2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43
The rate of bilirubin in the blood
One of the most important functions of the liver is the binding of blood bilirubin and its neutralization. By this, the tissues of the body, primarily the brain, are protected from its toxic effects. It is possible to assess this ability of the liver thanks to a biochemical blood test to determine the level of total bilirubin, and, if necessary, each of its fractions.
Content:
- Physiological bases of bilirubin metabolism
- Origin of the names of the different types of bilirubin
- Standard indicators of bilirubin metabolism
- Bilirubin metabolism pathology
- Dangers of hyperbilirubinemia and how to eliminate it
Physiological bases of bilirubin metabolism
Bilirubin is a chemical pigment that is formed in the body during the breakdown of red blood cells, which have completed their life cycle. The process of their destruction is carried out by the spleen. Through the portal vein system, bilirubin with the blood flow is directed directly to the liver, where its biochemical transformations are carried out into a substance that is relatively less toxic to tissues. The central reaction of this process is the reaction of conjugation with glucuronic acid. Deactivated bilirubin is excreted with bile through the bile ducts into the duodenum, giving it a specific color.
The main manifestation of a violation of bilirubin metabolism in the body is the yellowness of the skin. According to the characteristics of all its types, one can determine the origin of jaundice.
Origin of the names of the different types of bilirubin
In medical terminology, each type of bilirubin, which corresponds to the stages of its metabolism, has its own name. There are such types of it:
- Total bilirubin. This is all the bilirubin in the blood that circulates in the systemic circulation;
- Indirect bilirubin. This is the part of bilirubin that is formed as a result of the breakdown of red blood cells before conjugation in the liver;
- Direct bilirubin. This is the part of bilirubin that is excreted from the liver after it binds to glucuronic acid.
Standard indicators of bilirubin metabolism
It is impossible to assess the pathology without knowing the norm. For bilirubin, it depends on age and is presented in the form of a table.
| Children 1-3 days old | Children 3-6 days old | Children after a month | Adults | |
| General | 24 to 190 μmol / L | From 28 to 210 μmol / L | 3.5 to 20.4 μmol / L | 8 to 20.5 μmol / L |
| Straight | 0.5-10.2 | 1-12.4 | 0-5.1 | 0-5.1 |
| Indirect | 23.5-179.8 | 27-197.6 | Up to 16.5 | Up to 16.5 |
Fluctuations in the normal indicators of bilirubin in childhood, accompanied by its significant increase, are due to the accelerated decay of the so-called fetal erythrocytes. Their content in the blood of the fetus is much higher than that of adults. Naturally, in such conditions, the level of bilirubin cannot remain at the same level.
Disturbance in the metabolism of bilirubin in the body in the form of jaundice manifests itself when its total level increases by more than 50 μmol / l.
Bilirubin metabolism pathology
From a practical point of view, doctors are interested in detecting elevated bilirubin levels. This condition is called hyperbilirubinemia. If, when normal numbers of this pigment are found, the determination of its fractions is not required, then any hyperbilirubinemia requires such a procedure. Correct interpretation of the results obtained will reliably help in determining the pathology that caused the jaundice.
The main groups of causes that cause hyperbilirubinemia and the subtleties of its interpretation are given in the table.
| Possible reasons | |
| Hyperbilirubinemia due to both of its factions |
|
| Hyperbilirubinemia with a predominant increase in direct |
|
| Hyperbilirubinemia with a predominant increase in indirect |
|
The reasons for the increase in bilirubin are associated with a breakdown at any stage of its metabolism: increased output during the breakdown of erythrocytes, functional inferiority of the liver and unhindered excretion with bile. Any isolated hyperbilirubinemia with prolonged existence can gradually become mixed.
On the subject: List of permitted and prohibited products for the liver
Dangers of hyperbilirubinemia and how to eliminate it
The products of bilirubin metabolism have toxic properties in relation to body tissues. Toxic damage to the brain and heart deserves special relevance. The severity of pathological influences is directly proportional to the degree of hyperbilirubinemia. A pronounced increase in the level of total bilirubin (more than 170 μmol / l) threatens the development of hepatic encephalopathy, renal and cardiopulmonary failure. Hyperbilirubinemia more than 300 μmol / L can be fatal.
Methods for treating disorders of bilirubin metabolism depend on the specific type of jaundice and can be represented by detoxification therapy, massive infusions, diuretics, hepatoprotectors, glucocorticoid hormones, and surgical treatment.
The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.
Recommended:
Blood Sugar Rate - High And Low Blood Sugar
Blood sugar rateBlood glucose is a sugar that is carried by the bloodstream to all cells in the body to supply them with energy. The body regulates blood glucose levels so that they remain moderate: enough to fuel cells, but not enough to overload blood flow
Alpha-amylase Pancreatic Is Increased / Decreased In Blood And Urine. What Is The Amylase Rate?
What is alpha amylase (pancreatic)?Alpha-amylase is one of the enzymes of the digestive system, synthesized mainly by cells of the pancreas of the exocrine type and is responsible for the breakdown of complex carbohydrate components of food, starch and glycogen to simple carbohydrates (glucose)
Blood Test For ESR: Table Of Norms. What Does ESR Mean And What Does The Increased And Decreased Erythrocyte Sedimentation Rate Show?
Blood test for ESR: norm and deviationsThe erythrocyte sedimentation rate (ESR) is a non-specific laboratory blood index reflecting the ratio of plasma protein fractions.A change in the results of this test up or down from the norm is an indirect sign of a pathological or inflammatory process in the human body
Glycated Hemoglobin - What Does It Mean In A Blood Test? Indicator Rate
Glycated hemoglobin: the norm in the blood testGlycated hemoglobin is an iron-containing protein that may indicate the latent course of diabetes. It starts to be produced when blood sugar levels rise. Also glycated hemoglobin is called glycated hemoglobin
Blood Cancer - Signs, Symptoms, Stages And Treatments For Blood Cancer. Blood Cancer In Children
Signs, symptoms, stages and treatment of blood cancerContent:What is blood cancer?Blood cancer symptomsCauses of blood cancerStage 4 blood cancerBlood cancer in childrenBlood Cancer TreatmentWhat is blood cancer?Blood cancer is a malignant disease that affects and destroys the hematopoietic system
