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Mechanism of competitive inhibition. Certain drugs share the same plasma protein, bilirubin, for transportation in the bloodstream. When drug concentration is high, they may outcompete bilirubin for binding. Bilirubin is displaced out so serum unconjugated bilirubin levels rise, resulting in unconjugated hyperbilirubinemia.
Not only drugs but also endogenous substrates like bilirubin, steroidal hormones and thyroxine utilize this pathway. Enterohepatic circulation of drugs describes the process by which drugs are conjugated to glucuronic acid in the liver, excreted into bile, metabolized back into the free drug by intestinal bacteria, and the drug is then ...
Intrahepatic causes can be associated with elevated levels of conjugated bilirubin, unconjugated bilirubin or both. [21] They include: [21] Neonatal hyperbilirubinemia, where the newborn's liver is not able to properly process the bilirubin causing jaundice; Hepatocellular disease Viral infections (hepatitis A, B, and C) Chronic alcohol use
High unconjugated bilirubin may be due to excess red blood cell breakdown, large bruises, genetic conditions such as Gilbert's syndrome, not eating for a prolonged period of time, newborn jaundice, or thyroid problems. [4] [10] High conjugated bilirubin may be due to liver diseases such as cirrhosis or hepatitis, infections, medications, or ...
People with GS predominantly have elevated unconjugated bilirubin, while conjugated bilirubin is usually within the normal range or is less than 20% of the total. Levels of bilirubin in GS patients are reported to be from 20 μM to 90 μM (1.2 to 5.3 mg/dl) [38] compared to the normal amount of < 20 μM. GS patients have a ratio of unconjugated ...
The clinical significance of bilirubin glucuronide is involved in many conditions. Drugs that inhibit the activities of the components involved in bilirubin metabolism can give rise to accumulation of bilirubin in the blood. [5] In comparison, conjugation of some drugs is also usually impaired if the liver cannot normally metabolize indirect ...
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Rotor type hyperbilirubinemia is a distinct yet similar disorder to Dubin–Johnson syndrome [1] – both diseases cause an increase in conjugated bilirubin, but Rotor syndrome differs in that it is a result of impaired hepatocellular storage of conjugated bilirubin that leaks into plasma causing hyperbilirubinemia.
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