An interpretation of calcium protein findings in sera of lepra reaction cases by means of the McLean-Hastings equation.

In a recent paper (8) I showed that in the sera of leprosy patients the diffusible calcium level is well within the generallyaccepted range of normal variation, regardless of the degree of advancement of the disease or the presence of lepra reaction. On the other hand, it was found that in the lepra reaction cases the values of the other constituents were abnormal. Out of 12 such cases examined the total calcium level was low in 7 (58%), the nondiffusible calcium and the albumin were low in 10 (83%), and the globulin was above normal in 9 (75%). The pertinent data are given later (Table 1 and Text-fig. 1). It was concluded in that study that the reduction in concentration of total serum calcium is not due directly to any disturbance in calcium metabolism, as is believed by other leprosy workers, but to the lowering of concentration of the proteinbound (nondiffusible) calcium, and that probably that change is merely a sequela of the upset in the protein component system which results in the inversion of the albumin: globulin ratio, i.e., a shifting of the albumin level to below normal and of the globulin level to above normal. In the present communication it is the purpose to show that in the McLean-Hastings equation we have the means of further explaining this situation, and also of revealing a factor which may be of importance to the problem of treating cases afflicted with lepra reaction.