Effect of corticosteroid treatment on bilirubin metabolism in chronic aggressive hepatitis

The metabolism of unconjugated bilirubin from the plasma was studied in 17 patients with chronic hepatitis and 7 normal subjects following a single injection of bilirubin of 2 mg per kg body weight. From the plasma disappearance curves of unconjugated bilirubin, hepatic uptake, reflux from the liver to the plasma and hepatic conjugation were calculated by 2 compartmental analysis. The clearance remained within normal range in 5 patients with chronic persistent hepatitis but was significantly impaired in 12 patients with chronic aggressive hepatitis, in which corticosteroid treatment improved the clearance significantly (p less than 0.01). Since urinary excretion of d-glucaric acid remained unchanged by corticosteroid treatment, the improved clearance may be attributable to increased hepatic parenchymal function.