J.Jpn. Surg. Soc.. 79(7): 538-553, 1978

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Original article

IMMUNOLOGICAL STUDIES IN THE ETIOLOGY OF IDIOPATHIC PORTAL HYPERTENSION

It has been commonly understood that splenomegaly and portal hypertension in idiopathic portal hepertension (IPH) is due to the obstruction of intra-hepatic portal vein. However, the pathogenesis has been unknown. Clinically, there have been many patients with the history of blood transfusion and complaining of jaundice.
Therefore, the some possi bility detecting for HB_s antigen in the liver tissue of patients with IPH was studied by Orcein stain using Shikata's method and some immunological examinations were performed.
The resul ts were as follows :
1. HB_s antigen in the liver tissue were demonstrated in 23 out of 52 cases (42.3%) with IPH, among them, in 13 of 41 cases (31.7%) with liver fibrosis.
2. Among 10 patients with IPH, antinuclear antibodies were found in 4 cases (40%), antimitochondrial antibodies in 7 cases (70%) and smooth muscle antibodies in 4 cases (40%) in the serum using indirect immunofluorescence technique.
3. After splenectomy, disappeared or decreased titers of these antibodies were seen.
4. Clinical features of 4 cases with IPH as an autoimmune disorder of overlapping type were described. Two were cases of autoimmune hemolytic anemia, one case of progressive systemic sclerosis and the other case of lupoid hepatitis.
From these results suggested that immunological abnormality being induced by infection like as HB virus is a very important factor on pathogenesis of IPH.

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