Fulminant hepatitis associated with acquired defect in humoral immunity

ACASE of hypogammaglobulinaemia associated with fulminant hepatitis is presented. The evidence in support of hypogammaglobulinaemia includes lowered serum levels of immunoglobulins, loss of detectable isohaemagglutinins and absence of germinal centres in the appendix. The pathogenesis of the liver disease is discussed and it is suggested that the fulminant nature of the disease in this case may be due to failure of “cooperation” between T and B cells.