RESPONSES TO THE INJECTION OF EPINEPHRINE IN HEPATIC DISEASE

Abstract

The effect of epinephrine upon the blood sugar, blood lactic acid and blood pressure was studied in 14 cases of jaundice, 6 of cancer of the pan-creas or bile ducts, 5 of cirrhosis, 3 of cholecystitis, 6 of diabetes, 14 miscellaneous cases and 6 normal sub-jects. Apparently the rise in blood sugar is less marked in liver disease, diabetes and many other pathological states than in normal subjects. The blood sugar curve after epinephrine injection is in no way characteristic of liver disease and does not appear to correspond closely to the type or degree of damage present. Blood lactic acid in the postabsorptive period is occasionally increased in hepatic disease; this is not limited to lesions of the liver, nor is it consistently related to the severity of the process or to the concentration of bilirubin in the blood. Contrary to theoretical expectations, the lactic acid curves following epinephrine are frequently lower in liver disease, diabetes and certain other pathological ? conditions than in normal individuals. It is suggested that the abnormally small response of the blood sugar and lactic acid in liver disease and certain other pathological conditions, notably diabetes, results from an inhibition of the action of epinephrine on carbohydrate metabolism. The pressor effect of epinephrine tends to be the same in normal individuals and patients suffering from liver disorder, except in cases of carcinoma of the pancreas with obstruction of the bile ducts where this effect is decreased.