Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13208-13215
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13208
Antibody and complement levels in patients with hypersplenism associated with cirrhotic portal hypertension and therapeutic principles
Kun Zhang, Min Zeng, Ye-Juan Li, Hong-Fei Wu, Jin-Cai Wu, Zhen-Sheng Zhang, Jin-Fang Zheng, Yun-Fu Lv
Kun Zhang, Min Zeng, Department of Geriatric Center, Hainan General Hospital, Haikou 570311, Hainan Province, China
Ye-Juan Li, Reproductive Medicine Center, Maternal and Child Health Care Hospital of Hainan Province, Haikou 570311, Hainan Province, China
Hong-Fei Wu, Jin-Cai Wu, Zhen-Sheng Zhang, Jin-Fang Zheng, Yun-Fu Lv, Department of General Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China
Author contributions: Zhang K, Zeng M, Li YJ, Wu JC, Zheng JF and Lv YF contributed equally to this work; Lv YF was responsible for project design and thesis writing; Zhang K and Li YJ were responsible for implementation and statistical information; Wu JC, Zheng JF and Zeng M were responsible for data and statistical information collection; Wu HF and Zhang ZS participated in data collection and registration; all authors have read this article and consent to publication.
Supported by Hainan Provincial Department of Science and Technology, Qiongke[2020]256.
Institutional review board statement: The patient data and research content submitted in this project comply with relevant laws and regulations. The study was approved for implementation by the Ethics Committee of Hainan General Hospital, approval No: Med Eth Re [2020] 086.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study were included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Fu Lv, Doctor, MD, PhD, Academic Research, Chief Doctor, Professor, Research Scientist, Surgeon, Department of General Surgery, Hainan General Hospital, No. 19 Xiuhua Road, Xiuyin District, Haikou 570311, Hainan Province, China. yunfu_lv@126.com
Received: September 16, 2022
Peer-review started: September 16, 2022
First decision: October 19, 2022
Revised: October 30, 2022
Accepted: November 30, 2022
Article in press: November 30, 2022
Published online: December 26, 2022
Processing time: 101 Days and 7.1 Hours
Abstract
BACKGROUND

Hypersplenism associated with cirrhotic portal hypertension is a common condition often resulting from hepatitis B-related cirrhosis. However, the levels of immunoglobulin (Ig) and complement in patients with hypersplenism associated with cirrhotic portal hypertension remain unclear. This study was undertaken to determine the levels of Ig and complement in these patients, the relationship between these levels and Child-Pugh class and their clinical significance.

AIM

To investigate the antibody (Ig) and complement levels in patients with hypersplenism associated with cirrhotic portal hypertension and their clinical significance.

METHODS

Clinical data of 119 patients with hypersplenism associated with cirrhotic portal hypertension were statistically analyzed and compared with those of 128 control patients.

RESULTS

IgA and IgG levels in patients with hypersplenism were significantly higher than controls (P < 0.001). There was no significant difference in IgM between the two groups (P = 0.109). C3 and C4 levels in patients with hypersplenism were significantly lower than controls (P < 0.001). As liver function decreased, IgA and IgG levels increased (P < 0.001), and C3 and C4 levels decreased (P < 0.001).

CONCLUSION

Patients with hypersplenism associated with cirrhotic portal hypertension have significantly higher antibody (IgA and IgG) levels and significantly lower complement (C3 and C4) levels, which are both related to liver damage. Clinically, the administration of anti-hepatitis virus agents and protection of liver function should be strengthened.

Keywords: Hypersplenism associated with cirrhotic portal hypertension, Complement, Treatment, Hepatitis, B-immunoglobulin

Core Tip: Patients with cirrhotic portal hypertension and hypersplenism are clinically common. The spleen is an important immune organ, but studies on antibody and complement levels in patients are scarce. This study found that IgA and IgG levels increased and complement levels decreased in our patient population compared to the healthy controls. These findings indicate liver damage, supporting the need for anti-viral treatment in these patients.