The phagocytic and metabolic functions of the reticuloendothelial system (RES) were tested in seven patients with advanced cirrhosis of the liver due to excessive ingestion of ethanol. 125I-labelled microaggregated human serum albumin was used as a test substance. A group of 13 volunteers served as controls. Liver and spleen scans were performed in all patients. Routine blood analyses were made, including seven different liver tests. The results show that both the phagocytic and the metabolic activity of the RES were hampered significantly in all these patients compared with the control group. The liver and spleen scan findings were all pathological, showing a good correlation with the RES function test. The blood test that correlated best with the RES function test was the prothrombin time, which was likewise abnormal in all patients. It is concluded that certain functions of the RES are hampered after prolonged ethanol ingestion and that the enhanced frequency of infections in patients with alcohol liver cirrhosis might partly be due to their impaired RES function.

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The bone marrow activity in the liver-spleen (RES) scintigraphy has been diffucult to estimate correctly. If the activity of the bone marrow is to 'be decided as counts/time unit it is of importance that structures with a high activity as the liver and spleen are excluded from the registration. A dorsal registration of the pelvis during 180 s will give a rather correct information of bone marrow activity and besides an image of the pelvic bone marrow is obtained. Using 270 to 280 MBq 99Tc m-Albures all 45 normal cases had values below 150 KCNT (l KCNT = 1000 counts). All cases with cirrhosis (n= 15) or metastases in the liver (n= 14) had values over 150 KCNT. Values over 150 KeNT were also found in 29 of 34 patients with an increase in ASAT and ALAT (GOT, GPT) as the only pathologic finding and in 12 of 21 patients with a carcinoma but without metastases in the liver.

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