MECHANISM AND SIGNIFICANCE OF THE THYMOL TURBIDITY TEST FOR LIVER DISEASE

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Abstract
The turbidity produced by the thymol reagent of Maclagan in the serum of patients with infectious hepatitis is shown to depend on the presence both of lipids and of abnormal lipid protein complexes migrating in the [beta]-globulin fraction of the serum. The [gamma]-globulin fraction of serum also plays an important role in the reaction. The relative importance of the different components in the reaction varies with different sera. Development of the turbidity is prevented if the lipids are kept in soln. by the addition of a tween or are extracted with ether, or if the [gamma]-globulin is removed. In lipemic sera, the thymol reagent causes a non-specific increase in the turbidity due to increase in particle size of the lipid globules. Correction for this effect can be made by using a photometric blank prepared from serum and a thymol reagent containing such a high buffer conc. that precipitation of the globulin component is prevented. Immunologic studies did not reveal evidence that the protein concerned in the reaction was abnormal. A possible similarity between the mechanism of the thymol turbidity and cephalin flocculation reactions was discussed. In patients with acute infectious hepatitis, values for the thymol turbidity test were found to parallel alterations in serum lipids initially and alterations in [gamma]-globulin during late convalescence.