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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.
Digestive function, bilirubin excretion 2-30 ... Maintain calcium and phosphorus levels 1.7-4.1 ... 5.1-7.7 × 10 −5: C6 4.8-6.4 ...
Arterial levels for drugs are generally higher than venous levels because of extraction while passing through tissues. ... Total bilirubin: 1.7, [52] 2, [14] 3.4, [52 ...
Alkaline phosphatase – slightly elevated but less than 2–3 times the upper limit of normal. [citation needed] Gamma-glutamyl transferase – correlates with AP levels. Typically much higher in chronic liver disease from alcohol. [79] Bilirubin levels are normal when compensated, but may elevate as cirrhosis progresses. [citation needed]
In primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC), some use a modified Child–Pugh score where the bilirubin references are changed to reflect the fact that these diseases feature high conjugated bilirubin levels. The upper limit for 1 point is 68 μmol/L (4 mg/dL) and the upper limit for 2 points is 170 μmol/L (10 ...
An elevation in serum bilirubin level of more than 2 times ULN with associated transaminase rise is an ominous sign. This indicates severe hepatotoxicity and is likely to lead to mortality in 10% to 15% of patients, especially if the offending drug is not stopped .
The proportion of AST to ALT in hepatocytes is about 2.5:1, but because AST is removed from serum by the liver sinusoidal cells twice as quickly (serum half-life t 1/2 = 18 hr) compared to ALT (t 1/2 = 36 hr), so the resulting serum levels of AST and ALT are about equal in healthy individuals, resulting in a normal AST/ALT ratio around 1.
The bilirubin present in the plasma is largely unconjugated in this setting as they haven't been taken up and conjugated by the liver. [3] In this case, total serum bilirubin increases while the ratio of direct bilirubin to indirect bilirubin remains 96 to 4 as up to 96%-99% of bilirubin in the bile are conjugated mentioned above. [9] [1]