Ralph Wright

Cirrhosis associated with the Australia antigen in an infant who acquired hepatitis from her mother.

A 19-week-old English girl developed acute viral hepatitis, which became chronic with persistent hepatosplenomegaly and abnormal liver function tests. Liver biopsy at 1 year showed an active cirrhosis with multinucleated giant cells. The Australia (Au) antigen was detected repeatedly in the infants serum by immunodiffusion and by electron microscopy at the time of the acute attack and during the development of cirrhosis. She had apparently acquired the hepatitis from her mother, who had had jaundice at the end of pregnancy and for one month thereafter, and who was subsequently shown to be a carrier of Au antigen. Particles with surface projections resembling paramyxoviruses were observed in two of the later specimens of the infants serum.

IMMUNOLOGICAL STUDIES IN MULTIPLE SCLEROSIS: INCIDENCE OF CIRCULATING ANTIBODIES TO DIETARY PROTEINS AND AUTO-ANTIGENS.

or auto-antigens or both. Successful induction of autoimmune encephalomyelitis in various species of animals has been cited in support of the autoallergic pathogenesis of multiple sclerosis, although the experimental lesions are not very similar to those seen in multiple sclerosis. If a disturbance of immune responsiveness is involved this may be expressed by the formation of auto-antibodies against

Circulating Antibodies to Cow's Milk Proteins and Gluten in the Newborn

Recent studies have shown that in certain diseases of the alimentary tract abnormally high concentrations of circulating antibodies to cows milk proteins may occur. Thus Taylor and Truelove (1961) found that such antibodies were more likely to be present in high titres in patients with ulcerative colitis than in healthy subjects, and this has been confirmed by other workers (Gray, 1961 ; Davidson, 1961). Similarly, patients with coeliac disease and idiopathic steatorrhoea are much more likely to have circulating antibodies in high titres to cows milk proteins and to partly proteolysed wheat gluten (Taylor et al., 1961).

Pathogenesis of viral hepatitis

Over the past few years there has been increasing understanding of the pathogenesis of viral hepatitis. This review will be confined to hepatitis B and will not consider other viruses affecting the liver, such as cytomegalovirus, herpesvirus and the Epstein Barr virus. There is much less information about the pathogenesis of hepatitis A, C, D and E, which are discussed elsewhere in this issue. The hepatitis viruses vary in the severity of infection, in their extrahepatic manifestations and in the development of chronicity and of complicating hepatocellular carcinoma (HCC). Pathogenic mechanisms are central to these different pathological features and include the action of the virus itself on the hepatocytes, the host immune response to viral antigens and interaction with autoantigens.

1 Food allergy and intolerance

In summary, there has been a dramatic increase in our understanding of food allergy as a result of research in immune mechanisms and clinical studies over the last decade. The subject has been comprehensively reviewed in a major new publication (Brostoff and Challacombe, 1986).

Oedema of the ileum: a possible manifestation of food allergy: : Authors' reply

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