Significance of elevated IgG anticardiolipin antibody levels in patients with Budd-Chiari syndrome

Abstract

Objectives: Budd-Chiari syndrome (BCS) is characterized by hepatic venous outflow obstruction. Though hypercoagulable states are implicated in the causation of BCS, the etiology remains unknown in most cases. Presence of anticardiolipin antibodies (aCL) is a known cause of hypercoagulable state. We therefore studied the frequency of IgG aCL in BCS.

Methods: Sera were obtained from 19 patients with BCS, 50 healthy controls, 18 age- and gender-matched patients with cirrhosis, and 15 patients with acute viral hepatitis. IgG aCL levels were measured using a solid-phase enzyme immunoassay. Values exceeding mean + 2 SD of healthy controls were taken as abnormal.

Results: Mean +/- SD IgG aCL levels (GPL units) in the four groups were: healthy controls, 6.3 +/- 4.4; BCS, 13.8 +/- 13.3 (p < 0.05, compared with healthy controls); cirrhosis, 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 was: healthy controls, 3/50; BCS, 6/19; cirrhosis, 7/18; and acute viral hepatitis, 0/15. The number of patients with elevated IgG aCL was significantly higher among patients with BCS and cirrhosis, compared with controls (p = 0.03 and p = 0.002, respectively).

Conclusions: Patients with BCS had higher IgG aCL levels than healthy controls. However, as aCL levels were also elevated in patients with cirrhosis, the pathogenetic role of IgG aCL in the causation of BCS is doubtful.