Increased serum corrinoids correlates with disease severity and IgA levels in alcoholic cirrhosis

Relationship between increased serum cobalamin level and liver disease have been recently reported. In this work, levels of total corrinoids, cobalamin (vitamin B12) and cobalamin analogues and levels of IgA were determined by radioisotope dilution assay and nephelometric laser analyses. They all have been measured in superior vena cava, inferior vena cava and hepatic vein of controls and of alcoholic cirrhotic patients grouped according to the Child-Pugh classification. Compared with normal subjects, venous blood content of total corrinoids, of cobalamin and of IgA in alcoholic cirrhotics increased significantly with the severity of the disease (p less than 0.01). In severe, moderate, and mild alcoholic cirrhosis total corrinoids and cobalamin were, respectively, about 5-, 2-, and 1.5-fold higher than in controls, whereas IgA was 3-, 2.5- and 1.5-fold higher, respectively. The serum IgA level was significantly correlated with the level of seric saturated haptocorrin (r = 0.54; p less than 0.01) and with the seric total corrinoids (r = 0.39; p less than 0.01). In the absence of significant hepatic cytolysis, the enhanced level of seric corrinoids in cirrhosis could be partly explained by a competitive inhibition of the liver uptake of haptocorrin by circulating asialoglycoproteins, including IgA.