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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]
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 ...
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 ...
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]
In this article, all values (except the ones listed below) denote blood plasma concentration, which is approximately 60–100% larger than the actual blood concentration if the amount inside red blood cells (RBCs) is negligible.
[2] [1] A bilirubin level more than 34 μmol/L (2 mg/dL) may be visible. [1] Concerns, in otherwise healthy babies, occur when levels are greater than 308 μmol/L (18 mg/dL), jaundice is noticed in the first day of life, there is a rapid rise in levels, jaundice lasts more than two weeks, or the baby appears unwell. [1]
The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease.It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, [1] and was subsequently found to be useful in determining prognosis and prioritizing for receipt of ...
The International Business Center of Madeira (IBCM) or Madeira International Business Centre (MIBC), formally known as the Madeira Free Trade Zone, is a set of tax benefits authorised by Decree-Law 500/80 in 1980, legislated [1] [2] in 1986, and amended throughout the years by the Portuguese government to favor the Autonomous Region of Madeira.