Postprandial serum cholylglycine in the detection of hepatotoxicity induced by antituberculous agents

Abstract

Background: Measurement of bile acid levels has been proven helpful in the detection of hepatic abnormalities when routine liver function test results are normal or only slightly elevated. We compared the effectiveness of postprandial serum cholylglycine (CG), as determined by RIA, with commonly used liver function tests (SGOT, SGPT, alkaline phosphatase, gamma-glutamyl transpeptidase) in order to detect liver injury in patients receiving antituberculous agents. Method: We studied 100 patients receiving antituberculous agents. Laboratory tests were carried out before the initiation of therapy and after 1, 2, 3 and 8 weeks of treatment. The risk of hepatotoxicity in relation to age (>35 years) and/or the addition of pyrazinamide to the 6-month isoniazid–rifampin regimen was also assessed. Results: The percentage of patients with hepatic dysfunction detected by abnormal serum CG levels was significantly greater than that detected with conventional liver function tests. Neither age over 35 years nor the use of pyrazinamide was associated with a greater number of abnormalities in liver function tests. Conclusion: Postprandial serum CG by RIA proved to be a sensitive parameter for detecting hepatotoxicity by antituberculous agents.