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BILIRUBIN

BY-WANDE . A

1. DEFINITION 2. FORMS 3. NORMAL VALUES 4. CHANGE IN BILIRUBIN LEVELS 5. TESTS 6. JANDICE, Neonatal Jaundice

DEFINITION Bilirubin is the yellow breakdown product of normal heme catabolism. Heme is found in hemoglobin, a principal component of Red blood cells. Bilirubin is excreted in bile and urine and elevated levels may indicate certain diseases. It is responsible for the yellow discoloration in jaundice, the yellow color of bruises and urine and the brown color of stool. Bilirubin’s main physiologic role is as a cellular antioxidant.

FORMS

4 .This occurs when unconjugated bilirubin in the liver is conjugated with Glucuronic Acid by the enzyme Glucuronyltransferase. Indirect Bilirubin travels through the blood (bound to albumin) to the liver. DIRECT BILIRUBIN.3. NORMAL VALUES Total bilirubin Direct bilirubin Umol/L 5.Bilirubin circulates in the blood stream in 2 forms: INDIRECT (OR UNCONJUGATED BILIRUBIN) And DIRECT (OR CONJUGATED BILIRUBIN) INDIRECT BILIRUBIN.0-5.11.2 0-0.This form of Bilirubin does not dissolve in water (it is insoluble).1-17.1-0.0 1. 0.3.1-0.2-1.3-1. making it soluble in water. where it is changed to a soulbe form.1 Mg/dL 0.0. Much of it goes into the bile and thus out into the small intestine and some of it remains in the large intestine where it is metabolized many times to end as Stercobilin. 0. 0.9. 0.

Hepatitis. Urine analysis tests 2. TESTS 1. Chemotherapy. Bile-duct obstruction. Liver Cirrhosis. Liver function tests for values of.Alanie transaminase. In newborns. Aspartate transaminase.CHANGE IN BILIRUBIN LEVELS Mild rises in Bilirubin may be caused by. Blood film examination JAUNDICE .Drugs.Hemolysis. GammaGlutamyl transpeptidase. Biliary stricture Very high rises in Bilirubin may be caused byNeonatal hyperbilirubinaemia. Gilbert’s syndrome Moderate rises in Bilirubin may be caused by. a blood sample is usually taken from the heel (heel stick) 3. Alkaline phospatase 4.

the concentration of bilirubin in the plasma >1. There are 3 types of jaundice depending on the part of the physiological mechanism the pathology affects Pre-hepatic. Treatment. Hearing loss. It is caused by hyperbilirubinaemia.Also known as ‘icterus’.the pathology is located after the conjugation of Bilirubin in the liver NEONATAL JAUNDICE This occurs in newborns with values >5mg/dL. Pathological jaundice of neonates can lead to many diseases such as. is a yellow discoloration of the skin. Physical abnormalities and even death. .Brain damage (kernicterus).the pathology is located before the liver Hepaticliver the pathology is located within the Post-hepatic.5mg/dL.the sclera and other mucous membranes. It is common in about 70% of newborns and it can be both physiological and pathological.with Phototherapy or by a Blood transfusion.