The aminopyrine breath test does not correlate with histologic disease severity in patients with cholestasis

Authors

  • Alfred L. Baker M.D.,

    Corresponding author
    1. Liver Study Unit and Section of Gastroenterology of the Department of Medicine, University of Chicago, Chicago, Illinois 60637
    • University of Chicago, Box 400, 5841 South Maryland Avenue, Chicago, Illinois 60637
    Search for more papers by this author
  • Patricia S. Krager,

    1. Liver Study Unit and Section of Gastroenterology of the Department of Medicine, University of Chicago, Chicago, Illinois 60637
    Search for more papers by this author
  • Alvin N. Kotake,

    1. Liver Study Unit and Section of Gastroenterology of the Department of Medicine, University of Chicago, Chicago, Illinois 60637
    Search for more papers by this author
  • Dale A. Schoeller

    1. Liver Study Unit and Section of Gastroenterology of the Department of Medicine, University of Chicago, Chicago, Illinois 60637
    Search for more papers by this author

Abstract

To determine whether the aminopyrine breath test can be used to document the presence of cirrhosis in patients with cholestatic liver disease, 19 patients (13 primary biliary cirrhosis, 4 sclerosing cholangitis and 2 chronic extrahepatic bile duct obstruction) underwent clinical and biochemical evaluations, liver biopsies and an aminopyrine breath test. Results were compared with those in 10 patients with biopsy-proven chronic active hepatitis with bridging and/or cirrhosis and in 22 healthy subjects. The aminopyrine breath test results in the 10 cholestatic patients with cirrhosis were not significantly different from the results in precirrhotic cholestatic patients (mean ± S.D., 11.2 ± 5.0 vs. 11.6 ± 2.8 %dose per 2 hr, p < 0.05) or healthy subjects (11.5 ± 2.9 %dose per 2 hr). In contrast, the results in the patients with chronic hepatitis were markedly depressed (3.2 ± 1.9 %dose per 2 hr, p < 0.05). The aminopyrine breath test results did not correlate with results of conventional liver function tests in the cholestatic patients. These results demonstrate that the aminopyrine breath test is not clinically useful in identifying the presence of cirrhosis in patients with cholestatic liver disease, and provide further evidence that decreased microsomal enzyme function is a late feature of cholestatic liver disease.

Ancillary