Sixteen patients with typical signs and symptoms of anorexia nervosa were studied with measurement of serum thyroxine (T4), triiodothyronine (T3) and thyrotropin (TSH), both baseline and stimulated by thyrotropin-releasing hormone (TRH). The results of the patients were compared with those of 16 normal control subjects. Serum T4 (5.8 plus or minus 0.26 mug/100 ml, mean plus or minus SE) and T3 (82 plus or minus 5.7 ng/100 ml) of patients with anorexia nervosa were significantly (P less than 0.001) lower than those of control subjects (T4 7.7 plus or minus 0.32 mug/100 ml and T3 158 plus or minus 4.7 ng/100 ml respectively). Furthermore, the ratio of T3/T4 (1.48 plus or minus 0.243 x 10(-2)) in anorexia nervosa was also lower than that of control subjects (2.21 plus or minus 0.093 x 10(-2)) (P less than 0.001). Basal serum TSH was within normal or below the limits of detection. TSH and T3 rose after administration of TRH. The peak values of TSH were observed after 60 to 12o min, instead of 30 min normally seen after TRH injection.

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KAZUNOBU ISHIBASHI, TORU KASHIWAGI, AKIHIKO ITO, YOSHIO TANAKA, MASAFUMI NAGASAWA, TAKASHI TOYAMA, SHINITI OZAKI, MASAFUMI NAITO, AND MASAYOSHI AZUMA the changes in serum levels of hepatic fibrogenesis markers We serially measured the levels of serum N-terminal caused by interferon therapy for chronic hepatitis. 9,10peptide of type III procollagen (PIIINP), the 7S domain In this study, the serum levels of PIIINP, IV-7S, and HA of type IV collagen (IV-7S), and hyaluronate (HA) before were determined before, during, and after interferon therapy (0 month), at the end (6 months), and 24 weeks after the in chronic hepatitis type C, and the relationship between the end of interferon therapy (12 months) in patients with levels of these markers and the effectiveness of interferon chronic hepatitis type C to estimate the effects of intertherapy was investigated. feron alfa (IFN-a) divided into three groups: sustained complete response 21-67 years) who had persistently elevated ALT levels (more than (CR-S), complete response with rebound (CR-R), and 1.5 times the normal upper limit; the normal levels of ALT range nonresponse (NR). Serum PIIINP, IV-7S, and HA levels between 8 and 35 IU/L) for at least 6 months. The mean ALT level were significantly decreased and reached normal levels at initiation of IFN-a therapy was 115.2 { 77.6 IU/L (mean { SD). at 12 months in CR-S; only IV-7S levels were significantly All patients were positive for HCV RNA (assayed by RT-PCR using primers derived from the 5-untranslated region) and anti-HCV (asdecreased at 12 months in CR-R, whereas these levels sayed by Abbott HCV-EIA second-generation kit, Abbott Laboraremained abnormally high in the NR. These results sugtories, North Chicago, IL) in serum. The route of HCV infection in-

The "2 by 2" standard of Hb decline can be used to identify patients likely to develop severe anemia. The early reduction of ribavirin can help prevent progression to severe anemia, thus allowing ribavirin therapy to be completed even in older patients.