ABSTRACT
The proteins in the thoracic duct lymph were studied in 46 patients with bilharzial hepatic disease in various stages. The thoracic duct proteins were compared to those of serum and ascitic fluid. Total protein and albumin in thoracic duct lymph were 66 and 69% of the concentration of those in the serum of nonascitic patients. The proteins in the thoracic duct lymph were 29% of the serum level in patients with tense ascites. The lymph to serum and ascitic fluid to serum ratios of the total protein and albumin were similar to each other in moderate and severe ascites, reflecting a low protein content in both the ascitic fluid and thoracic duct lymph. The gamma-globulin concentration was raised in the serum of all patients as well as in the ascitic fluid of those with tense ascites. A contrasting pattern of the proteins is present in the thoracic duct lymph in bilharzial hepatic fibrosis. In the early stages the lymph has a relatively high concentration of protein, which decreases as the disease advances.