Effects of corticosteroids on bilirubin metabolism in patients with Gilbert's syndrome.

To elucidate the mechanism whereby corticosteroids decrease the serum bilirubin concentration, changes in bilirubin metabolism were studied in patients with Gilbert's syndrome using a bilirubin load test and/or nicotinic acid test before and after corticosteroid treatment. Steroid administration increased hepatic clearance and uptake of bilirubin; the transfer rate for biliary excretion was unaffected. These results suggest that the main effect was enhancement of hepatic uptake or storage of bilirubin, which may be an important mechanism whereby corticosteroids reduce serum bilirubin concentrations in various liver disorders.