Antipyrine Kinetics in Patients with Primary Biliary Cirrhosis

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Abstract
Fourteen antimitochrodrial antibody‐positive patients (13 women, 1 man) with biopsy‐proven primary biliary cirrhosis, aged 40 to 71 years (mean, 57 years) weighing 43 to 102 kg (mean, 63 kg), along with 14 age‐ and sex‐matched healthy controls, received a single 1.0‐ to 1.2‐g dose of intravenous antipyrine. Plasma antipyrine levels were determined during a 12‐ to 24‐hour period. Patients' mean serum chemistry values were: albumin, 3.9 g/dL (range, 3.1–4.4) and total bilirubin, 1.9 mg/dL (range, 0.3–10.9). Seven of the fourteen patients had cirrhosis. Mean kinetic variables for antipyrine in controls and primary biliary cirrhosis patients were: Vd, .54 versus .49 L/kg; half‐life, 12.0 versus 15.1 hours (P < .07); clearance, .55 versus .41 mL/min/kg (P < .04). Within the primary biliary cirrhosis group, there was no correlation between total bilirubin and clearance (r = .09), nor did clearance vary significantly among histologic categories. Clearance of antipyrine in primary biliary cirrhosis patients is reduced by an average of 25%, but the clinical prognosticators of serum bilirubin levels and histologic grade do not correlate with or predict the degree of clearance impairment.