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Bilirubin (BR) (from the Latin for "red bile") is a red-orange compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates.This catabolism is a necessary process in the body's clearance of waste products that arise from the destruction of aged or abnormal red blood cells. [3]
In acute appendicitis, total bilirubin can rise from 20.52 μmol/L to 143 μmol/L. In pregnant women, the total bilirubin level is low in all three trimesters. [6] The measurement of bilirubin levels in the newborns is done through the use of bilimeter or transcutanoeus bilirubinometer instead of performing LFTs.
In the less common instance that white blood cells are attacked, symptoms may include increased proneness to infection, fevers, and/or mouth sores. [ 6 ] [ 7 ] It has been variously reported that between 7.8% [ 4 ] and 23% [ 8 ] of patients who have autoimmune hemolytic anemia , will also have thrombocytopenia and thus Evans syndrome.
Kernicterus is a bilirubin-induced brain dysfunction. [1] The term was coined in 1904 by Christian Georg Schmorl.Bilirubin is a naturally occurring substance in the body of humans and many other animals, but it is neurotoxic when its concentration in the blood is too high, a condition known as hyperbilirubinemia.
Hemolytic jaundice, also known as prehepatic jaundice, is a type of jaundice arising from hemolysis or excessive destruction of red blood cells, when the byproduct bilirubin is not excreted by the hepatic cells quickly enough. [1]
The level of total bilirubin is often further increased if the blood sample is taken after fasting for two days, [40] and a fast can, therefore, be useful diagnostically. A further conceptual step that is rarely necessary or appropriate is to give a low dose of phenobarbital: [41] the bilirubin will decrease substantially.
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Kernicterus is rare in adults but is prevalent in newborns with underdeveloped blood-brain barriers and lower albumin binding capacities, which otherwise buffers excess bilirubin in adults. To date, only 4 such cases have been published, with 3 of them associated with CN-2, the milder form of the syndrome.
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