Metabolism of the bromsulphalein in Dubin-Johnson syndrome. Diagnostic value of the paradoxical increase in plasma levels at BSP.

Abstract

The appearance of a late rise in the plasma level of Bromsulphalein ® (BSP) in the clearance of this dye has been considered as a pathognomonic sign of Dubin-Johnson syndrome. Three cases of obstructive extrahepatic jaundice, 1 of primary hepatic amyloidosis and 1 of hypernephroma with hepatic metastases showed the same biologic feature as 4 cases of Dubin-Johnson syndrome. Analysis of the plasma dye disappearance curves brought out important differences between these diseases and Dubin-Johnson syndrome. Nevertheless, liver biopsy is still considered essential to confirm the diagnosis.