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Hyperbilirubinemia is a clinical condition describing an elevation of blood bilirubin level due to the inability to properly metabolise or excrete bilirubin, a product of erythrocytes breakdown. In severe cases, it is manifested as jaundice , the yellowing of tissues like skin and the sclera when excess bilirubin deposits in them. [ 1 ]
For infants with hemolytic jaundice, severe and prolonged cases of hyperbilirubinemia, or high serum bilirubin that does not decrease after phototherapy, blood exchange transfusion is carried out at the umbilical venous catheter to mechanically remove bilirubin.
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. [56] Unconjugated bilirubin is not water-soluble and so is not excreted in the urine.
The symptoms of TACO can include shortness of breath , low blood oxygen levels , leg swelling (peripheral edema), high blood pressure (hypertension), and a high heart rate (tachycardia). [ 3 ] It can occur due to a rapid transfusion of a large volume of blood but can also occur during a single red blood cell transfusion (about 15% of cases). [ 2 ]
Normal levels of bilirubin in blood are below 1.0 mg/dl (17 μmol/L), while levels over 2–3 mg/dl (34–51 μmol/L) typically result in jaundice. [4] [9] High blood bilirubin is divided into two types: unconjugated and conjugated bilirubin. [10] Causes of jaundice vary from relatively benign to potentially fatal. [10]
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 ...
When the total serum bilirubin increases over 95th percentile for age during the first week of life for high risk babies, it is known as hyperbilirubinemia of the newborn (neonatal jaundice) and requires light therapy to reduce the amount of bilirubin in the blood. Pathological jaundice in newborns should be suspected when the serum bilirubin ...
The heme is ultimately converted to bilirubin and removed in stool and urine. [44] Hemoglobin may be cleared directly by the kidneys resulting in fast clearance of free hemoglobin but causing the continued loss of hemosiderin loaded renal tubular cells for many days. Additional effects of free hemoglobin seem to be due to specific reactions ...