Effect of bucolome in preterm infants.

Sir, Segni et al. (Archives, 1977, 52, 549) reported the prevention of hyperbilirubinaemia in premature infants by bucolome. The effect of bucolome on hyperbilirubinaemia in Gilbert's syndrome was well established by observation ofabout 30 cases ofthesyndrome(Yamamoto et al., 1974). However, as for the mechanism of the effect, we found that bucolome showed no induction of liver microsomal enzymes (Adachi and Yamamoto, 1976) but did show a strong tendency to dissociate bilirubin from serum albumin (Yamamoto and Adachi, 1974). This dissociation was shown in vivo in Gunn rats, and in vitro using human albumin and red cells. We believe, therefore, that although bucolome is useful in cases of Gilbert's syndrome, it should not be further tried in premature infants.