title: Successful treatment of severe unconjugated hyperbilirubinemia via induction of UGT1A1 by rifampicin.
abstract: We report two patients with uncommon Gilbert's syndrome with severe unconjugated hyperbilirubinemia which was reduced from 200 to 60-90 micromol/L by long-term administration of rifampicin. Hepatic induction of bilirubin-glucuronosyltransferase was suggested by increased relative amounts of conjugated serum bilirubin. This molecular mechanism was confirmed in primary cultures of human hepatocytes.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, Karolinska Institutet, Karolinska University Hospital-Huddinge K63, S-141 86 Stockholm, Sweden.
authors.forename: Ewa
authors.initials: E
authors.lastname: Ellis
authors.forename: Martin
authors.initials: M
authors.lastname: Wagner
authors.forename: Frank
authors.initials: F
authors.lastname: Lammert
authors.forename: Antal
authors.initials: A
authors.lastname: Nemeth
authors.forename: Judith
authors.initials: J
authors.lastname: Gumhold
authors.forename: Christian P
authors.initials: CP
authors.lastname: Strassburg
authors.forename: Christian
authors.initials: C
authors.lastname: Kylander
authors.forename: Despina
authors.initials: D
authors.lastname: Katsika
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.forename: Curt
authors.initials: C
authors.lastname: Einarsson
authors.forename: Hanns-Ulrich
authors.initials: HU
authors.lastname: Marschall
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D002478:Cells, Cultured; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005878:Gilbert Disease / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D014453:Glucuronosyltransferase / Q000037:antagonists & inhibitors* / Q000097:blood; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D008297:Male; D012293:Rifampin / Q000627:therapeutic use*; D013997:Time Factors; D000099148:UGT1A1 Enzyme
chemical_list: D001663:Bilirubin; D004791:Enzyme Inhibitors; D014453:Glucuronosyltransferase; D012293:Rifampin; D000099148:UGT1A1 Enzyme