Rapid turnover serum proteins in fulminant hepatitis.

An attempt was made to find reliable indices for early diagnosis of fatal cases of acute viral hepatitis, using the values of serum proteins with rapid turnover. Of the subfractions of serum protein, prealbumin, alpha2-HS-glycoprotein and Normotest were measured simultaneously before the appearance of hepatic coma/or gastrointestinal bleeding in 78 cases of acute viral hepatitis, verified by biopsy or necropsy. The mean value of prealbumin with a very short half-life of one or two days, was 6.0 mg/dl in fatal cases, 7.4 mg/dl in surviving ones of subacute form of fulminant hepatitis. The difference between fatal and surviving cases was not statistically significant. In contrast to this, the values alpha2-HS-glycoprotein with a comparatively short halflife of four to six days, showed statistically significant difference between fatal (21.9 mg/dl) and surviving cases (37.4 mg/dl). Normotest was also depressed in fatal (10.7%) and surviving cases (45.3%). The difference was statistically significant. The present results indicate the possibility of differentiating fatal cases from surviving ones at an early stage, using the reduction of alpha2-HS-glycoprotein and the value of Normotest.