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α2-macroglobulin assay is of major significance in the differential diagnosis of nephrotic syndrome, where an elevated α2-macroglobulin:albumin ratio is indicative of postrenal hematuria. In patients with liver cirrhosis and diabetes, the level of α2-macroglobulin is found to be elevated.
In hyperfibrinolytic states, after major surgery, in septicemia and severe hepatic insufficiency, the measured levels of α2-macroglobulin are often low. Patients with acute pancreatitis exhibit low serum concentrations that correlate with the severity of the disease.
