ADRENAL CORTEX IN LIVER DISEASE

Abstract

A group of 9 patients (cirrhosis, 4; homologous serum jaundice, 1; chronic active infectious hepatitis, 1; chronic hepatitis with "pseudo-colic", 1; arsenical hepatitis, 2) was treated with aqueous and oil extracts of adrenal cortex. All were rapidly going downhill despite usual therapy. All recovered promptly and laboratory tests reverted to normal. Reexamination after a year revealed no evidence of liver dysfunction. There was evidently: (1) psychic stimulation; (2) alteration of the carbohydrate-protein metabolism with glyconeogenesis from protein, deposition of liver glycogen, possible formation in the liver of [alpha]2-globin (hypertensinogen), changes in blood and sugar levels; and (3) Na and fluid retention with K excretion and changes in body hair and pigment. Of 3 patients with hyperglycemia, 1 had a Cushing-like syndrome with possible permanent diabetes; 2 patients had hypertension, 2 had unexplained precordial distress, and all had latent edema. There was remission of complicating ulcerative colitis in 1 case. The further use of the drug in colitis and the sprue syndrome is being investigated. Care must be used in admn. of adrenal cortex extracts. Unlike the reported experience with ACTH and cortisone, extract of adrenal cortex may be discontinued when recovery is noted. It is believed that this is evidence of a true physiologic effect, possibly in balancing an adaptive homeostatic regulating mechanism or in the actual regeneration and repair of damaged liver cells.