Volumetric, hemodynamic, and excretory characteristics of the liver in acromegaly.

Abstract

Hepatic parenchymal and biliary functions were assessed in 11 patients with clinical features of acromegaly be determination of storage capacity (S) and transfer maximum (Tm) for sulfobromophthalein (BSP). In spite of considerable clinical diversity, BSP Tm was increased in every patient, averaging 17.6 mg/min. (normal 9.6 [plus or minus] SD 1.9) in the 6 men, and 13.5 mg/min. (normal 7.2 [plus or minus] SD 1.9) in the 5 women. BSP S was within normal limits. Although "liver volume," calculated from measurements of hepatic photoscans, was augmented by approximately 50% in 5 of 7 patients, splanchnic blood flow (EHBF, dye dilution and extraction technique) and volume (regional dilution technique) remained entirely normal. This, together with increased hepatic extraction for indocyanine green (mean 79%, as compared with the normal of 63%) and oxygen suggests a relative reduction in tissue perfusion that is proportional to the increment in hepatic mass. The mechanisms responsible for the augmented excretory capacity for BSP remain obscure. Changes in enzymatic processes within parenchymal cells are considered a possible explanation.