Criteria for immunosuppressive treatment (corticotherapy) in the early stage of chronic viral hepatitis.
Thirty-five patients showing quatitative deviations from normal of the M and G immunoglobulin (Ig) fractions were selected for study from a larger group of patients with viral hepatitis. In 15 of the 35 cases, most of which showed high IgM and/or IgG serum levels, moderate doses of prednisone were administered for 60 days. Determinations of Ig levels were performed before and after corticotherapy, two and four months respectively after the onset of the acute viral hepatitis. The rest of 20 patients were used as controls. In the cases in which the clinical and biological parameters indicated an improvement after treatment, the initial high IgM titers showed a tendency to decrease while in those with severe evolution, IgM levels increased. A similar behaviour of IgM titers, though less marked, was also noticed in the control group, of untreated patients. These variations are assumed to predict the further favourable of severe course of the disease; Ig variations and particularly the IgM ones, might be useful criteria for the selection of cases with high risk of developing chronic hepatitis, so that corticotherapy could be applied in the early stages, to prevent the progress to more severe forms of the disease.