Albumin metabolism in hookworm anaemias

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Abstract
17 patients infected with hookworms were used in a study of albumin metabolism and faecal albumin loss. They were compared with 9 controls. Factors relating to the use of 131I-labelled albumin as a measure of albumin metabolism are discussed. Some doubt has recently been expressed as to whether faecal activity appearing in this method represents wholly albumin breakdown in or near the gut, or partly endogenous breakdown with subsequent secretion of iodide. The weight of evidence has indicated the former. The method of measuring salivary excretion of iodide and its fate may need elaborating. There seems to be little division of opinion about the bowel origin of excessive albumin losses. It is claimed that hookworm patients lose excessive albumin into their gut. The loss of albumin is roughly 0·1 g. per 100 hookworms of the species Necator americanus. This is equivalent to the loss of 3 ml. plasma per 100 hookworms. This figure agrees very well with other published work based on red cell losses estimated by 51Cr. There seems to be a satisfactory correlation between albumin and plasma losses on the one hand, and numbers of hookworms harboured on the other. Female hookworms were in the preponderance (ratio 3 : 2). In Kampala only N. americanus was found. The worms were themselves devoid of radio-activity.