Abstract
A case of novobiocin-induced jaundice is described in which the main feature was elevated unconjugated bilirubin in the serum. No evidence of hemolysis or hepato-cellular failure was demonstrated.
The effect of novobiocin on serum bilirubin was studied by administering 2 g. of the drug daily in four divided oral doses for two days. An increase in serum unconjugated bilirubin was nearly always observed in the normal subjects and in patients with cirrhosis of the liver. This rise was particularly significant in three patients with hemolytic anemia and in two patients with Gilbert's disease. After an oral dose of 500 mg. the BSP clearance was decreased after one hour and it was close to normal after three hours. Since hemolysis is not responsible for this elevation of serum unconjugated bilirubin, the novobiocin-induced hyperbilirubinemia appears to be due to a direct effect of the drug upon the liver.
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