cycles
Stable x3
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Room temperature
14 days
Refrigerated
14 days
Frozen
14 days
Freeze/thaw cycles
Stable x3
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Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
"Excessive lipemia; hemolysis from traumatic venipuncture
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Methodology
"Immunologic "
Limitations
"During inflammation or steroid therapy, normal concentrations do not rule out hemolysis; decreased with oral contraceptives; increased with androgens
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Reference Range
"34-200 mg/dL
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Clinical Significance
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Decreased to absent levels occur more with intravascular than extravascular hemolysis: haptoglobin binds hemoglobin, and carries it to the reticuloendothelial system. Thus, haptoglobin is useful in work-up for hemolytic states. It is low in the megaloblastic anemias, which have a hemolytic component. It is decreased in infectious mononucleosis. Decreases can occur with hematoma or tissue hemorrhage. Haptoglobin can be low with liver disease. Congenital absence occurs (small fraction of Blacks/Orientals have ahaptoglobinemia, absence of detectable haptoglobin). Frequently elevated as an acute phase reactant, in inflammatory disorders (eg, collagen diseases, infections, tissue destruction, and with advanced malignant neoplasms).1
Haptoglobin is a protein that binds free hemoglobin. Part of a2 on serum protein electrophoresis, serum haptoglobin is a glycoprotein consisting of two pairs of nonidentical chains, a and ß, made by the liver. The subunit structure is represented as a2ß2. The haptoglobin-bound hemoglobin complex is removed rapidly by the reticuloendothelial system and metabolized to free amino acids and iron in just a few hours. This represents an efficient method for the conservation of iron. Low a2 is commonly due to hemolysis and/or liver disease. Serum protein electrophoretic pattern showing low albumin, polyclonal increase in ?-globulin, and decrease in a2-globulin shown to be due to decreased haptoglobin has been correlated with poor prognosis in severe liver disease.2 Haptoglobin is decreased for two to three days after only 25 mL of blood is lysed.1 Thus, transfusions, which contain red blood cells which do not all survive in the recipient, can lower the level. The decrease in haptoglobin (after hemolysis) precedes any drop in hemopexin levels or the appearance of methemalbumin in serum or urine. Myoglobin, unlike hemoglobin, is not bound by haptoglobin.
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Decreased to absent levels occur more with intravascular than extravascular hemolysis: haptoglobin binds hemoglobin, and carries it to the reticuloendothelial system. Thus, haptoglobin is useful in work-up for hemolytic states. It is low in the megaloblastic anemias, which have a hemolytic component. It is decreased in infectious mononucleosis. Decreases can occur with hematoma or tissue hemorrhage. Haptoglobin can be low with liver disease. Congenital absence occurs (small fraction of Blacks/Orientals have ahaptoglobinemia, absence of detectable haptoglobin). Frequently elevated as an acute phase reactant, in inflammatory disorders (eg, collagen diseases, infections, tissue destruction, and with advanced malignant neoplasms).1
Haptoglobin is a protein that binds free hemoglobin. Part of a2 on serum protein electrophoresis, serum haptoglobin is a glycoprotein consisting of two pairs of nonidentical chains, a and ß, made by the liver. The subunit structure is represented as a2ß2. The haptoglobin-bound hemoglobin complex is removed rapidly by the reticuloendothelial system and metabolized to free amino acids and iron in just a few hours. This represents an efficient method for the conservation of iron. Low a2 is commonly due to hemolysis and/or liver disease. Serum protein electrophoretic pattern showing low albumin, polyclonal increase in ?-globulin, and decrease in a2-globulin shown to be due to decreased haptoglobin has been correlated with poor prognosis in severe liver disease.2 Haptoglobin is decreased for two to three days after only 25 mL of blood is lysed.1 Thus, transfusions, which contain red blood cells which do not all survive in the recipient, can lower the level. The decrease in haptoglobin (after hemolysis) precedes any drop in hemopexin levels or the appearance of methemalbumin in serum or urine. Myoglobin, unlike hemoglobin, is not bound by haptoglobin.
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