Hypersideremic and hyperbilirubinemic effect of nicotinic acid in patients with Gilbert's syndrome.
Nicotinic acid test (NA) administration is followed by a rise in unconjugated bilirubin and serum total iron in healthy man. A similar concomitant effect has never been investigated in Gilbert's syndrome (GS) patients, who by definition have a hyperbilirubinemia higher than that of controls. The aim of this study was to verify whether, in addition to the hyperbilirubinemic action, NA could induce parallel hypersideremia in GS subjects. The data we obtained confirm in GS patients: 1. the well-known hyperbilirubinemia; 2. a delayed NA plasma concentration curve, and document that in GS the hypersideremic effect is comparable to that of controls. Previous investigators reported that NA produces an equimolar rise of bilirubin and iron levels in healthy man. In our study the extent of the sideremic response to NA occurring in GS patients is comparable to that seen in controls, and appears unrelated to the bilirubinemic values. If the NA effects are based on the documented hemolytic properties of NA, a disturbance in bilirubin handling by the liver of GS subjects appears to be plausible in the presence of almost normal behavior of NA-induced hypersideremia.
Gentile
S
S
Istituto di Medicina Generale e Metodologia Clinica, 1st Medical School of Naples, Italy.
Gentile
F
F
D000293:Adolescent; D000328:Adult; D005878:Gilbert Disease / Q000097:blood*; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced*; D006933:Hyperbilirubinemia, Hereditary / Q000097:blood*; D007501:Iron / Q000097:blood*; D008297:Male; D009525:Niacin / Q000097:blood / Q000494:pharmacology*
D009525:Niacin; D007501:Iron