Bromsulphthalein

Abstract: Although, in suitable patients, oral chenodeoxycholic acid (CDCA) dissolves gallstones, the results of recent animal studies suggest that it might be hepatotoxic. Liver function was therefore studied in patients with gallstones before and during treatment with CDCA and liver biopsies were carried out both in patients with cholelithiasis given bile acid therapy and in those who had been given no medical treatment. In 25 patients treated with 0·5-1·5 g CDCA/day (7-20 mg kg body weight−1 day−1) there was no significant change in serum bilirubin, albumin, globulin, transaminase, isocitric dehydrogenase, alkaline phosphatase, and gamma glutamyl transpeptidase levels before and at monthly intervals during six months' treatment. The kinetics of bromsulphthalein (BSP) clearance and its apparent transport maximum were not significantly changed during CDCA therapy. The mean fasting serum bile acid concentrations of 18·0 ± SEM 1·2 μmoles/litre before and 20·0 ± 3·5 μmoles/litre during treatment were both significantly greater than control values. Liver histology was not appreciably different in 11 patients treated with CDCA from that in eight patients with untreated cholelithiasis and in three patients who had received CDCA three to four months before biopsy. These results suggest that in doses of 0·5 to 1·5 g/day CDCA is not hepatotoxic in man.

Abstract: Two patients had jaundice during treatment with oral contraceptives. One of them had a history of idiopathic jaundice of pregnancy. The laboratory data included elevated levels of serum transaminase and alkaline phosphatase, and increased sulfobromophthalein (Bromsulphthalein) retention. Optical microscopy of the livers revealed intrahepatic cholestasis and slight hepatocellular damage. Electron microscopy showed cholestasis and hepato-cellular damage. Similar cases have been reported in the literature.