The recent development in immunology have facilitated the study of the immunological
aspects of acute and chronic liver disease which are frequently associated with changes
in serum immunoglobulin levels. After thatemphasized values of serum immuno globulin
assay in the diagnosis of primary disease of the liver by Hobbs (1967), these changes,
are often characteristic of the individual disease and may therefore help in their
differentiation and provide evidences as to the pathogenesis.
At the department of clinical pathology, Yonsei University Medical College, using the
Laser-Nephelometry (Model PDQ, Hyland Labolatories, Costa Mesa, calif.) the rapid and
accurate measurement of serum immunoglobulin has been made. 101 cases of acute and
chronic liver disease were observed. Control sera were obtained from 51 healthy adult
Korean. Serum immunoglobulin levels were measured by the Laser-Nophelometry, using
monospecific antisera obtained from Hyland manufacture.
The results are as the follows.
1) The mean±2S.D. values of Ig G, Ig A, Ig M in adult healthy Korean were 1364±
362mg%, 378±145mg%, and 127±54mg %, respectively.
The more age, the higher the levels of immunolobulin in sera, except third decade of
female.
2) In the case of the acute hepatitis, the levels of Ig M were significantly increased in
the both HBs Ag negative and HBs Ag positive group, while the levels of Ig G were
increased in the cases of the HBs Ag positive group, which provided the valuable
differential point between the 2 types of the acute hepatitis.
3) In the case of HBs Ag negative group, Ig M were significantly in creasedon the first
week, Ig G and Ig A on the second week and to the normal levels on the 8th week
after the onset of the symptoms. In contrast in the cases of HBs Ag positive group,
IgM is increased on the second week and then decreased to the normal level at the
12th week-persisting longer than HBs Ag negative group-lt is important test that the
measurement of different Classes of serum immunoglobulin to observe the course of
acute viral hepatitis.
4) Serum Ig G levels are higher than control group in all cases, but not cases of acute
HBs Ag negative hepatitis and metastatic cancer. Especially Ig G is increased in 90.5%
of postnecrotic cirrhosis, and 78.6% of primary hepatocellutar carcinoma.
5) Serum Ig A levels are higher than control group in all cases, but not in cases of
primary biliary cirrhosis. Especially Ig A levels are increases more two times than the
control, in cases of liver abscess and metastatic carcinoma of the liver.
6) Serum Is M levels are higher in all liver diseases except in cases of hepatic
carcinoma. Especially Ig M levels are increased in cases of primary biliary cirrhosis.
No single test can answer the many complex questions that beset the clinician
confronted with problems in liver diseases, but the importance of IgA in the diagnosis
of amebic abscess, of IgM in the diagnosis of primary biliary cirrhosis is supported by
the present data.
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