Abstract
Salivary caffeine clearance (SCC) can be considered a measure of hepatic microsomal enzyme activity. It may thus provide a quantitative assessment of hepatic function. To assess this we have studied 20 children with a variety of liver disorders; 8 had cirrhosis with serum albumin (ALB) < 35g/l. Caffeine (3mg/kg) was administered orally following an overnight fast. Salivary caffeine concentration was measured by HPLC at 0,1,4,6,12,24 hr. Caffeine saliva half life (t½) was calculated from SCC. t½ in normal controls ranged from 2.2 to 5.4 hr. t½ in liver disease from 4.4 to 56 hr; a significant correlation was obtained between t½ and ALB (r=-0.65). There were also significant correlations with prothrombin time (PT) and total serum bilirubin (r= 0.65 and 0.84 respectively); there was no relationship between t½ and any other liver function test. However, the mean PT and t½ were significantly higher in the 8 cirrhotic children when compared to the other children. In two children, one with biliary cirrhosis and the other with alpha-1-antitrypsin, SCC improved dramatically following orthoptic liver transplantation, t½ before /after;41 to 5.5 hr, 9.6 to 5.4 hr, respectively. In one child with Wilson's disease t½ changed from 56 to 7.0 hr following treatment. We conclude that the SCC may permit quantification of liver function in a fashion not possible with standard biochemical tests
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Cheeseman, P., Shazli, A., Shabrawy, M. et al. EXAMINATION OF THE SEVERITY OF LIVER DISEASE, IN CHILDREN WITH THE NON-INVASIVE SALIVARY CAFFEINE CLEARANCE TEST. Pediatr Res 20, 694 (1986). https://doi.org/10.1203/00006450-198607000-00051
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DOI: https://doi.org/10.1203/00006450-198607000-00051