Comparison of the cephalin-cholesterol flocculation test with various criteria of liver function
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The results of the cephahn-cholesterol flocculation test in 100 patients with clinical evidence of mild and moderate grades of liver disease are compared with the bromsulphthalein and hippuric acid tests, serum albumin and globulin fractions, prothrombin time, icterus index and serum cholesterol partition.
The cephalin-cholesterol flocculation test gave by far the best correlation with the clinical observations, and was positive in 98 of the 100 patients. In 10 patients the flocculation test was positive when all the other tests or combinations of tests were negative. Analysis of our results indicates that the flocculation test is an index of active parenchymal damage, rather than a measure of residual function. The interpretation of negative and slight flocculation reactions is discussed in the light of these observations.
Bromsulphthalein retention was found in 68 per cent of the cases; decreased hippuric acid excretion in 25 per cent; hyperexcretion of hippuric acid in 39 per cent; hypoalbuminemia in 47 per cent; decreased prothrombin in 37 per cent; elevated icterus index in 34 per cent; and decreased cholesterol esters in 20 per cent.
The many instances of hyperexcretion of hippuric acid observed in our cases of mild to moderate forms of liver disease indicate that this is not a normal phenomenon. It may be regarded as a manifestation of the hyperirritability of the liver, which is the earliest accompaniment of liver damage.
KeywordsLiver Disease Obstructive Jaundice Pernicious Anemia Hippuric Acid Icterus Index
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