INCREASED SERUM IGE IN ALCOHOL ABUSERS

Background It has been reported that total serum IgE is increased in p atients with alcoholic cirrhosis, but it is not clear if this fact is related to alcoholic liver disease or to alcohol intake. Objective To measure serum IgE in a group of chronic alcoholics with different stag es of liver injury in order to elucidate if IgE increase is related to alcoholic liver damage. Patients and methods Total serum IgE was dete rmined by enzyme immunoassay in 186 chronic alcoholic patients (137 ma le/49 female) and 101 healthy controls. Patients and controls with kno wn reasons for IgE elevation were excluded. Among alcoholic patients, 24 had fatty liver, 28 hepatic fibrosis, 29 alcoholic hepatitis, and 6 7 liver cirrhosis (38 patients were not evaluable concerning liver inj ury). Results Total serum IgE was found to be increased in alcoholics (median 154.5 IU/mL, range 1-7329 IU/mL) with respect to healthy contr ols (median 20 IU/mL, range <1-1417 IU/mL) (P < 0.001). IgE increase w as moderate (180-1000 IU/mL) in 60 alcoholics (32.3%) and marked (> 10 00 IU/mL) in 27 (14.5%). Male alcoholics had higher IgE levels than fe males (median 191 IU/mL and range 1-7329 IU/mL vs 105 IU/mL and range 2-2189 IU/mL) (P = 0.009). On logistic regression analysis, alcoholism , male sex and younger age (but not smoking) were independently associ ated with higher IgE levels. No clear relationship was noted between s erum IgE and severity of alcoholic liver disease. Thus, no correlation was observed between IgE and parameters of liver function (serum bili rubin, albumin or prothrombin index). Likewise, IgE concentrations wer e not significantly different in patients with liver cirrhosis with re spect to patients with less severe liver disease. Serum IgE was increa sed (> 180 IU/mL) in 47.8% of cirrhotics and in 44% of patients withou t liver cirrhosis. In contrast, other immunoglobulins (IgG, IgA and Ig M) were significantly correlated with liver dysfunction.Conclusion Chr onic alcoholism should be considered as a cause of increased total ser um IgE, regardless of the severity of the underlying liver disease.