Cirrhosis of the liver is a major cause of morbidity and mortality among young children below 5 years of age in India. The clinical findings and histopathological features are pathognomonic and unusual.1-3 The involvement of multiple systems, the presence of hypergammaglobulinemia, and progressive fatal course suggest the contribution of immunological processes in this syndrome. In an earlier communication we described elevated serum immunoglobulin values, the presence of metabolic conversion products of the β1c fraction, smooth muscle autoantibodies, and markedly reduced serum complement values in such patients. Furthermore, hepatitis-associated antigen (HAA) was detected in six of 30 patients with cirrhosis, compared with none out of 30 controls. If the association of the hepatitis antigen with Indian childhood cirrhosis is causal, one must explain the persistence of the virus antigen in the serum of such patients who were exposed early in life in order to have shown liver cell damage
Chandra RK, Chawla V, Verma IC, Ghai OP, Malik GR. Hepatitis-Associated Antigen and Depressed Cellular Immunity in Indian Childhood Cirrhosis. Am J Dis Child. 1972;123(4):408–409. doi:10.1001/archpedi.1972.02110100140053
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