Changes in immunofunction in fulminant hepatitis.

Abstract

Summary: The prognosis for fulminant hepatitis (FH) complicated by infections is poor with a progressive reduction of host immuno-competency.Immunological differences were examined in 13 patients who survived FH and 19 patients who died from the disease. Although T cells were at normal levels in those who survived the disease, they were reduced in many of those who died. B cells were markedly reduced both in the survivors and non-survivors.Lymphocyte function, as evaluated by Con-A stimulation, tended to be greater in the survivors.Lymphocyte subset studies using monoclonal antibodies revealed normal or slightly reduced OKT 11, slightly increased OKT 4, and slightly reduced OKT 8 and OKIa 1. For B cell subsets, IgG was markedly reduced from normal levels, IgA was slightly reduced, but the IgM level was normal.Immunoglobulin (IgG, IgA, and IgM) levels were normal in both groups of patients, but were significantly higher in the survivors than in the non-survivors. Transferrin was reduced in both groups; and it decreased significantly (p< 0.05) during the hospitalization of the non-survivors. Fibronectin was reduced in both groups on admission, but it increased significantly (p<0.01) in the survivors while it decreased significantly (p<0.05) in those who died during hospitalization.