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Bilirubin

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Bilirubin

The predominant orange pigment of bile. It is the major metabolic breakdown product of heme, the prosthetic group of hemoglobin in red blood cells, and other chromoproteins such as myoglobin, cytochrome, and catalase. The breakdown of hemoglobin from the old red cells takes place at a rapid rate in the reticuloendothelial cells of the liver, spleen, and bone marrow. The steps in this breakdown process include denaturation and removal of the protein globin, oxidation and opening of the tetrapyrrole ring, and the removal of iron to form the green pigment biliverdin, which is then reduced to bilirubin by the addition of hydrogen. The formed bilirubin is transported to the liver, probably bound to albumin, where it is conjugated into water-soluble mono- and diglucuronides and to a lesser extent with sulfate. See Liver

In mammalian bile essentially all of the bilirubin is present as a glucuronide conjugate. Bilirubin glucuronide is passed through the liver cells into the bile caniculi and then into the intestine. The bacterial flora further reduces the bilirubin to colorless urobilinogen. Most of the urobilinogen is either reduced to stercobilinogen or oxidized to urobilin. These two compounds are then converted to stercobilin, which is excreted in the feces and gives the stool its brown color. See Hemoglobin



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? Mentioned in ? References in periodicals archive
 
In 3 cases, serum bilirubin increase occurred but became normal after a week.
Hydrocortisone (200 mg/day) was given to patients in both groups; no differences between groups were noted in body temperature, leukocyte count, platelet count, serum creatinine level, serum bilirubin level, AST level, and C-reactive protein level.
4] are a swollen and tender liver, elevated levels of hepatic enzymes in serum, elevated serum bilirubin levels and the appearance of jaundice, and decreased serum levels of proteins such as albumin and fibrinogen (ATSDR 2003a).
 
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