Studies on Serum Immunoglobulin Patterns in HBsAg Positive Patients

Studies of immunoglobulin levels in disease become popular in the mid and late 1960's and there have been many investigation of immunoglobulin alteration in hepatic disorders. More sensitive methodes for detecting hepatitis B virus(H-BV) antigen(HBsAg) are developed. As a result, it has provided higher incidence of HBV carriers. Several investigators have reported that serum immunoglobulin M(IgM) value is much higher in acute viral hepatitis. The purpose of this study is early detection of acute viral hepatitis among HBsAg positive patients and recognitiono of present illness from past history by determination of serum immunoglobulin along with conventional liver function tests. The auther have done serum immunoglobulin in 50 cases of HBsAg positive patients who visited to EWUH with symptoms during the period, March to October 1981. Diagnosis of those patients was made on the basis of symptom, liver function test, and histologic liver biopsy. The results are summerized as follow : 1. Mean value(±2SD) of IgG, IgA, IgM in HBsAg positive acute viral hepatitis are 1676±349mg%, 294±165mg%, and 229±134mg%. 2. Immunoglobulin M levels iin approxiamtely 84% of all HBsAg positive acute viral hepatitis are significantly higher than other hepatic disease. 3. Immunoglobulin G level is significantly higher in liver cirrhosis and hepatoma, and immunoglobulin A level is higher in chronic hepatitis, while immunoglobulin M is higher in acute vital hepatitis than normal. 4. The relationship between immunoglobulin levels and liver enzme generally reveals that the higher the enzyme level, the higher the IgM level and the lower the enzyme level, the higher the IgG and IgA. In conclusion, Immunoglobulin M levels in HBsAg positive acute viral hepatitis cases are significantly high, therefore, it could be a good indicator of not only differentiating present illness from the past history, but also differentiating acute viral hepatitis from other hepatic disease.