We present a case report of a previously undocumented incident of massive hemoperitoneum from a liver laceration secondary to vomiting. The patient presented with the complaint of vomiting and abdominal pain. Computed tomography revealed perihepatic and perisplenic fluid collections. With this evidence and a rapidly falling hematocrit, she underwent emergency laparotomy. Intraoperative findings included 3 L of blood in the abdomen and a liver laceration at the juncture of the liver and the falciform ligament.
There exists in the serum α-globulins an immunosuppressive factor(s) which was first described by Kamrin (1), and subsequently separated chromatographically by Mowbray (2), and by our laboratories (3, 4). This factor has been demonstrated to prolong skin grafts (3) and to inhibit antibody formation (5, 6). We have also found that this factor inhibits lymphocyte proliferation induced in vitro by both mitogens and antigens (4). We have recently found that the active factor is a polypeptide(s) which migrates electrophoretically with, and may be bound to, an α-globulin protein(s) (7). We have called the active material “immunoregulatory α-globulin” (IRA).4
The mechanism of action of this immunosuppressive factor remains to be determined. Studying mitogen stimulation of lymphocytes in tissue culture, we have observed that the IRA is not suppressive if this agent is added after the lymphocytes have become activated (8). This observation suggests that the IRA acts upon the early events involved in antigen recognition.
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