PREVALENCE OF SERUM ANTICARDIOLIPID ANTIB ODIES IN ALCOHOLIC CIRRHOSIS

Objective. - Although portal obstruction is a complication in cirrhosi s which is usually associated with hepatocellular carcinoma, ifs preci se neoplastic or thrombotic nature is not easy to determine. Serum ant iphospholipid antibodies could be involved in thrombosis-related porta l obstruction. Patients and methods. - The presence of serum anticardi olipid antibodies was investigated by an immunoenzymatic technique in 129 patients with alcoholic cirrhosis, 47 patients with hepatocellular carcinoma with (n = 18) or without (n = 29) portal obstruction, and 8 2 patients without hepatocellular carcinoma or portal obstruction. Fiv e control groups were included: patients with non alcoholic cirrhosis (n = 21), non cirrhotic alcoholic liver disease (n = 21), chronic vira l hepatitis (n = 14), extra-hepatic cholestasis (n = 9), and hypergamm aglobulinemia associated with human immunodeficiency vines infection w ithout liver disease (n = 28). Results. - The prevalence of serum anti cardiolipid antibodies was 57% in patients with alcoholic cirrhosis, w hich was significantly different from the prevalence in the control gr oups which ranged from 0 to 32%. Anticardiolipid antibodies were of Ig A isotypes in 90.5% of the cases, mainly related to the degree of live r failure but not to hepatocellular carcinoma or portal obstruction. C onclusion. - In alcoholic cirrhosis, serum anticardiolipid antibodies do not seem to be related to the pathogenesis of portal obstruction in patients with hepatocellular carcinoma. They could rather reflect liv er lesions and immunological dysfunctions.