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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.
Van den Bergh reaction is a chemical reaction used to measure bilirubin levels in blood. [1] [2] More specifically, it determines the amount of conjugated bilirubin in the blood. The reaction produces azobilirubin. Principle: bilirubin reacts with diazotised sulphanilic acid to produce purple coloured azobilirubin. [3]
Unconjugated bilirubin is a breakdown product of heme (a part of hemoglobin in red blood cells). The liver is responsible for clearing the blood of unconjugated bilirubin, by 'conjugating' it (modified to make it water-soluble) through an enzyme named UDP-glucuronyl-transferase. When the total bilirubin level exceeds 17 μmol/L, it indicates ...
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 ]
Reference ranges (reference intervals) for blood tests are sets of values used by a health professional to interpret a set of medical test results from blood samples. Reference ranges for blood tests are studied within the field of clinical chemistry (also known as "clinical biochemistry", "chemical pathology" or "pure blood chemistry"), the ...
Outside the United States, blood tests made up of the majority of the same biochemical tests are called urea and electrolytes (U&E or "U and Es"), or urea, electrolytes, creatinine (UEC or EUC or CUE), and are often referred to as 'kidney function tests' as they also include a calculated estimated glomerular filtration rate. The BMP provides ...
A hallmark of Dubin–Johnson syndrome is the unusual ratio between the byproducts of heme biosynthesis: [citation needed] Unaffected subjects have a coproporphyrin III to coproporphyrin I ratio around 3–4:1. In patients with Dubin–Johnson syndrome, this ratio is inverted, with coproporphyrin I being 3–4 times higher than coproporphyrin III.
Results from the urine test should be confirmed by a complete blood count (CBC) and serum testing for total serum bilirubin and fractionated bilirubin. [32] Increased reticulocytes and the presence of schistocytes in the blood smear of the patient observed during CBC indicates hemolysis. [28]