RESUMEN
UNLABELLED: Sera of 832 healthy persons and patients suffering from chronic inflammatory liver disease were investigated by radioimmunoassay for HBsAg and anti-HBs. Diagnosis in patients was secured by biopsy. The persons were divided into: 1. Healthy persons: n = 478 blood donors, hospital especially exposed to HBV, patients with healed hepatitis; 2. PATIENTS: n = 354 acute hepatitis, chronic persistent and aggressive hepatitis, post-hepatitic, cryptogenic and alcoholic cirrhosis. The results demonstrate considerable accumulation of HBsAg in chronic liver disease (72% in CAH, 66% in posthepatic liver cirrhosis) whereas anti-HBs was more frequently observed in healthy persons (38% in hospital staff, 49% in healed hepatitis). Furthermore, HBsAg and anti-HBs were frequently observed simultaneously in chronic hepatitis and cirrhosis (23% in CAH). A strong shift in the relation of antigen to antibody to the disadvantage of antibody in the examined collectives of chronic hepatitis and cirrhosis is evident. Chronic inflammatory HBsAg positive liver disease should therefore be regarded as chronic virus infection. We suppose an absolute or relative deficiency of antibody to HBsAg is probably an important factor for the development of chronicity of hepatitis B.
Asunto(s)
Antígenos de Superficie de la Hepatitis B/análisis , Hepatitis/etiología , Cirrosis Hepática/etiología , Enfermedad Crónica , Hepatitis/inmunología , Anticuerpos contra la Hepatitis B/análisis , Humanos , Tolerancia Inmunológica , Cirrosis Hepática/inmunología , RadioinmunoensayoRESUMEN
The activity of plasma pseudocholinesterase (PChE) was determined on admission and prior to discharge from the hospital in 200 patients admitted consecutively to a medical ward specialized in liver and infectious diseases. In 24% of patients without liver diseases and without malignant growths the pseudocholinesterase-activity was below normal on admission but increased during the observation period toward normal values. There was a negative correlation between pseudocholinesterase-activity and the intensity of the inflammatory activity as measured by granulocyte count, ESR, body temperature and IgA. This correlation could be established for patients without demonstrable liver pathology as well as for liver diseases. Elevated pseudocholinesterase-levels were observed only in three cases of toxic liver injury (2 heavy drinkers, 1 case of polytoxicomania). In all patients with malignant diseases subnormal values of pseudocholinesterase were observed. Only one patient had normal pseudocholinesterase-activity on admission, but the pseudocholinesterase decreased within a few weeks to subnormal values as the underlying malignant melanoma progressed. The decrease of pseudocholinesterase-activity in malignant diseases was independent of the presence of liver metastases.