URINARY 17-KETOSTEROIDS IN BILHARZIAL CIRRHOSIS OF THE LIVER

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Abstract
In bilharzial cirrhosis of the liver, which is known to differ pathologically from other forms of hepatic cirrhosis, a study of 35 patients (28 males and 7 females) showed that the urinary excretion of 17-ketosteroids was distinctly below normal levels. The diminution was proportional to the severity of the disease. Observations on the effect of injection of 100 mg. of testosterone propionate indicated that the lowered excretion of 17-ketosteroids in this disease is due to a hepatic defect, as the diseased liver failed to metabolize the exogenous androgen. Although other factors, including hypopituitarism and hypo-gonadism, are cliamed to participate in this diminution, the results of the present study leave no doubt that these factors are subsidiary and that the main cause is the diseased liver itself. The reduction in urinary 17-ketosteroids may become evident early in the disease before other liver function tests show any impairment. This determination, therefore, is a sensitive and important liver function test.

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