Bilirubin Metabolism and Hyperbilirubinemia

  • Yaron Ilan
  • Namita Roy Chowdhury
  • Jayanta Roy Chowdhury
Part of the Current Clinical Practice book series (CCP)


As a physical sign and a biochemical marker, jaundice and hyperbilirubinemia are among the most frequently used “liver function tests.” The clinical significance of jaundice varies according to the underlying disease. Knowledge of the pathophysiology of bilirubin metabolism is required for its interpretation. Acquired causes of hyperbilirubinemia, which usually indicate liver disease or biliary obstruction, need to be differentiated from inborn errors of bilirubin metabolism. In acute hepatitis, jaundice is common and usually transient, whereas in alcoholic hepatitis and alcoholic or nonalcoholic liver cirrhosis, jaundice has a dismal prognosis (1). In the intensive care unit, in septic or multitrauma patients, it is associated with a higher mortality rate. In primary biliary cirrhosis, it is a major prognostic indicator predicting survival (1). Impairment of bile flow due to obstruction of the intrahepatic or extrahepatic biliary tract leads to accumulation of conjugated bilirubin in the blood and jaundice, and is an indication for surgical or endoscopic relief of the obstruction.


Serum Bilirubin Level Bile Pigment Unconjugated Bilirubin Unconjugated Hyperbilirubinemia Bilirubin Conjugation 
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Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Yaron Ilan
  • Namita Roy Chowdhury
  • Jayanta Roy Chowdhury

There are no affiliations available

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