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Bilirubin is not normally detectable in the urine of healthy people. If the blood level of conjugated bilirubin becomes elevated, e.g. due to liver disease, excess conjugated bilirubin is excreted in the urine, indicating a pathological process. [60] Unconjugated bilirubin is not water-soluble and so is not excreted in the urine.
Drug-induced liver injury, as Hy's law states, patients with bilirubin of >3 mg/dL have 10% mortality rate. [36] End stage liver disease models also include hyperbilirubinemia as a critical parameter in prognosis of cirrhosis. Moreover, serum bilirubin is positively associated with mortality in patients with severe sepsis or traumatic brain injury.
In the human liver, bile is composed of 97–98% water, 0.7% bile salts, 0.2% bilirubin, 0.51% fats (cholesterol, fatty acids, and lecithin), and 200 meq/L inorganic salts. [2] [3] The two main pigments of bile are bilirubin, which is orange-yellow, and its oxidised form biliverdin, which is green.
The system is usually referred to as the biliary tract or system, [9] and can include the use of the term "hepatobiliary" when used to refer just to the liver and bile ducts. [1] The name biliary tract is used to refer to all of the ducts, structures and organs involved in the production, storage and secretion of bile. [10] The tract is as follows:
Bilirubin is conjugated with glucuronic acid in the liver by the enzyme glucuronyltransferase, making it soluble in water. Much of it goes into the bile and thus out into the small intestine. Although 20% of the secreted bilirubinoid bile is reabsorbed by the small intestine, [2] conjugated
The bilirubin results from the breakup of the hemoglobin of dead red blood cells; normally, the liver removes bilirubin from the blood and excretes it through bile. Other disorders caused by excessive alcohol consumption are grouped under alcoholic liver diseases and these include alcoholic hepatitis, fatty liver, and cirrhosis. Factors ...
Bilirubin di-glucuronide is a conjugated form of bilirubin formed in bilirubin metabolism. [1] The hydrophilic character of bilirubin diglucuronide enables it to be water-soluble. It is pumped across the hepatic canalicular membrane into the bile by the transporter MRP2 .
[1] [9] In the liver sinusoid, albumin disassociates with the indirect bilirubin and returns to the circulation while the hepatocyte transfers the indirect bilirubin to ligandin and glucuronide conjugates the indirect bilirubin in the endoplasmic reticulum by disrupting unconjugated bilirubin's internal hydrogen bonding, which is the thing that ...
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