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This test helps to identify the type of jaundice. The serum of the patient is mixed with diazo reagent. If a red colour develops immediately it is called a direct positive. It happens if conjugated bilirubin is present. In an indirect positive test, the patient's serum is first treated with alcohol and later mixed with diazo reagent.
Liver function tests (LFTs or LFs), also referred to as a hepatic panel or liver panel, are groups of blood tests that provide information about the state of a patient's liver. [1] These tests include prothrombin time (PT/INR), activated partial thromboplastin time (aPTT), albumin , bilirubin (direct and indirect), and others.
Serum tests evaluate plasma bilirubin, haemolysis and liver function and are essential for definitive diagnosis. When total serum bilirubin exceeds 2.5 mg/dL and unconjugated bilirubin occupies >85% of total amount, it is classified as unconjugated hyperbilirubinemia. [6]
Gilbert syndrome is a phenotypic effect, mostly associated with increased blood bilirubin levels, but also sometimes characterized by mild jaundice due to increased unconjugated bilirubin, that arises from several different genotypic variants of the gene for the enzyme responsible for changing bilirubin to the conjugated form.
Results from the urine test should be confirmed by a complete blood count (CBC) and serum testing for total serum bilirubin and fractionated bilirubin. [32] Increased reticulocytes and the presence of schistocytes in the blood smear of the patient observed during CBC indicates hemolysis. [28]
Azobilirubin is a coloured compound formed by the condensation of diazotized sulfanilic acid with bilirubin in the van den Bergh reaction. [1] The quantity of bilirubin in patients with jaundice can be determined by the formation of azobilirubin in the presence of methanol.
Blood fractionation is the process of fractionating whole blood, or separating it into its component parts. This is typically done by centrifuging the blood. The resulting components are: a clear solution of blood plasma in the upper phase (which can be separated into its own fractions, see Blood plasma fractionation),
Biliverdin reductase (BVR) is an enzyme (EC 1.3.1.24) found in all tissues under normal conditions, but especially in reticulo-macrophages of the liver and spleen. BVR facilitates the conversion of biliverdin to bilirubin via the reduction of a double bond between the second and third pyrrole ring into a single bond.