Studies of Sulfobromophthalein Sodium (BSP) Metabolism in Man. I. In Normal Subjects and Patients with Hepatic Disease*

Abstract

Sulfobromophthalein sodium transport and metabolism have been studied in 33 persons with hepatic disorders and 19 without such disorders. Single injections and continuous infusions of BSP were administered intravenously, and measurements reflecting hepatic uptake, relative storage capacity, conjugation, and maximal biliary excretion of BSP were obtained. Hepatic uptake, relative storage capacity, and maximal biliary excretion of BSP are diminished in most hepatobiliary diseases whether primarily hepatocellular or obstructive. This finding supports the impression that disturbances of function at the cellular and subcellular levels occur following extrahepatic bile-duct obstruction. Determination of retained BSP and BSP conjugates at both 60 and 120 minutes after a single injection of the dye may be helpful in differentiating cirrhosis from obstructive jaundice. In patients with cirrhosis, BSP retention declined more sharply between the first and second hours after injection than in patients with obstructive jaundice. The percentage of serum BSP present in conjugated from 1 hour after injection was significantly less in patients with cirrhosis than in those with obstruction. In these 2 groups of patients, the percentage of conjugated BSP in the serum at 120 minutes was approximately equal. The appearance of conjugated BSP in the serum during continuous infusion of the dye is related to time as well as to the nature of the patho-physiologic process.