Anti-albumin antibodies in chronic liver diseases: diagnostic significance of these antibodies in patients with conventional or immunosuppressive therapy.

The two categories of anti-albumin antibodies (AAA), namely precipitins (AA-P) and agglutinins (AA-Aggl), were investigated in 260 patients with morphologically diagnosed chronic liver diseases (CLD). A parallelism was observed between AA-P titre and the severity of chronic hepatitis as revealed by clinical diagnosis. Thus, significant differences in AA-P titre were noticed between chronic persistent hepatitis (CPH) and chronic aggressive hepatitis (CAH) and between CAH and liver cirrhosis (LC). No correlation was found between AA-P positivity and either HBsAg presence or disease activity, maximum AA-P values being registered in decompensated, inactive LC. AA-P positivity was found associated with a higher degree of liver cell dysfunction. In every category of CLD a striking association was also observed between AA-P positivity and raised serum aspartate transaminase and bilirubin levels, thus suggesting a common pathogenic substrate, namely liver cell membrane damage. These correlations were also observed after immunosuppressive therapy which would argue for the maintenance of AA-P diagnostic value. AA-Aggl showed raised incidences and titres in CAH patients, the values decreasing in LC. Therefore, the main diagnostic value is attributed to AA-P.