Serum prealbumin, transferrin and immunoglobulins in fatty liver, alcoholic cirrhosis and primary biliary cirrhosis.

The serum concentrations of prealbumin, transferrin and immunoglobulins, as well as their concentration ratios, were determined in patients with fatty liver, alcoholic cirrhosis and primary biliary cirrhosis to evaluate the usefulness of these measurements in the differentiation between these diseases, and in the evaluation of the severity of the liver injury. Alcoholic cirrhosis was characterized by high IgA/prealbumin and IgG/prealbumin ratios, whereas in fatty liver these ratios remained normal or close to normal. The IgG concentration and the ratio of IgG/prealbumin were markedly higher in advanced than in early alcoholic cirrhosis, IgG/prealbumin being the most sensitive indicator. None of the assays reflected the degree of fatty degeneration. In primary biliary cirrhosis the mean IgG concentration was 93% higher than in alcoholic cirrhosis. One of ten patients with primary biliary cirrhosis had a normal IgM level, whereas 2 of 10 patients with alcoholic cirrhosis had a value above normal (greater than 2.9 g/l). IgM alone did not differentiate between alcoholic and primary biliary cirrhosis, while the ratio of IgA/IgM seems useful: a value over 2.0 was found in all patients with alcoholic cirrhosis but in none of those with primary biliary cirrhosis.