Predictive markers of chronic liver disease in hemophilia
CR Hay, FE Preston, DR Triger, M Greaves, JC Underwood and L Westlake
In an attempt to predict progressive liver damage in hemophiliac patients
by noninvasive means, we conducted a retrospective analysis of clinical and
laboratory data from 44 liver biopsies taken from 35 hemophiliac patients.
This showed that serum IgG was normal in patients with chronic persistent
hepatitis (CPH) but significantly elevated in those with chronic active
hepatitis (CAH) or cirrhosis (CIR) (P less than .001). Relationships were
less significant between liver histology and IgM (P less than .01), IgA (P
less than .05), and globulin (P less than .05). This was unaffected by
human immunodeficiency virus (HIV) antibody status in asymptomatic
individuals. Although patients with progressive liver disease were also
older than those with CPH (P less than .001), the immunoglobulin
abnormalities were independent of this. Neither clinical examination nor
liver biochemistry at the time of biopsy were of significant diagnostic
value. Our results indicate that in the absence of AIDS an elevated IgG
level is a reliable indicator of progressive hemophilic liver disease.
Volume 69,
Issue 6,
pp. 1595-1599,
06/01/1987
Copyright © 1987 by The American Society of Hematology