LATENT LIVER DISEASE IN PERSONS RECOVERED FROM CATARRHAL JAUNDICE AND IN OTHERWISE NORMAL MEDICAL STUDENTS AS REVEALED BY THE BILIRUBIN EXCRETION TEST

Abstract

The frequency with which chronic nonhemolytic jaundice occurs in otherwise healthy young persons is not commonly recognized, nor is it usually appreciated how often an uncomplicated attack of catarrhal jaundice is followed by residual liver dysfunction which persists long after the acute episode. Fourteen medical students in a group of less than 200 were found to have a persistent, low-grade, non-hemolytic hyperbilirubinemia with a marked inability to excrete intravenously injected bilirubin. Several had other evidences of liver dysfunction. In a group of 16 persons, otherwise random, who were long recovered from a well studied attack of catarrhal jaundice, 10 revealed abnormal bilirubin excretion and 4 of these 10 had signs and symptoms of liver disease which prior to the test had been unexplained. Observations of 29 presumably normal persons yielded basal bilirubin values which fell within a narrow range and displayed a relatively uniform behavior in the excretion of bilirubin. The bilirubin excretion test used here consisted of the intravenous injection of 1.5 mgms. per kg of body wt. of bilirubin (Eastman Kodak) and the results were expressed in terms of % bilirubin retention 4 hrs. after inj. Analyses were done by a photo-electrometric technique using a diazo reaction.