Plasma volume, intravascular albumin and its transcapillary escape rate in patients with extensive skin disease
SUMMARY
Plasma volume and plasma concentration and transcapillary escape rate of albumin (TERalb), i.e. the fraction of intravascular mass of alhumin that passes to the extravascular space per unit time, were determined using 125I-labelled human albumin in eight patients with extensive skin disease. Plasma volume and plasma alhumin concentration were reduced (P<0.05). Thus the intravascular albumin mass was moderately decreased to an average of 0.55 ± 0.06 (s.d.) g/cm height compared with a normal mean value of 0.77 ± 0.07 (s.d.) g/cm. This 29% decrease is statistically significant (P<0.001). The transcapillary escape rate of alhumin (TERalb) was significantly elevated, mean 8.6 ± 1.1 (s.d.) %× h−1 as compared to normal subjects, mean 5.6 ± 1.1 (s.d.) %× h−1, (+ 54% P<0.001). The same patients were studied again after a 1-week treatment with prednisone, 25–60 mg per day. Plasma albumin concentration, plasma volume and intravascular mass of albumin were unchanged, while TERalb, decreased significantly during treatment, mean 5.9 ± 0.8 (s.d.)%× h−1, (P<0.01).
It is suggested that displacement of albumin into the skin and loss of albumin from the skin are the dominating mechanisms ofthe reduction in the intravascular alhumin mass in patients with extensive skin disease.