Successful treatment of severe unconjugated hyperbilirubinemia via induction of UGT1A1 by rifampicin.
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.
Ellis
Ewa
E
Department of Medicine, Division of Gastroenterology and Hepatology, Karolinska Institutet, Karolinska University Hospital-Huddinge K63, S-141 86 Stockholm, Sweden.
Wagner
Martin
M
Lammert
Frank
F
Nemeth
Antal
A
Gumhold
Judith
J
Strassburg
Christian P
CP
Kylander
Christian
C
Katsika
Despina
D
Trauner
Michael
M
Einarsson
Curt
C
Marschall
Hanns-Ulrich
HU
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
D001663:Bilirubin; D004791:Enzyme Inhibitors; D014453:Glucuronosyltransferase; D012293:Rifampin; D000099148:UGT1A1 Enzyme