Value of serum immunoglobulins in the diagnosis of liver disease

Abstract

Serum Ig''s were determined in 145 consecutive patients with biopsy-proven stearosis, alcoholic hepatitis, alcoholic hepatitis with fibrosis, alcoholic hepatitis with cirrhosis, inactive cirrhosis, chronic active alcoholic hepatitis, chronic active hepatitis [CAH], primary biliary cirrhosis [PBC] and nonspecific hepatitis. IgM was both a sensitive (90.5%) and spcific (86.2%) marker for PBC, and mean IgM levels were higher in PBC than in other diagnostic categories (P < 0.05). IgA levels were most commonly elevated in alcoholic liver disease [ALD] (P < 0.005). IgA detected 95% of alcoholic disease, but was poorly specific (41.1%). A trend of rising IgA with increasing severity of alcoholic injury was observed, but the differences were not significant. IgG was most commonly elevated into CAH and alcoholic hepatitis with cirrhosis, but the IgG values did not differ significantly from those found in other diagnostic categories. These results substantiate assertions of a diagnostic sensitivity for elevated IgA in ALD and IgM in PBC. With the exception of IgM in PBC, however, serum Igs are not specific markers of liver histology.