The presence of jaundice in a patient is a distinct concern to the clinician. He is confronted at the outset with its medical or surgical implications. For the differentiation of this jaundice, a number of clinical and laboratory methods are available; of these, the cholesterol ester fraction has been of particular interest to us.
In a discussion of the subject, Sidney A. Portis,1 on the basis of his clinical observations, remarked that in obstructive jaundice the cholesterol esters are often diminished before any other liver function tests give abnormal results. A review of the literature revealed a number of contradictory statements on this matter.
The significance of a low cholesterol ester ratio of the serum in cases of parenchymatous jaundice has been well established.2 It has been generally agreed that the liver cell esterifies cholesterol and that injury to the liver cell or decrease of its function interferes
King JC, Taubenhaus M. VALUE OF CHOLESTEROL ESTERS IN DIFFERENTIAL DIAGNOSIS OF JAUNDICE. JAMA. 1951;146(14):1298-1301. doi:10.1001/jama.1951.03670140024007