The colloidal gold reaction of blood serum in hepatic and other diseases

Summary and Conclusions

A series of 155 patients with hepatic or biliary tract disease, ninety patients without evident hepatic or biliary tract disease, and twenty-five normal males were studied for the purpose of evaluating the reaction between blood serum and colloidal gold solutions as an index of hepatic disease. Pathological examination of the liver was performed in thirty-nine cases.

The test was positive in twenty-seven of thirty cases of hepatic cirrhosis, and in twenty-two of twenty-nine cases of acute hepatitis, and in varying proportions in other types of hepatic disease. It was infrequently positive in obstructive jaundice and uncomplicated cholecystitis. Positive reactions were not encountered with sera of twenty-five normal males, but occurred in fourteen of ninety cases in which hepatic disease could not be demonstrated by physical examination or by other laboratory tests which were employed. Syphilis was present in seven of these fourteen cases and in eight, including four of syphilis, there were appreciable degrees of fever, frequently of long duration. In cases of cirrhosis and acute hepatitis, the test usually remained positive after bromsulphalein and hippuric acid tests had become negative. In well-defined instances of hepatic disease it was occasionally positive when the latter tests were negative, although the reverse situation also occurred. The test was negative in nine instances in which there were pathologic findings of marked or moderate hepatic damage, and in six instances in which slight hepatic pathology was present. On the other hand, it was negative in each of four cases in which pathologic examination revealed a normal liver.

It is concluded that although in our cases the test was not exceedingly sensitive in most circumstances, both its persistent positivity in cirrhosis and hepatitis and its positivity in certain febrile diseases in which other tests of liver function may be negative warrant further investigation.

We gratefully acknowledge our indebtedness to Commander O. A. Brines, U. S. N. (formerly Attending Pathologist of Receiving Hospital) for his reviewing of the pathological material; to Dr. Gordon B. Myers, Professor of Medicine, Wayne University, for helpful advice and suggestions; and to Mrs. Virginia Weeks and Mrs. Camille Hubel for generously given technical assistance.