PETER V. D. BARRETT, M.D.; PAUL D. BERK, M.D.; MATTHEW MENKEN, M.D.; NATHANIEL I. BERLIN, M.D.
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Bilirubin-14C in tracer quantities was administered to 26 patients in 29 studies to determine the plasma bilirubin-14C specific activity disappearance rates. Unconjugated bilirubin was separated from the conjugated pigments by a solvent method. The plasma disappearance curve was found to take the form of the sum of two exponentials, the more rapid of which had an average half-life of 21.5 min. A multicompartmental model of bilirubin metabolism is proposed on the basis of the data, and calculations of bilirubin production and intercompartmental rate constants are made. A mechanism is postulated to explain the hyperbilirubinemia of Gilbert's disease. Eight patients were studied with a nonradioactive bilirubin infusion test, and the results were compared with the isotope studies. It is concluded that the bilirubin-14C method provided a more accurate evaluation of bilirubin production and of hepatic excretion patterns.
BARRETT PVD, BERK PD, MENKEN M, et al. Bilirubin Turnover Studies in Normal and Pathologic States Using Bilirubin-14C. Ann Intern Med. 1968;68:355–377. doi: https://doi.org/10.7326/0003-4819-68-2-355
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Published: Ann Intern Med. 1968;68(2):355-377.
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