Plasma volume, intravascular albumin and its transcapillary escape rate in patients with extensive skin disease

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Abstract
Plasma volume and plasma concentration and transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular mass of albumin that passes to the extravascular space per unit time, were determined using 125I-labeled human albumin in 8 patients with extensive skin disease. Plasma volume and plasma albumin concentration were reduced (P < 0.05). Thus the intravascular albumin mass was moderately decreased to an average of 0.55 .+-. 0.06 (SD) g/cm height compared with a normal mean value of 0.77 .+-. 0.07 (SD) g/cm. This 29% decrease is statistically significant (P < 0.001). The transcapillary escape rate of albumin (TERalb) was significantly elevated, mean 8.6 .+-. 1.1 (SD) % .times. h-1, as compared to normal subjects, mean 5.6 .+-. 1.1 (SD) % .times. h-1, (+54%, P < 0.001). The same patients were studied again after a 1 wk treatment with prednisone, 25-60 mg/day. Plasma albumin concentration, plasma volume and intravascular mass of albumin were unchanged, while TERalb decreased significantly during treatment, mean 5.9 .+-. 0.8 (SD) % .times. h-1, (P < 0.01). Displacement of albumin into the skin and loss of albumin from the skin are possibly the dominating mechanisms of the reduction in the intravascular albumin mass in patients with extensive skin disease.