Endocrine changes associated with Laennec's cirrhosis of the liver

Abstract 

A study has been made of endocrine functions in seventy-one patients with cirrhosis of the liver. These patients were graded I, II, and III according to the severity of their liver disease.

Fifty-five of the subjects were males and sixteen were females. Clinical endocrine changes observed in the male subjects consisted of decreased libido and potency, atrophy of the testicles, decreased body hair and gynecomastia. Telangiectasia and “liver palms” were also regarded as possibly being related to altered endocrine function.

Decrease in libido and potentia were found in thirty-seven of fifty-two (71 per cent) of the male subjects who could be questioned satisfactorily.

Decreased axillary hair was present in forty-six of the fifty-five male patients (84 per cent). Forty of the forty-six individuals with severe cirrhosis (87 per cent) had a decrease in axillary hair. The greatest decrease of body hair was found in this group.

Testicular atrophy was present in thirty-six of fifty patients (70 per cent) in whom the size of the testes was measured. Seventy-five per cent of the severe cases had atrophy of the testicles.

Gynecomastia was present in twenty-three of fifty-five patients (42 per cent).

Following injection of testosterone propionate intramuscularly, four male subjects had no increase in the quantity of 17-ketosteroid substances in the urine but two had significant increase in the total excretion of androgens.

In three male patients in whom the urinary gonadotrophin excretion was assayed no increased excretion was formed.

In the females there were alterations in menstrual pattern, sexual drive, body hair, the uterus and in other target organs of estrogen including the breast.

Seven of eight female subjects who were in the reproductive age had menstrual abnormalities. Four of these patients had amenorrhea or infrequent bleeding. There was a decrease of axillary hair, atrophy of the breasts in five of these seven patients and chronic cystic mastitis in one.

In almost all of eighty-seven patients with Laennec's cirrhosis with postmortem examinations at the Mallory Institute of Pathology there was a decrease in lipoid content of the adrenals and in eight of twenty-three patients there was atrophy of the testes.

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