This paper is only available as a PDF. To read, Please Download here.
Abstract
Estriol metabolism was studied in 23 patients with pruritus gravidarum and eight patients
with recurrent jaundice of pregnancy by determining the urinary excretion of the four
known estriol conjugates. Comparison of the results with those obtained in normal
pregnant women revealed marked changes in estriol metabolism in the two cholestatic
conditions. These include a decrease in the urinary excretion of estriol-3-glucuronide
and an increase in the proportions of urinary estriol-3-sulfate, 16-glucuronide and
estriol-3-sulfate. These changes are considered to be secondary to the cholestasis
and are mostly due to impaired enterohepatic circulation of estrogens. The results
are thus consistent with the view that although pruritus gravidarum and recurrent
jaundice of pregnancy are not caused by a primary abnormality of estrogen metabolism,
they probably represent an abnormal reaction of the liver to the elevated estrogen
levels produced in pregnancy in susceptible women.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Jaundice in late pregnancy.Acta Obstet Gynec Scand. 1964; 5 (supp): 1
- A study of recurrent jaundice in pregnancy.Acta Obstet Gynec Scand. 1954; 33: 434
- Jaundice in pregnancy. A clinical study.Acta Med Scand. 1955; 151 (supp): 302
- Recurrent jaundice of pregnancy. A clinical study of twenty-two cases.Amer J Med. 1959; 27: 40
- Recurrent intrahepatic cholestasis of pregnancy. Report of six cases and review of the literature.Medicine (Balt). 1967; 46: 299
- Some aspects of the interaction between natural and synthetic female sex hormones and the liver.Amer J Med. 1970; 49: 630
- Alterations in sulphobromophtalein sodium-removal mechanisms from blood during normal pregnancy.J Clin Invest. 1963; 42: 1431
- An assessment of changes in liver function during normal pregnancy using a modified bromsulphthalein test.J Obstet Gynaec Brit Comm. 1965; 72: 717
- Oral contraceptives and liver damage.Brit Med J. 1964; 2: 1133
- Recurrent cholestatic jaundice of pregnancy with demonstrated estrogen sensitivity.Amer J Med. 1967; 43: 795
- Estrogen pharmacology. I. The influence of estradiol and estriol on hepatic disposal of sulfobromophtalein (BSP) in man.J Clin Invest. 1964; 43: 1905
- Estrogen pharmacology. IV. Studies on the structural basis for estrogen-induced impairment of liver function.Medicine (Balt). 1966; 45: 471
- Recurrent jaundice in pregnancy. II. A study of estrogens and their conjugation in late pregnancy.Amer J Med. 1967; 42: 341
- Biochemical and clinical aspects of the enterohepatic circulation of oestrogens.Acta Endocr (Kobenhavn). 1967; 124 (supp): 101
- Oestrogen metabolism in liver disease.J Endocr. 1970; 46: 129
- A method for the quantitative determination of urinary estriol conjugates in human pregnancy.J Ster Biochem. 1972; 3: 807
- Biogenese von Östriol-16α-monoglucuronid und Östriol-17β-monoglucuronid.Acta Endocr. 1966; 52: 43
- Enzymatische Untersuchungen über die Glucuronidierung von Östriol beim Menschen.Z Klin Chem. 1966; 4: 153
- Studies on phenolic steroids in human subjects: VI. Biosynthesis of estriolglucosiduronic acid-16-14C by human liver.J Clin Endocr. 1964; 24: 638
- Characterization of estriolglucosiduronic acid formed in vitro by human liver.Steroids. 1969; 13: 559
- Comparison of the conjugated metabolites of intravenously and intraduodenally administered oestriol.Acta Endocr. 1968; 57: 657
- Reinvestigation of the metabolism of estriol-16-glucosiduronate in subjects with biliary T-tube drainage.J Clin Endocr. 1971; 32: 819
- Biliary and urinary metabolites of estriol-15-3H-3-sulfate-35S in women.J Clin Endocr. 1967; 27: 539
- Enterohepatic metabolism of estriol-3-sulfate-16-glucosiduronate in women.J Clin Endocr. 1968; 28: 862
- Estriol-3-glucosiduronate, a major urinary metabolite of oestriol and oestriol-16(17?)-glucosiduronate.Acta Endocr. 1965; 50: 261
- Comparison of the metabolism of oestriol-3-glucosiduronate and oestriol-16-glucosiduronate in pregnant women.Acta Endocr. 1966; 52: 30
- Metabolism of estrone-16-C14 sulfate in women.Amer J Obstet Gynec. 1960; 80: 889
- Studies on oestrogen excretion in human bile.Acta Endocr (Kobenhavn). 1962; 72 (supp): 1
- Studies on conjugated monoand dihydroxy metabolites of progesterone in plasma, bile and urine in a human subject.Bull Schweiz Acad Med Wiss. 1969; 25: 328
- The metabolism of small and of large amounts of progesterone in man.Acta Endocr (Kobenhavn). 1969; 60: 221
- Urinary excretion of estriol conjugates in normal pregnancy.J Ster Biochem. 1973; 4: 57
- Identification and determination of oestrogens in various biological materials in pregnancy.Ann Clin Res. 1970; 2: 365
- Changes in the urinary estriol conjugate pattern in twin pregnancy.J Endocr. 1972; 55: 223
- Studies on phenolic steroids in human subjects. VIII. Metabolism of estriol-16α-glucosiduronate.J Clin Invest. 1969; 48: 380
- Studies on phenolic steroids in human subjects. IX. Role of the intestine in the conjugation of estriol.J Clin Invest. 1969; 48: 390
- Estriol conjugates in amniotic fluid at term.Scand J Clin Lab Invest. 1972; 122 (supp): 45
- Gas-chromatographic studies on oestrogens in the bile of pregnant women.Biochim Biophys Acta. 1965; 97: 134
Adlercreutz H, Tikkanen MJ: Defects in hepatic uptake and transport and biliary excretion of oestrogens; some new concepts of liver metabolism. Méd Chir Dig (in press).
Article info
Publication history
Accepted:
December 5,
1972
Footnotes
☆This study was aided by grants from the Nordisk Insulinfond, Denmark, and the Sigrid Jusélius Foundation, Finland.
Identification
Copyright
© 1973 Published by Elsevier Inc.
