EFFECT OF HEPATIC DYSFUNCTION ON CIRCULATING LEVELS OF SULFOBROMOPHTHALEIN AND ITS METABOLITES *

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Abstract
The levels of free and conjugated sulfobromophthalein (BSP) were determined in sera and urine from normal subjects and patients with hepatic dysfunction. The results showed that normal subjects conjugate and secrete BSP rapidly; only trace amounts of BSP and BSP metabolites are present in the serum 45 minutes after intravenous injection of a standard dose of the dye. Patients with viral hepatitis and cirrhosis conjugate BSP poorly and retain large amounts of unconjugated dye. Patients with impaired liver function caused by methyltestosterone and extrahepatic biliary obstruction conjugate the dye and accumulate large amounts in the serum. This accumulation was noted before changes in serum bilirubin, alkaline phosphatase and glutamic oxalacetic transaminase were evident. The measurement of the BSP metabolites appears sensitive for differentiating liver defects in uptake and conjugation from those affecting intracellular or extracellular obstruction. Urinary BSP was mainly in the conjugated form. The percentages of conjugated dye in the urine of each group of subjects were not remarkably different and could not serve to differentiate the various disease states from the normal.