Two cases of nonhemolitic unconjugated hyperbilirubinemia associated with remarkable retention of both ICG and BSP excretion.

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Two cases, case 1, 70 and case 2, 31 years old male, of nonhemolitic unconjugated hyperbilirubinemia associated with remarkable retention of both ICG and BSP excretion are presented. Both cases had had hepatitis about 20 years ago. Laboratory examinations including transaminase and alkalin phosphotase were normal except for high serum unconjugated bilirubin (about 2mg/dl), remarkable ICG retention (R15 about 80%) and BSP retention (R15 about 18%) in both cases. Case 1 had slightly shortened red cell turnover rate (51Cr-RBC T1/2 22.5 days) and chronic inactive hepatitis in his liver biopsy specimen. Case 2 had normal red cell turnover rate and normal liver histology. The analysis of ICG curve and BSP conjugates suggested abnormalities somewhere from dye uptake to transfer mechanism, and slightly disturbed excretion. Although the influences of hepatitis can be completely excluded, these cases seem to have new type of constitutional hyperbilirubinemia.
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