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SUMMARY. The levels of 12 serum proteins including 'acute-phase reactants', immunoglobulins and albumin were measured in 20 patients suffering from thermal bums. The acute-phase reactants: C-reactive protein, a-I antitrypsin, a-I antichymotrypsin, haptoglobin and orosomucoid, all increased in concentration. Highest levels, which showed significant correlations with injury severity, occurred at 6-8 days post-bum. The levels of albumin, a-I lipoprotein and transferrin were decreased. The immunoglobulins IgG, IgA and IgM showed an initial decrease followed by a steady return to normal levels.Four patients, of whom three died, developed serious sepsis. The levels of a-I antichymotrypsin and C-reactive protein were much higher in patients with sepsis than in those without sepsis. The highest levels occurred during and often before the episode of sepsis was clinically evident. The immunoglobulins especially IgG and IgA were lower in those patients who developed sepsis than in those who did not.The results suggest that the serum levels of either C-reactive protein or a-I antichymotrypsin could be used both as an aid to diagnosis of sepsis and also to monitor the effect of therapy.

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Thyroxine-binding prealbumin (TBPA) concentrations were measured in 54 patients with rheumatoid arthritis (RA) and 50 control subjects. TBPA levels were significantly depressed in the RA patients, of whom 15 had values below the laboratory reference range. Although significant negative correlations were seen between TBPA and the erythrocyte sedimentation rate, C-reactive protein and alpha 1-antichymotrypsin measurements, TBPA levels showed little relationship to disease activity as assessed clinically. On the other hand, RA patients with reduced TBPA had an increased frequency of associated anthropometric and serum visceral protein abnormalities indicating nutritional impairment. TBPA is probably subjected to diverse stimuli in patients with RA and should not be considered to act as a 'pure' negative acute phase reactant.