A case of hereditary elliptocytosis associated with constitutional indocyanine green excretory defect.

Abstract

A 24-year-old woman was diagnosed as having hereditary elliptocytosis and post-tranfusion hepatitis. On admission, a marked delay in indocyanine green (ICG) plasma clearance was noted while bromsulhpalein excretion was almost normal. Even when her levels of serum bilirubin and transaminases were decreased to the normal ranges and a liver biopsy revealed no evidence of any liver cirrhosis or active hepatitis, ICG excretion still remained abnormal. These findings were compatible to those of constitutional ICG excretory defect.

Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications

“…In fact, the ICG test was performed only in 46.2% of the present patients with HCC in all institutions. In addition, there are issues related to bolus injection of ICG, needed for an ICG test, and allergy to ICG, and constitutional ICG excretory defect [28] and the possibility of underestimation of hepatic function for patients who have a progressed portal-venous shunt [29] have been reported. Moreover, there might also be problems when liver damage and Child-Pugh, which has been reported to be inferior to liver damage [8] , are used together in the evidence-based JSH guideline.…”