Abstract
The quantitative alterations of the plasma proteins in liver disease have been recognized for many years. The work of Gros 1 , Kendall 2 and de Vries 3 suggests, however, that a qualitative change in the plasma globulin, as indicated by an increase in the euglobulin fraction, may occur frequently in hepatic disease. These investigations indicate that an increase in euglobulin may distinguish the globulin of liver disease from that of other diseases. Since the plasma globulin 4 and, particularly, the euglobulin 5 have been shown to play an important rôle in colloidal gold precipitation, these studies of the colloidal gold reaction of blood serum in liver disease were undertaken.
The method is essentially the same as that of the Lange test on spinal fluid except for serum dilution, salt concentration and acidity of the colloidal gold solution. One tenth of a cubic centimeter of the patient's blood serum is diluted to 1:350 with 0.9% sodium chloride, and serial dilutions are made as in the Lange reaction, using 0.3% sodium chloride in the ten tubes. Five cubic centimeters of colloidal gold, properly acidified, are added to each tube and the reactions are read in 12–24 hours. The colloidal gold solution is the same as that used routinely in the serology laboratory. The colloidal gold solution is acidified with 1/50 normal hydrochloric acid, and the degree of acidity is determined by testing the solutions with sera from normal patients and from patients with obvious liver disease. Standardization of acidity is done only once for each supply of colloidal gold prepared. The acid is added dropwise immediately before each test is performed. Usually 1.1 to 1.6 cc of 1/50 normal hydrochloric acid are added to every 50 cc of colloidal gold used.
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