Abstract
Serum immunoglobulin (IgG, IgA, IgM) values are not diagnostic of any one liver disease, although a high serum IgM in patients with chronic cholestasis makes obstruction to large main bile ducts unlikely. Changes in circulating antibodies are nonspecific and include positive antinuclear factor in some patients with chronic hepatitis and primary biliary cirrhosis. The antimitochondrial (M) test has proved useful in the differential diagnosis of primary biliary cirrhosis from surgical obstruction to main bile ducts. The antibody against smooth muscle is positive in about two thirds of patients with activechronic hepatitis. Delayed type hypersensitivity reactions are impaired in primary biliary cirrhosis, but this effect seems to be a consequence of the disease rather than related to etiology. A form of chronic hepatitis and cirrhosis is associated with persistence of Australia antigen in the serum. In some of these patients primary hepatocellular carcinoma may develop. The evaluation of immunosuppressive regimens in the treatment of liver disease, particularly active chronic hepatitis and primary biliary cirrhosis, has been impeded by lack of controlled prospective trials. However, recent controlled trials have suggested that prednisolone increases the life span of patients with active chronic hepatitis. Serum alpha-feto-globulin can be found in about 30 per cent of Caucasians and 60 per cent of non-Caucasians suffering from primary hepatocellular carcinoma.
Published Version
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