SIGNIFICANCE OF ELEVATED IGG ANTICARDIOLIPIN ANTIBODY-LEVELS IN PATIENTS WITH BUDD-CHIARI SYNDROME

Objectives: Budd-Chiari syndrome (BCS) is characterized by hepatic ven ous outflow obstruction. Though hypercoagulable states are implicated in the causation of BCS, the etiology remains unknown in most cases. P resence of anticardiolipin antibodies (aCL) is a known cause of hyperc oagulable state. We therefore studied the frequency of IgG aCL in BCS. Methods: Sera mere obtained from 19 patients with BCS, 50 healthy con trols, 18 age- and gender-matched patients with cirrhosis, and 15 pati ents with acute viral hepatitis. IgG aCL levels mere measured using a solid-phase enzyme immunoassay. Values exceeding mean + 2 SD of health y controls mere taken as abnormal. Results: Mean +/- SD IgG aCL levels (GPL units) in the four groups mere: healthy controls, 6.3 +/- 4.4; B CS, 13.8 +/- 13.3 (p < 0.05, compared with healthy controls); cirrhosi s, 15.1 +/- 14.9 (p < 0.05, compared with healthy controls and p = ns, compared with BCS patients); and acute viral hepatitis, 5.0 +/- 2.5 ( p ns, compared with healthy controls). The levels in BCS and cirrhosis patients were similar (p = ns). The number of patients with elevated aCL mas: healthy controls, 3/50; BCS, 6/19; cirrhosis, 7/18; and acute viral hepatitis, 0/15. The number of patients with elevated IgG aCL w as significantly higher among patients with BCS and cirrhosis, compare d with controls (p = 0.03 and p = 0.003, respectively). Conclusions: P atients with BCS had higher IgG aCL levels than healthy controls. Howe ver, as aCL levels were also elevated in patients with cirrhosis, the pathogenetic role of IgG aCL in the causation of BCS is doubtful. (Am J Gastroenterol 1998;93:954-957. (C) 1998 by Am. con, of Gastroenterol ogy).