The inverse starving test is not a suitable provocation test for Gilbert's syndrome.

BMC Research Notes
Niels TeichIngolf Schiefke

Abstract

The aim of this study was to evaluate a simple diagnostic test for Gilbert's syndrome (GS), which avoids hospitalization and exposure to toxic test substrates. GS is the most frequent cause of isolated unconjugated hyperbilirubinemia. The nicotinic acid test and the starving test are established approaches to diagnose GS. However, these tests cause considerable side effects or require hospital admission. In single GS patients, we observed rapid serum bilirubin normalization after a standard European lunch (the "inverse starving test"). At two consecutive days, 18 profoundly characterized GS patients (7 females, 11 males, median age 34.5 years, range 21-58 years) were investigated with the nicotinic acid test and the inverse starving test. Unconjugated serum bilirubin (UCB) levels were measured before and hourly up to four hours after lunch (median 645 kcal), and after the ingestion of 170 milligrams nicotinic acid, respectively. Patients who consulted their physicians with jaundice were significantly more likely to undergo invasive diagnostic procedures than patients with an incidental finding of elevated UCB, despite UCB levels were indifferent in both groups. Two hours after nicotinic acid ingestion, relative UCB exceeded 1.7...Continue Reading

References

Jun 1, 1975·Journal of Medical Genetics·D Owens, J Evans
Oct 1, 1991·British Journal of Clinical Pharmacology·W SiegmundR Wulkow
Apr 1, 1989·Baillière's Clinical Gastroenterology·K J Watson, J L Gollan
Jul 31, 1987·Deutsche medizinische Wochenschrift·A SiegB Kommerell
Nov 2, 1995·The New England Journal of Medicine·P J BosmaR P Oude Elferink
Apr 24, 2001·The American Journal of Gastroenterology·G D MurthyD Pasquale
Feb 2, 2006·Gastroenterología y hepatología·H HallalF Carballo
Oct 24, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Tim O LankischChristian P Strassburg

❮ Previous
Next ❯

Citations

Jul 16, 2011·The American Journal of the Medical Sciences·Carina RodriguesElsa Bronze-da-Rocha
May 25, 2013·Journal of Gastroenterology and Hepatology·Laura J HorsfallIrene Petersen

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.