Clinical feminization and serum testosterone levels in male patients with chronic African endomyocardial fibrosis.

Thirteen out of 19 male patients aged sixteen years and above who had clinically diagnosed chronic African endomyocardial fibrosis (E.M.F.) had some clinical evidence of feminization. Serum was obtained from ten patients and assayed together with serum of ten age- and sex-matched normal controls for testosterone. The serum testosterone level in the 10 E.M.F. patients was uniformly below the lowest normal level, and the mean serum level for E.M.F. was significantly lower than the mean for the controls. Persistent and severe hepatic congestion in E.M.F. may lead to feminization long before cardiac cirrhosis occurs.