Tests of “Hepatic Function” in Portal Cirrhosis

Abstract

Summary Hepatic function was measured in 50 patients with portal cirrhosis of the liver. Twenty healthy persons were studied similarly as a control group. The cases of portal cirrhosis were classified arbitrarily into three groups on the basis of clinical severity: I) 14 patients without symptoms, latent cirrhosis; II) 23 with moderate clinical symptoms of hepatic failure; and III) 13 individuals severely ill and deeply jaundiced. Marked differences were found corresponding, in general, with the clinical severity of illness. In the group without symptoms attributable to the liver per se, parenchymal function was not significantly changed when compared with the normal group, whereas markedly abnormal and significant deviations were encountered in severely ill patients with hepatic failure and deep jaundice. Hepatic function was studied at intervals in 32 patients with symptoms of portal cirrhosis treated medically for periods less than four months to two and a half years. Pronounced improvement in hepatic function was noted in all patients who continued under medical treatment for longer than four months. The serum bilirubin, the cholesterol cholesterol-ester ratio, the total plasma proteins, the plasma albumin, the urinary urobilinogen and the elimination of hippuric acid roughly paralleled the clinical course. The bromsulfalein excretion test remained abnormal longer than other tests of hepatic function and abnormal values were obtained in 7 of 15 patients so studied. The variations in cephalin cholesterol flocculation, thymol turbidity and alkaline phosphatase did not parallel the clinical course.