Raised bilirubin

Bilirubin ( BR ) is an orange-yellow pigment derived from senescent RBCs. It is extracted and biotransformed mainly in the liver and excreted in bile and urine 80 % from breakdown of Hb and prematurely destroyed erythroid cells in the bone marrow Rest -turnover of various heme-containing proteins found on other tissues ( mainly liver and muscles )

Approximately 4 mg/ kg body weight of bilirubin ( BR ) produced /Dthat roughly equates to 250-400 mg BR is insoluble in water Present in three forms in the plasma

In normal circumstances plasma BR is mostly unconjugated ( 80 % ) Once BR released into plasma it is bound to albumin which serves as its transport throughout the body BR is transported to liver ( bound to albumin ) then via a complex mechanism rendered water soluble in liver by conjugation with glucoronic acid mainly to diglucuronide which is excreted in the bileSmall amounts are abosrbed back from the gut and re-excreted ( enterohepatic circulation ) Only conjugated BR is excreted in urine when its plasma level ↑↑ es beyond a certain level - it is not present in the urine of normally and is not eliminated in the urine in...