A shortened, 2-hour rifampin test: a useful tool in Gilbert's syndrome.
BACKGROUND
Diagnosis of Gilbert's disease often involves unnecessary testing and patient anxiety. Rifampin test can support the diagnosis; it has been described in short series and lacks standardization in dose, collection times, result presentation and interpretation. Our objective was to compare the response to oral rifampin in a series of patients with Gilbert's disease, 2 and 4 h after drug administration.


METHODS
Eighty-nine patients with Gilbert's disease (elevated total bilirubin with no hepatopathy or hemolysis) were recruited. After a basal blood collection, 900 mg rifampin were administered per os and new samples were drawn 2 and 4 h later. Total and esterified bilirubin were measured in every sample. Haptoglobin concentration was also analyzed.


RESULTS
When expressed as relative increase with respect to basal values, variations observed 2 h after rifampin intake were all above 15%. A significant correlation (r = 0.902; p = 0.000) was found between relative increases 2 and 4 h after drug administration. No significant variations were found in haptoglobin concentrations.


CONCLUSIONS
Rifampin test is useful in diagnosing Gilbert's disease, but variations in total bilirubin concentrations (basal and post-rifampin) make that no absolute cut-off value can be used. Correlation between 2- and 4-h relative increases suggests that a shortened version could simplify the test.
Hallal
H
H
Digestive Diseases Section, Hospital General Universitario Morales Meseguer, Murcia, Spain. hassib@ono.com
Egea
J M
JM
Mas
P
P
García
M D
MD
Pérez-Cuadrado
E
E
Carballo
F
F
D000328:Adult; D001663:Bilirubin / Q000097:blood; D004791:Enzyme Inhibitors; D005878:Gilbert Disease / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D012293:Rifampin
D004791:Enzyme Inhibitors; D001663:Bilirubin; D012293:Rifampin