Caloric intake and unconjugated hyperbilirubinemia.
Reduction in caloric intake was associated with a greater absolute rise in the serum bilirubin concentration in patients with Gilbert's syndrome and partial hepatic bilirubin uridine diphosphate glucuronyltransferase (UDPG-T) dysfunction compared to patients with hemolytic unconjugated hyperbilirubinemia and normal subjects. Two patients with overt hemolysis but an exaggerated response to caloric deprivation had reduced UDPG-T activities comparable to Gilbert's syndrome. The UDPG-T activities in the other patients with hemolytic jaundice were normal. The combination of fasting and novobiocin in 2 normal subjects produced a greater increase in bilirubin level than either fasting or novobiocin alone. These data suggest that theunderlying UDPG-T dysfunction, rather than the prefasting level of unconjugated hyperbilirubinemia, is responsible for the diet-induced hyperbilirubinemia in Gilbert's syndrome. The diet test appears to differentiate Gilbert's syndrome from hemolytic jaundice as well as from normal subjects, irrespective of the initial serum bilirubin concentration.
D000743:Anemia, Hemolytic / Q000097:blood; D004032:Diet; D005215:Fasting; D005878:Gilbert Disease / Q000097:blood* / Q000201:enzymology; D014453:Glucuronosyltransferase / Q000172:deficiency / Q000378:metabolism; D006461:Hemolysis; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood*; D006933:Hyperbilirubinemia, Hereditary / Q000097:blood*; D008099:Liver / Q000378:metabolism; D009675:Novobiocin
D009675:Novobiocin; D014453:Glucuronosyltransferase