Immunoglobulin M antibody against hepatitis B core antigen for the diagnosis of fulminant type B hepatitis.

We attempted to diagnose fulminant type B hepatitis by the hepatitis B core antibody of the immunoglobulin M class. Of 27 consecutive cases of fulminant hepatitis not due to drug-related causes or type A hepatitis, 11 cases with and 9 without hepatitis B surface antigen in the serum revealed a high activity of immunoglobulin M hepatitis B core antibody by radioimmunoassay (S/N ratio 36.3 +/- 20.3). The remaining 7 cases with presumed non-A, non-B hepatitis, as well as the other 4 cases with drug-related causes, did not show any detectable activity (0.99 +/- 0.16). Serums from 30 asymptomatic carriers did not reveal a high activity of immunoglobulin M hepatitis B core antibody (2.1 +/- 1.2), although titers of non-class-specific hepatitis B core antibody were invariably high. On the basis of the results obtained, immunoglobulin M hepatitis B core antibody may be applied for the diagnosis of type B etiology in cases of fulminant hepatitis with or without hepatitis B surface antigen in the serum.