Quantitative Serum Immunoglobulin Determinations in Active Chronic Hepatitis and Idiopathic Cirrhosis

Abstract

A substantial increase in the serum gamma globulins is commonly observed in many types of chronic inflammatory diseases of the liver, and it is associated with an increased turnover rate (Popper and Schaffner; Cohen). Among the many different serum determinations available from the modern clinical laboratory, the serum gamma globulin level constitutes the only variale correlating roughly to the degree of mesenchymal inflammatory reaction in the liver (Emmrich and Petzold; Popper and Schaffner; Takatsuki; Waldstein et al.). However, the electrophoretically separated gamma globulin fraction contains only part of the total serum immunoglobulins (Ig), while some of the smaller immunoglobulin classes migrate as beta globulins, or with intermediate beta-gamma-mobility (Heremans). The participation of different immunoglobulin classes in the hypergammaglobulinemia of different types of chronic inflammatory liver disorders was observed first using immunoelectrophoretic techniques (Bargob et al.; Hartmann et al.; Heremans; Scheidegger and Zahnd). In recent years, a number of workers have used quantitative immunodiffusion methods (Mancini et al.) in an attempt to determine quantitative changes of individual immunoglobulins in liver disease (Fahey; Feizi; Gleichmann and Deicher, 1968 a, b; Hobbs, 1967; Lee; McKelvey et al.; Paronetto et al., 1964; Tomasi). These investigations have resulted in recognizing certain typical immunoglobulin “constellations” for different types of inflammatory liver disorders, some of which may have diagnostic value. These observations, on the other hand, pose important questions as to the reasons for the different reaction patterns found.

Supported by a grant from the Deutsche Forschungsgemeinschaft.