09 Bilirubin

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Bilirubin Metabolism

• 6 carbon like glucose. Very polar and soluble

• rising serum conjugated bilirubin can be detected

Hemolysis

Obstruction

• high conjugated bilirubin, also in urine
• no stercobilin

Primary Liver Disease

• fractionating into direct/indirect not helpful

• unpredictable

Rifampin/Probenecid

Gilbert

Crigler-Najjar

• babies

Dubin Johnson

• no pruritus: can excrete bile salts

Rotor

Neonatal Jaundice

Summary