Hypergammaglobulinemia in chronic liver diseases

ABSTRACT

Immunoglobulins G, A, and M were measured by the radial immunodiffusion method in the serum of 49 patients with chronic liver diseases and 21 normal controls. The 49 patients were subjected. to histopathological examination. 48 of them were divided according to the results of the this examination into. 5 groups Goup I] 13 patients with bilharziasis; Group II] 9 patients with bilharziasis plus chronic persistent hepatitis; Group III] 6 patients with bilharziasis plus chornic active hepatitis; Group lV] 7 patients with chronic persistent hepatitis; Group V] 13 patients with chronic active hepatitis. Immunoglobulin levels in the controls were used to calculate the normal immunoglobulin ranges in the Egyptian population. Comparatively abnormal high values of immunoglobulins were found in the patients. In bilharzial patients 75% showed abnormally high levels, and values. > 3600 mg/dl were found in 2 patients. 46.5% showed raised levels of IgA, 2 patients being > 450 mg/dl. 61.5% demonstrated raised levels of IgM, with 3 patients > 475 mg/dl. In bilharziasis plus chronic persistent hepatitis 57% of patients showed a raised level of IgG, with 2 patients > 3600 mg/dl, 28.5% showed values > 450 mg/dl for IgA. 12.5% showed a raised IgM level of 275 mg/dl. 100% of patients with bilharziasis plus chronic active hepatitis showed abnormally high levels of IgG. 20% showed IgA > 450 mg/dl. 80% had a raised level of IgM, 2 patients being] > 475 mg/dl. 28.5% of patients with chronic persistent hepatitis demonstrated a raised level of. IgG, one patients > 3600 mg/dl. 14% showed increased IgA level > 450 mg/dl, 71% showed abnormal levels of IgM with one patient 475 mg/dl. 45% of chronic active hepatitis patients showed a high concentration of IgG, 3 patients > 3600 mg/dl. 45% had abnormally high IgA values, 2 patients] 450 mg/dl; 54.5% showed high levels of IgM. Since 100% and 80% of patients showed high levels of lgG and IgM respectively in bilharziasis plus chronic active hepatitis and IgG and IgM were not highly elevated in patients with bilharziasis plus chronic persistent hepatitis and, chronic persistent hepatitis per se therefore this may serve as a distinguishing factor between both active and chronic hepatitis. Bilharziasis on top of chronic active hepatitis seems to be an additional factor adding to the seriousness of the condition and enhancing hypergammaglobulinaemia which is evident in raised levels of IgG and IgM