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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 ...
When total serum bilirubin exceeds 2.5 mg/dL and unconjugated bilirubin occupies >85% of total amount, it is classified as unconjugated hyperbilirubinemia. [6] A complete blood cell count illustrating decreased fraction of intact erythrocytes signifies haemolysis, hinting for haemolytic diseases. [4]
Digestive function, bilirubin excretion 2-30 × 10 −6: 3-30 × 10 −6: Bilirubin: Hemoglobin metabolite 2-14 × 10 −6: 1-10 × 10 −6: Biotin (Vitamin H) Gluconeogenesis, metabolize leucine, fatty acid synthesis 7-17 × 10 −9: 9-16 × 10 −9: Blood Urea Nitrogen (BUN) 8-23 × 10 −5: Bradykinin: 7 × 10 −11: Bromide: 7-10 × 10 −9 ...
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.
The bilirubin-UGT enzyme performs a chemical reaction called glucuronidation. Glucuronic acid is transferred to unconjugated bilirubin, which is a yellowish pigment made when your body breaks down old red blood cells, [35] and then being converted to conjugated bilirubin during the reaction. Conjugated bilirubin passes from the liver into the ...
Hemolytic jaundice, also known as prehepatic jaundice, is a type of jaundice arising from hemolysis or excessive destruction of red blood cells, when the byproduct bilirubin is not excreted by the hepatic cells quickly enough. [1]
Hyperbilirubinemia, more precisely hyperbilirubinemia due to the unconjugated fraction, may cause bilirubin to accumulate in the grey matter of the central nervous system, potentially causing irreversible neurological damage, leading to a condition known as kernicterus. Depending on the level of exposure, the effects range from unnoticeable to ...
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]