The clinical efficacy of a short course of steroid therapy in differentiating the etiology of jaundice was determined. Also, observations were made on the mechanism of action of steroids on bilirubin metabolism. A standard five-day course of prednisone, 60 mg daily, was given to 33 patients. The final diagnosis was established by biopsy, laparotomy, or autopsy. Clinically, the response to this course of steroids clearly separated extrahepatic jaundice due to malignancy from intrahepatic jaundice of viral inflammatory origin. In viral hepatitis, the suggested mechanism of action of steroids appears to be enhanced clearing of conjugated bilirubin from the serum.
Wruble LD, Kalser MH, Jones RH, Vloedman D, Bachorik P. JaundiceValue of Five-Day Steroid Test in Differential Diagnosis. JAMA. 1966;195(3):184–188. doi:10.1001/jama.1966.03100030078018
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