Immunological Disturbance in Diseases of Liver and Thyroid

Hyperglobulina?mia Elevation of total serum globulin levels is a wellknown phenomenon accompanying most forms of liver disease. It was the basis of positivity of many of the seroflocculation tests now no longer used. Recognition of the different fractions of the total serum globulin concentration has been fruitful and has led to the first indications of an abnormal immune response in patients with chronic liver disease. Since gammaglobulin levels to a great extent reflect antibody-like protein levels, the hypergammaglobulinxmia, which is associated with an increased turnover rate, is likely to be part of an immunological response. Electrophoresis of the serum proteins shows a polyclonal response in patients with chronic hepatocellular disease. The increase in gammaglobulin also involves fast gammaglobulin and leads to a characteristic filling in of the gap normally present between the beta. and gammaglobulins (Fig 1). Rarely, a monoclonal picture may be seen. Of 27 patients 18 were found with liver disease and cryoglobulinaemia and 6 of these with monoclonal immunoglobulins were found to have antibody activity, directed to human gammaglobulin, alpha y