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In the liver, bilirubin is conjugated with glucuronic acid by the enzyme glucuronyltransferase, first to bilirubin glucuronide and then to bilirubin diglucuronide, making it soluble in water: the conjugated version is the main form of bilirubin present in the "direct" bilirubin fraction. Much of it goes into the bile and thus out into the small ...
The former, referring to elevated unconjugated bilirubin, is often caused by haemolytic diseases resulting in increased bilirubin production and impaired bilirubin conjugation. The latter is often attributed to direct hepatocyte injury that impedes conjugated bilirubin secretion. [6]
When total bilirubin levels exceed 40 μmol/L, bilirubin deposition at the sclera, skin, and mucous membranes will give these areas a yellow colour, thus it is called jaundice. [6] The increase in predominantly unconjugated bilirubin is due to overproduction, reduced hepatic uptake of the unconjugated bilirubin and reduced conjugation of bilirubin.
This conjugated bilirubin is then returned to the blood, probably by rupture of the congested bile canaliculi and direct emptying of the bile into the lymph exiting the liver. Thus, most of the bilirubin in the plasma becomes the conjugated type rather than the unconjugated type, and this conjugated bilirubin, which did not go to the intestine ...
Choluria (or bilirubinuria) is a symptom defining an abnormal darkness of the urine, mainly due to a high level of conjugated bilirubin. [1] [2] Choluria is a common symptom of liver diseases, such as hepatitis and cirrhosis. It can be described as dark or brown urine, often referred to as the color of Coca-Cola.
Van den Bergh reaction is a chemical reaction used to measure bilirubin levels in blood. [1] [2] More specifically, it determines the amount of conjugated bilirubin in the blood. The reaction produces azobilirubin. Principle: bilirubin reacts with diazotised sulphanilic acid to produce purple coloured azobilirubin. [3]
Rotor syndrome (also known as Rotor type hyperbilirubinemia) [2] is a rare cause of mixed direct (conjugated) and indirect (unconjugated) hyperbilirubinemia, relatively benign, autosomal recessive [3] bilirubin disorder characterized by non-hemolytic jaundice due to the chronic elevation of predominantly conjugated bilirubin. [2]
Mean corpuscular hemoglobin concentration (MCHC) ... where distance is the direct ... Direct/conjugated bilirubin: 0.0 [14] or N/A [5] 5, [14] 7 [5] [52]
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