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In medicine, bilirubinuria is an abnormality in which conjugated bilirubin is detected in the urine. [1] The term "biliuria" is very similar, but more general. It refers to the presence of any bile pigment in the urine. Conjugated bilirubin is detected in urine at bilirubinemia of approximately 30-34 mmol/L or 2 mg/dL.
In biliary obstruction, below-normal amounts of conjugated bilirubin reach the intestine for conversion to urobilinogen. With limited urobilinogen available for reabsorption and excretion, the amount of urobilin found in the urine is low. High amounts of the soluble conjugated bilirubin enter the circulation where they are excreted via the kidneys.
Treatment of the condition is specific to the cause of hemolysis, but intense phototherapy and exchange transfusion can be used to help the patient excrete accumulated bilirubin. [11] Complications related to hemolytic jaundice include hyperbilirubinemia and chronic bilirubin encephalopathy, which may be deadly without proper treatment. [12] [13]
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [3] [6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. [7]
Classification and diagnosis of the underlying disease of hyperbilirubinemia are crucial for prescription of treatment. [6]Physical examination reviews clinical symptoms like degree of jaundice, vital signs and sensations of pain, further followed by urine tests, blood analysis and imaging.
Intestinal bacteria reduce the bilirubin to urobilinogen, which is later oxidised and either excreted with the faeces as stercobilin or in the urine as urobilin. Conjugated bilirubin appears in urine when the normal degradation cycle is altered due to the obstruction of the biliary ducts or when the kidney's functional integrity is damaged.
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Conjugated bilirubin is normally stored in the gallbladder as a constituent of bile and is excreted through the intestines; it does not occur at detectable levels in the urine. [81] The presence of bilirubin in the urine (termed bilirubinuria) occurs as a consequence of high blood levels of conjugated bilirubin in liver disease or bile duct ...