Bromsulfophthalein clearance and aminopyrine test in patients with Gilbert's syndrome

Bromsulfophthalein (BSP) clearance and aminopyrine breath tests were performed in 13 patients with Gilbert's syndrome (GS) and six healthy volunteers. The BSP clearance was significantly lower in the GS patients (1.28 +/- 0.37 dl/min) than in the healthy volunteers (1.98 +/- 0.45 dl/min). The difference in clearance was not due to a significant difference in volume of distribution. The 13 patients with Gilbert's syndrome could be divided into three groups according to their BSP disappearance curves: in 7 the curves were normal; another 3 patients the disappearance rate of BSP was normal at the beginning, but became abnormally low later on; and in the last 3 patients, an abnormal BSP disappearance rate was observed during the whole experiment. Kinetic analysis of these BSP disappearance curves indicated increased regurgitation of BSP from the liver to the blood in the second group and defective hepatic BSP uptake in the third group. The aminopyrine breath test also demonstrated heterogeneity among the GS patients. There was no correlation between the impaired BSP clearance and the aminopyrine breath test.