Constitutional ICG excretory defect-Investigation of cases reported until December, 1974

Abstract

The investigation was performed on 76 cases with apparent discrepancy between ICG test and BSP test. These cases showed delayed disappearance of ICG and normal disappearance of BSP from plasma. In 37 cases liver function tests were out of normal limits. 10 cases had familial occurrence. 45 cases were considered as a new type of dye excretory disorder of liver, constitutional ICG excretory defect.
Plasma disappearance rate (K), retention rate (R), transfer rate constants, step formation on ICG plasma disappearance curve, cholecystography and heredity of these 45 cases were showed as follows:
1) ICG test K: 0.019±0.007, R₁₅: 79.0±12.6%. Three fractional transport rates were determined for the two-pool system: (a) fractional hepatic removal rate: 0.0217± 0.0052, (b) fractional hepatic plasma reflux rate: 0.0230±0.0208, (h) fractional biliary secretory rate: 0.0374±0.0152.
2) BSP test K: 0.092±0.023, R₄₅: 4.5±1.8%, (a): 0.1078, (b): 0.0087, (h): 0.0462.
3) The step formation on ICG plasma disappearance curve during 20 to 25 minutes after injection was observed in 20 cases.
4) The gallbladder was visualized in 18 or 19 cases in which cholecystography was performed. A non-visualized case had cholelithiasis.
5) The delayed plasma disappearance of ICG was showed in 17 members of 10 families.
From these results the impaired characteristic hepatic secretory of ICG was suspected to be congenital or constitutional.