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Letter to the Editor
Measles and rubella antibodies
in patients with chronic liver disease
High measles and rubella antibody titres are found in patients with autoimmune chronic hepatitis (1.2). We evelualed the benefit of measuring these antibodies as an aid lmthe diagnosisof chronicliver diseases. In a retrospective study we gathered sera fmm 57 patients wltb chronic liver disease, while a prospectivestudy included 68 patients sera sent for ‘liver immunology’ ssreenlnB.The complement tiation test (CFr) was used for measles and the heamagglutination iebibition test (HIT) for mbel!a antibodies. The mean titre of measles antibadier was 152o-times higher in patients with autoimmune chmnic active hepatitis than in patients with primary bilimy cirrhosis and ~ntrais @ = 0.001). and mbella entibodles 7-B-times. Eighteen of twenty patients with autoimmune cbmnic active hepatitis showed bigb meesles CFI. t&es (~468) an&or rubella HIT titres
TABLEt
(>1/320), values S&stantially above Ibose seen in healthy subjecis.
High concentrations
of IgC G-16 g0) were
found in 85%. high anti-nuclear antibodies in W% and high smooth muscleantibody in 65% (Table 1). Three patients with cryptogenic and two with alcoholic cirrhosis also had high measlles/rubellaantibodies. None of 19 pedents with primary biliary cinbosis had ltigb measlenlmbella antibodies. Sty-eight conwative sera sent for ‘liver immunology’screeningwere examinedfor anti&dies to measles and rubella virus and for other viral (herpes simplex virus, cylomeBakw+ms,respiratory syncytiel vims. mumps virus, coxsackieB virus), mycoplasmal and cblen,ydial antibodii.. Twelve e-embed raiwd mea&s/ rubella antibodies, 11 of which were from seven patients with autoimmunecbmrdcective hepatitis and one from en unclassifiedliver d&se case. One patient with autoimmune chronic active hepatitis and three with suspected autoimmune chronic active hepatitis showed normal titres. The patients with autoimmune cbmnic active hep atitis had normal titre of other antimicmbial antibodies except for occasional high tines of Santibodii to herpes simplex and cytome@ovims. Our results show that high titres of antibody to mcesks andkvrrubella virus in a patient with chronic liver disease is hiBhlyindicative of auroimmune cbmnic active he.@i!is end makes the &agwsis of grimmy biliary cirrhosis unlikely. For measles antikdy. the CR is to be preferred since if measures antibcdy to the nucleopmtein whichis the prevailing antibody to me&Is virus in patients with autoimmune chronic active hepatitis. Rubella antibodies are best assayed by the HIT. Only substantiaUyelevated titres are of diagwrtic vnlue.
Letter to the Editor
Measles and rubella antibodies
in patients with chronic liver disease
High measles and rubella antibody titres are found in patients with autoimmune chronic hepatitis (1.2). We evelualed the benefit of measuring these antibodies as an aid lmthe diagnosisof chronicliver diseases. In a retrospective study we gathered sera fmm 57 patients wltb chronic liver disease, while a prospectivestudy included 68 patients sera sent for ‘liver immunology’ ssreenlnB.The complement tiation test (CFr) was used for measles and the heamagglutination iebibition test (HIT) for mbel!a antibodies. The mean titre of measles antibadier was 152o-times higher in patients with autoimmune chmnic active hepatitis than in patients with primary bilimy cirrhosis and ~ntrais @ = 0.001). and mbella entibodles 7-B-times. Eighteen of twenty patients with autoimmune cbmnic active hepatitis showed bigb meesles CFI. t&es (~468) an&or rubella HIT titres
TABLEt
(>1/320), values S&stantially above Ibose seen in healthy subjecis.
High concentrations
of IgC G-16 g0) were
found in 85%. high anti-nuclear antibodies in W% and high smooth muscleantibody in 65% (Table 1). Three patients with cryptogenic and two with alcoholic cirrhosis also had high measlles/rubellaantibodies. None of 19 pedents with primary biliary cinbosis had ltigb measlenlmbella antibodies. Sty-eight conwative sera sent for ‘liver immunology’screeningwere examinedfor anti&dies to measles and rubella virus and for other viral (herpes simplex virus, cylomeBakw+ms,respiratory syncytiel vims. mumps virus, coxsackieB virus), mycoplasmal and cblen,ydial antibodii.. Twelve e-embed raiwd mea&s/ rubella antibodies, 11 of which were from seven patients with autoimmunecbmrdcective hepatitis and one from en unclassifiedliver d&se case. One patient with autoimmune chronic active hepatitis and three with suspected autoimmune chronic active hepatitis showed normal titres. The patients with autoimmune cbmnic active hep atitis had normal titre of other antimicmbial antibodies except for occasional high tines of Santibodii to herpes simplex and cytome@ovims. Our results show that high titres of antibody to mcesks andkvrrubella virus in a patient with chronic liver disease is hiBhlyindicative of auroimmune cbmnic active he.@i!is end makes the &agwsis of grimmy biliary cirrhosis unlikely. For measles antikdy. the CR is to be preferred since if measures antibcdy to the nucleopmtein whichis the prevailing antibody to me&Is virus in patients with autoimmune chronic active hepatitis. Rubella antibodies are best assayed by the HIT. Only substantiaUyelevated titres are of diagwrtic vnlue.
