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Hyperbilirubinemia, jaundice and anergy
M Cainzos1, J A Alcalde, J Potel
1University of Santiago de Compostela, School of Medicine, Hospital General of Galicia, Spain.
Hepato-Gastroenterology
|August 1, 1992
Summary
Jaundiced patients exhibit significantly impaired delayed hypersensitivity response, with 84% showing anergy compared to 24% in controls. Elevated bilirubin levels correlate with this reduced immune function.
Area of Science:
- Immunology
- Gastroenterology
- Hepatology
Background:
- Delayed hypersensitivity is a key immune response.
- Jaundice, often indicating hepato-pancreato-biliary (HPB) pathology, may impact immune function.
Purpose of the Study:
- To investigate the delayed hypersensitivity response in jaundiced patients with HPB pathology.
- To assess the correlation between jaundice severity and immune status.
Main Methods:
- A prospective study involving 177 subjects (118 jaundiced patients, 59 controls).
- Utilized a multitest technique to evaluate delayed hypersensitivity response.
- Classified subjects into immunocompetent, relatively anergic, and anergic groups.
Main Results:
- Significantly lower immunocompetence in jaundiced patients (16.1%) compared to controls (76.3%) (p < 0.0001).
- Higher rates of anergy or relative anergy in patients (84%) versus controls (24%) (p < 0.0001).
- No difference in anergy index between malignant and benign HPB pathology.
- Patients with a mean bilirubin level of 12 mg/dl showed a shift towards anergy.
Conclusions:
- Jaundiced patients with HPB pathology exhibit profound deficits in delayed hypersensitivity.
- Immune anergy is prevalent in this patient group, irrespective of pathology type (benign vs. malignant).
- Elevated bilirubin levels are associated with impaired cellular immunity.