Breath14CO2 after intravenous administration of [14C]aminopyrine in liver diseases

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Abstract
The determination of14CO2 in breath after oral administration of [14C]aminopyrine has been proposed as a quantitative liver function test. In order to shorten the procedure and avoid misinterpretations related to variable rates of intestinal absorption, the [14C]aminopyrine breath test (ABT) was performed after intravenous administration of [14C]aminopyrine in 21 controls and 89 patients with biopsy-proven liver disease. The specific activity of the first hour sample corrected for body weight (SA1) was the most discriminant expression of breath data. The SA1 value, expressed as the percentage of the administered dose, was 0.86±0.1% (mean±sd) in controls and significantly less in patients (0.46 ±0.31%). Low values were observed in patients with untreated chronic active hepatitis (0.16±0.13%), alcoholic cirrhosis (0.2±0.15%), and untreated postnecrotic cirrhosis (0.47±0.17%). In contrast, normal values were obtained in chronic persistent hepatitis (0.86±0.13%) and 58% of noncirrhotic alcoholic liver diseases (0.83±0.27%). The results of duplicate studies were reproducible and SA1 correlated with other conventional liver function tests, including 45-min BSP retention. Among these, ABT was the most sensitive screening test for the presence of cirrhosis, especially in alcoholic patients, where it allowed a sharp distinction between cirrhotic and noncirrhotic cases. The results obtained in chronic hepatitis suggested that ABT may provide a reliable index of the activity of the disease. In our hands, intravenous ABT, performed over a 1-hr period, was a fast, sensitive, and discriminant liver function test.