Aminopyrine N-demethylation: a prognostic test of liver function in patients with alcoholic liver disease

To determine whether results of the aminopyrine breath test, an indirect measurement of functional hepatic microsomal mass, can be correlated with mortality and changes in clinical status and liver function, 51 hospitalized patients who had alcoholic hepatitis were studied prospectively for 3 wk. The aminopyrine breath test was performed weekly, and the results were compared with clinical features of liver disease and SGOT, SGPT, bilirubin, albumin, and prothrombin time. Only an aminopyrine breath test of > 1% of administered dose of 14C as 14CO2 correlated with 3-week survival (P = 0.0075). Only an increase of more than 100% in the aminopyrine breath test was associated with clinical improvement (P = 0.0036). For the 21 patients who had histologic confirmation of alcoholic liver disease, the aminopyrine breath test also correlated best with the degree of histologic severity. In this group of patients with alcoholic hepatitis the aminopyrine breath test predicted short-term survival, clinical improvement, and histologic severity more reliably than conventional liver function tests.