Serum levels of three classes of immunoglobulins (IgG, IgA, IgM) in pathological conditions were measured by quantitative precipitin reaction using class specific antisera.
Increases of three classes of immunoglobulins were found in chronic liver diseases, rheumatoid arthritis and malignant lymphoma so far investigated.
Liver cirrhosis had the higher level of IgG than chronic hepatitis. In histological studies on liver biopsy specimens, IgG was shown to have a correlation with hepatic fibrosis, hepatocyte degeneration and mesenchymal reaction. In acute hepatitis IgA and IgM were elevated, but IgG was within normal limits. A patient with Rotor's syndrome had an increased IgA and a slightly elevated IgM with a low IgG level.
Systemic lupus erythematosus showed an increase of IgG and IgA with normal or slightly decreased IgM.
In nephrotic syndrome all three classes of immunoglobulins were reduced with the less decrease of IgM.
In monoclonal gammopathy, the anomalous protein showed the highest level of corresponding immunoglobulin class and the remaining immunoglobulins were usually decreased, while in Bence Jones proteinemia, all immunoglobulins were within normal range.
In cases of acute leukemia treated with corticosteroid, three classes of immunoglobulins were decreased, though chronic myelogenous leukemia showed a normal IgG and a slightly elevated IgA with a reduced IgM level.
In agammaglobulinemia all three classes of immunoglobulins were most conspicuously decreased. Five cases of ataxia teleangiectasia showed a selectively low concentration of IgA. In these cases IgG levels were normal or slightly reduced with elevated IgM levels.
Pathophysiological meanings of these findings have been discussed with special reference to metabolic behaviours of each class of immunoglobulin under the conditions described.
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