Bilirubin , Direct
- Conjugated Bilirubin is a better indicator than total Bilirubin during the resolving phase of hepatic and cholestatic disorders.
- Direct Conjugated Bilirubin accumulates in sever haemolysis or biliary obstruction ( gall stones , biliary cirrhosis) and in the congenital Dubin – Johnson
Bilirubin , Total
- Unconjugated Bilirubin forms almost all of the total Bilirubin in hepatocellular failure (e.g. Hepatitis) or in Gilbert’s disease (an asymptomatic congenital disorder found in 3% of the population).
- Also increased in neonatal physiological jaundice , Crigler –Najjar syndrome, Dubin – johnson syndrome , hypothyroidism , and transient familial hyperbilirubinemia in infants
Bilirubin , urine
- In the conjugated state it can pass in the urine and is found in obstructive jaundice and toxic damage to liver. It may appear in hepatitis before jaundice and is also useful in following the course of infective hepatitis. increased in conditions that have an elevated serum conjugated Bilirubin.
Bilirubin Metabolism
