During the past five years several reports have indicated that methemalbumin appears in the peripheral blood of patients with severe hemorrhagic necrotizing pancreatitis.1,2 These reports, based upon a study of patients at the United Birmingham Hospitals in England, show that methemalbuminemia accurately reflects the severity of pancreatic inflammation and can be utilized to differentiate mild edematous pancreatitis, which has a low morbidity and mortality, from the more fulminating forms of the disease.
The presence of methemalbumin in the peripheral circulation appears to be related to the formation of hematin from hemoglobin as enzymes act upon red blood cells (RBC) liberated into the inflamed area in and around the pancreas. A variety of hemolytic states also may produce methemalbuminemia; however, this occurs only when the amount of hemoglobin liberated during hemolysis is sufficient to exceed the binding capacity of haptoglobin in the patient's serum. Northam and associates1 report that
Anderson MC, Toronto IR, Needleman SB, Gramatica L. Assessment of Methemalbumin as a Diagnostic Test for Acute Pancreatitis. Arch Surg. 1969;98(6):776-780. doi:10.1001/archsurg.1969.01340120124023