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Causes of increased and decreased haptoglobin
Medical expert of the article
Last reviewed: 06.07.2025
Haptoglobin is an acute phase protein. Its concentration in the blood increases due to stimulation of liver cell IL. However, changes in the concentration of haptoglobin in the blood are not as regular as those of other acute phase proteins. This is due to the fact that during in vivo hemolysis, which often accompanies acute phase processes, haptoglobin selectively binds to free plasma hemoglobin, which leads to a decrease in its content in the blood. Therefore, the overall result may be an increase, decrease, or maintenance of the normal concentration of this protein. To exclude the effect of hemolysis on the results of haptoglobin determination, they must be compared with the data of a study of at least one more acute phase reactant. The main diseases and conditions leading to an increase in the concentration of haptoglobin in the blood serum are similar to those given for orosomucoid. In addition, an increase in the content of haptoglobin in the blood is observed in cholestasis and treatment with glucocorticosteroids.
A decrease in haptoglobin concentration is detected in all types of hemolysis in vivo - autoimmune, isoimmune, mechanical (artificial heart valves, injuries, etc.); in acute and chronic liver diseases; ineffective erythropoiesis (folic acid deficiency, hemoglobinopathies); defects in the erythrocyte membrane or metabolism (glucose-6-phosphate dehydrogenase deficiency); enlargement of the spleen.
In nephrotic syndrome, the degree of decrease in haptoglobin concentration in the blood depends on its phenotype. In Hp 1-1, whose molecular weight is relatively low, haptoglobin concentration decreases due to its loss in the urine. In other types of haptoglobin (with a higher molecular weight), there is virtually no loss in the urine and its concentration in the blood does not decrease.
The content of haptoglobin in the blood serum increases in malignant neoplasms of certain localizations (breast cancer, gastrointestinal tract, genitals, lungs, etc.). Changes in the relative content of haptoglobin types in the blood serum of patients with genital and breast cancer are possible (predominance of Hp 1-1 in malignant tumors of the breast and a decrease in the content of Hp 2-2 in cervical cancer).