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. 1978 Jan;19(1):40–45. doi: 10.1136/gut.19.1.40

Assessment of the (14C) aminopyrine breath test in liver disease.

J Galizzi, R G Long, B H Billing, S Sherlock
PMCID: PMC1411775  PMID: 624504

Abstract

Different methods of performing the (14C) aminopyrine breath test have been assessed. A tracer dose of 2 muCi without a loading dose and with a single breath collection at two hours was the method selected, since it gave the best discrimination between patients with hepatocellular diseases and normal subjects (5.2 +/- 0.2%, mean +/- SEM). Reduced values occurred in patients with chronic active hepatitis (with and without cirrhosis) (1.5 +/- 0.2%), alcoholic cirrhosis (1.7 +/- 0.4%) and hepatitis (2.5 +/- 0.3%), and late primary biliary cirrhosis suggesting defective microsomal function with respect to demethylation. Normal results were common in early primary biliary cirrhosis. Two weeks of prednisolone therapy caused some improvement in the breath test in nine of 10 patients with chronic active hepatitis. It is concluded that the (14C) aminopyrine breath test is a simple test for detecting hepatocellular dysfunction, but has no obvious diagnostic advantage over the determination of serum aspartate transaminase and two hour post-prandial bile-acids.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRODIE B. B., AXELROD J. The fate of aminopyrine (pyramidon) in man and methods for the estimation of aminopyrine and its metabolites in biological material. J Pharmacol Exp Ther. 1950 Jun;99(2):171–184. [PubMed] [Google Scholar]
  2. Barnes S., Gallo G. A., Trash D. B., Morris J. S. Diagnositic value of serum bile acid estimations in liver disease. J Clin Pathol. 1975 Jun;28(6):506–509. doi: 10.1136/jcp.28.6.506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bircher J., Küpfer A., Gikalov I., Preisig R. Aminopyrine demethylation measured by breath analysis in cirrhosis. Clin Pharmacol Ther. 1976 Oct;20(4):484–492. doi: 10.1002/cpt1976204484. [DOI] [PubMed] [Google Scholar]
  4. Gelehrter T. D. Mechanisms of hormonal induction of enzymes. Metabolism. 1973 Jan;22(1):85–100. doi: 10.1016/0026-0495(73)90033-4. [DOI] [PubMed] [Google Scholar]
  5. Hepner G. W., Vesell E. S. Assessment of aminopyrine metabolism in man by breath analysis after oral administration of 14C-aminopyrine. Effects of phenobarbital, disulfiram and portal cirrhosis. N Engl J Med. 1974 Dec 26;291(26):1384–1388. doi: 10.1056/NEJM197412262912605. [DOI] [PubMed] [Google Scholar]
  6. Hepner G. W., Vesell E. S. Quantitative assessment of hepatic function by breath analysis after oral administration of (14C)aminopyrine. Ann Intern Med. 1975 Nov;83(5):632–638. doi: 10.7326/0003-4819-83-5-632. [DOI] [PubMed] [Google Scholar]
  7. Lauterburg B. H., Bircher J. Expiratory measurement of maximal amino-pyrine demethylation in vivo: effect of phenobarbital, partial hepatectomy, protacaval shunt and bile duct ligation in the rat. J Pharmacol Exp Ther. 1976 Feb;196(2):501–509. [PubMed] [Google Scholar]
  8. Levi A. J., Sherlock S., Walker D. Phenylbutazone and isoniazid metabolism in patients with liver disease in relation to previous drug therapy. Lancet. 1968 Jun 15;1(7555):1275–1279. doi: 10.1016/s0140-6736(68)92292-7. [DOI] [PubMed] [Google Scholar]
  9. Palva I. P., Mustala O. O. Drug-induced agranulocytosis, with special reference to aminophenazone. I. Adults. Acta Med Scand. 1970 Jan-Feb;187(1-2):109–115. doi: 10.1111/j.0954-6820.1970.tb02916.x. [DOI] [PubMed] [Google Scholar]
  10. Palva I. P., Mustala O. O. Drug-induced agranulocytosis. II. The role of medication in a food outcome. Acta Med Scand. 1972 Jan-Feb;191(1-2):121–124. [PubMed] [Google Scholar]
  11. Rikkers L., Sherlock S. Influence of azathioprine on hepatic reserve in chronic active liver disease. Gut. 1975 Mar;16(3):214–219. doi: 10.1136/gut.16.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Schalm S. W., Summerskill W. H., Gitnick G. L., Elveback L. R. Contrasting features and responses to treatment of severe chronic active liver disease with and without hepatitis BS antigen. Gut. 1976 Oct;17(10):781–786. doi: 10.1136/gut.17.10.781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schoene B., Fleischmann R. A., Remmer H., von Oldershausen H. F. Determination of drug metabolizing enzymes in needle biopsies of human liver. Eur J Clin Pharmacol. 1972 Mar;4(2):65–73. doi: 10.1007/BF00562499. [DOI] [PubMed] [Google Scholar]
  14. Winchell H. S., Stahelin H., Kusubov N., Slanger B., Fish M., Pollycove M., Lawrence J. H. Kinetics of CO2-HCO3 minus in normal adult males. J Nucl Med. 1970 Dec;11(12):711–715. [PubMed] [Google Scholar]
  15. Winchell H. S., Wiley K. Considerations in analysis of breath 14CO2 data. J Nucl Med. 1970 Dec;11(12):708–710. [PubMed] [Google Scholar]

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