STUDY ON THE CAUSE OF ELEVATED TOTAL SERUM IMMUNOGLOBULIN M IN PATIENTS WITH ACUTE HEPATITIS A

Abstract

Remarkable elevation of total serum immunoglobulin M (IgM) is a characteristic feature of acute hepatitis A. The cause of this elevation was investigated and the results were obtained as follows; (1) In examination of fecal microflora in patients with acute hepatitis, no significant difference was found between type A and B hepatitis. (2) In patients with acute hepatitis A, serum level of IgM class anti-lipid A antibody activity during acute pahse was significantly higher than that of acute hepatitis B, however, it decreased uniformly during convalescent phase in all cases of hepatitis A. This change was most remarkable in a hepatitis A patient with endotoxemia. The change of serum level of IgM class anti-lipid A antibody activity was parallel with change of total serum IgM.
These results suggest that the reticuloendotherial system (RES) of the liver is markedly damaged in acute hepatitis A. If IgM antibody is producted against many gut derived bacterial antigens spilled over to the peripheral blood because of damaged liver RES, the elevation of total serum IgM in acute hepatitis A could be mostly understood.