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    Bilirubin

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    vnicasantiago
    Looking for a comprehensive review of bilirubin in clinical chemistry? This page provides an in-depth analysis and explanation of bilirubin, its relevance in medical diagnostics, and key considerations for interpretation.

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    Bilirubin

    Uploaded by

    vnicasantiago
    17 views12 pages
    Looking for a comprehensive review of bilirubin in clinical chemistry? This page provides an in-depth analysis and explanation of bilirubin, its relevance in medical diagnostics, and key considerations for interpretation.

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    Looking for a comprehensive review of bilirubin in clinical chemistry? This page provides an in-depth analysis and explanation of bilirubin, its relevance in medical diagnostics, and key considerations for interpretation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    17 views12 pages

    Bilirubin

    Uploaded by

    vnicasantiago
    Looking for a comprehensive review of bilirubin in clinical chemistry? This page provides an in-depth analysis and explanation of bilirubin, its relevance in medical diagnostics, and key considerations for interpretation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 12

    BILIRUBIN

    • The end product of hemoglobin metabolism


    and principal pigment in bile.
    • Formed in the destruction of heme-containing
    proteins such as:
    1.Myoglobin
    2.Catalase
    3.Cytochrome oxidase
    BILIRUBIN
    METABOLISM
    Comparison between conjugated and
    Unconjugated Bilirubin

    Reference Value:
    Conjugated bilirubin: 0-0.2 mg/dl (0-3umol/L)
    Unconjugated bilirubin: 0.2-0.8 mg/dl (3-14umol/L)
    Total bilirubin: 0.2-1.0mg/dl (3-17umol/L)
    Delta Bilirubin
    • It is a conjugated bilirubin tightly bound to albumin.
    • It has longer half life than other forms of bilirubin.
    • It is dormed due to prolonged elevation of conjugated
    bilirubin in biliary obstruction.
    • It helps monitoring decline of serum bilirubin following
    surgical removal of gallstones.
    • It reacts with diazo reagent in direct bilirubin assay
    • It is not calculated in neonatal patients (less than or
    equal 14 days)
    • Reference Value: <0.2 mg/dl (<3umol/L)
    • Formula:
    • TB - DB + IB = Delta Bilirubin
    JAUNDICE
    • Icterus or hyperbilirubinemia
    • Yellow discoloration of skin, sclerae, and
    mucus membranes
    • Clinically evident when bilirubin level exceeds
    2 mg/dl
    Classification of Jaundice
    METHODS
    • Serum specimens should be free from
    hemolysis and lipemia.
    • Serum should be measured in the dark and
    measured ASAP or within 2-3hours of
    collection.
    • If serum or plasma is separated from the cells
    and stored in the dark, it is stable for 2 days at
    room temperature, 1 week at 4°C, and
    indefinitely at -20°C.
    I. BILIRUBIN ASSAY
    I
    A. Evelyn and Malloy Method
     Coupling Accelerator : Methanol
     Diazo Reagents:
    • Diazo A = 0.1% Sulfanilic Acid + HCI
    • Diazo B = 0.5% Sodium Nitrite
    • Diazo Blank = 1.5% HCI

     Final Reaction: pink to purple azoblilirubin


    b. Jendrassik and Grof
    • It is a popular technique for the discreet
    analyzers
     Coupling Accelerator: Caffeine Sodium
    Benzoate
     Buffer: Sodium Acetate
     Ascorbic Acid: terminates the initial
    reaction and destroys the excess diazo
    reagent
     Final reaction: pink to blue azoblirubin
    Important Notes:
    • Conjugated bilirubin produced a color in aqueous solution
    • Unconjugated bilirubin is the fraction that produced a color
    only after the addition of alcohol
    • Delta bilirubin is the conjugated bilirubin bound to albumin:
    elevated in obstructive jaundice
    • The purpose of adding a methanol or caffeine solution is to
    allow indirect bilirubin to react ( solubilize) with the color
    reagent
    • Total bilirubin is measured 15mins after adding methanol or
    caffeine solution
    • Caffeine-benzoate is preferred over methanol because the
    latter promotes protein precipitation and increase turbidity
    Reference

    Clinical Chemistry 7e Int Ed by Michael L. Bishop (2013–02-01).


    (2021). Lippincott Williams & Wilkins.

    Rodriguez, M.T., EdD,MSMT. Clinical Chemistry Review Handbook


    for Medical Technologist. 2014

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