Secretory IgA chronic hepatitis in patients with contaminated small bowel secondary to schistosomal hepatic fibrosis [SHF]

ABSTRACT

This work included 15 patients with SHF, portal hypertension complicated with chronic hepatitis and GIT bacterial overgrowth. Five normal persons were included as a control group for the bacteriological study. Clinical, bacteriologic, histologic and immunologic study were done for all patients. All patients were screened for HBsAg, HBeAg, and HCV antibody. All positive patients were excluded. Marked increase in bacterial counts were observed in the gastric aspirate and stool samples of patients. Histopathologic study revealed chronic active hepatitis in 13 patients and chronic persistent hepatitis in 2 patients. Immunohistochemical study using anti S-IgA antibody revealed positive staining in all cases while none of the control group showed positive staining. Therefore, S-IgA may be the cause of chronic hepatitis and it is highly related to mucosal infection, which is a common finding in cirrhotic patients