EFFECT OF BILIRUBIN ON DRUG CONJUGATIONS IN CHILDREN.

The formation of glucuronides of salicylate, salicylamide, and acetaminophen in two sisters with congenital unconjugated hyperbilirubinemia responsive to phenobarbital was normal at widely different (6 to 37 mg per 100 ml) serum bilirubin concentrations. The conjugation of salicylate with glycine, and the formation of salicylamide sulfate and acetaminophen sulfate were also normal. This shows that unconjugated hyperbilirubinemia per se does not affect the biotransformation of the three drugs tested. The clinical and pharmacokinetic characteristics of the children in this study are consistent with a recently proposed mechanism involving a deficiency in hepatic anion-binding protein (rather than glucuronyl transferase) as one cause of unconjugated hyperbilirubinemia. [ABSTRACT FROM AUTHOR]