title: Clinical significance of antiphospholipid antibodies in fulminant hepatic failure.
abstract: We examined the incidence of antiphospholipid antibodies (APA) in patients with fulminant hepatic failure (FHF) and various liver diseases using the enzyme-linked immunosorbent assay (ELISA), and assessed possible correlations with the pathophysiology of these diseases. The APA assay employed cardiolipin (CL), phosphatidylserine (PS), and phosphatidylinositol (PI) as antigens. Anti-CL IgA antibody was detected in 13/14 (92.9%) patients with FHF. The incidence of anti-CL-IgG, anti-CL-IgM, anti-PS-IgG, and anti-PI-IgG was 14.3%, 35.7%, 64.3%, and 71.4%, respectively. Despite the high incidence of APA in FHF, these antibodies were not detected in most patients with acute or chronic hepatitis. There was a negative correlation between anti-CL-IgA and the platelet count, and a negative correlation between anti-PI-IgG and the amount of residual liver parenchyma. Our results suggest that APA develop secondarily to hepatocyte or sinusoidal cell damage and may aggravate both thrombocytopenia and liver failure.
authors.affiliation: Third Department of Internal Medicine, Ehime University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tada
authors.forename: K
authors.initials: K
authors.lastname: Akamatsu
authors.forename: T
authors.initials: T
authors.lastname: Konno
authors.forename: T
authors.initials: T
authors.lastname: Ohuchi
authors.forename: K
authors.initials: K
authors.lastname: Ohkubo
authors.forename: K
authors.initials: K
authors.lastname: Hayama
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Wakabayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Ohta
mesh_terms: D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006501:Hepatic Encephalopathy / Q000276:immunology*; D006525:Hepatitis, Viral, Human / Q000276:immunology; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid