Bilirubin- The Reason Behind the Yellow Skin in Jaundice

 

It is a yellowish to brown pigment present in bile physiological aq. solution secreted by liver] that helps in food digestion by breaking down the fatty acids and absorb fat soluble vitamins. It is formed by breakdown of hemoglobin,the oxygen carrying protein in rbc. It is a necessary process for the waste product clearance of the body. 

It is structurally similar to phycobilin and phytochrome pigment [used by plants to sense light] .

It says a lot about your health and its high levels can be dangerous too. It is responsible for the color of healing bruises and yellowing of skin and sclera in jaundice.  It is normal to have some bilirubin in blood.  SO, NORMAL  bilirubin levels for adults is 0.1 to 1.2 mg per dl and 1 mg per dl for youngsters under  18.

Bilirubin in Blood is Found in Two Forms

  1. Conjugated bilirubin [bound to glucuronic acid] also called direct bilirubin. It is water soluble.

  2. Unconjugated bilirubin is also called indirect bilirubin. It is fat soluble. 

A high level of bilirubin in the bloodstream signifies a condition called hyperbilirubinemia which is induced by a faster red blood cell breakdown. The causes can be classified as-

  1. Prehepatic- increase in conjugated bilirubin[ increased breakdown of rbc]

  2. Intahepatic-

    1. Newborn baby's liver is not working properly. It's also called neonatal hyperbilirubinemia.

    2. Hepatocellular diseases like viral infections, autoimmune disorders-

    3. Genetic syndromes like rotor syndrome, gilbert's syndrome.

    4. Drugs like sulfonamides,protease inhibitors 

  3. Post hepatic- includes,

    1. Large bile duct obstruction eg; stones.

    2. Benign or malignant biliary stricture

    3. Pancreatitis

Jaundice becomes visible in the sclera of eyes at levels around 3 mg per dl and in the skin at higher levels.

Bilirubin tests are important because if untreated, it may lead to liver disorders damage or its disorders. 

The test is prescribed if the clinician suspect following symptoms

  • Yellow skin or sclera of eyes

  • Dark urine

  • pale stools

  • Abdominal pain

Bilirubin is degraded by light, so the sample collected should be protected from light.  The sample in adults is taken from a vein in the arm by needle and in newborns, from heels.  

Nowadays, a non-invasive method is also used which is done by an instrument named transcutaneous bilirubin meter.

It is not frequently tested but has become a part of liver function tests. But it should be checked regularly if you are having a history of liver conditions. 

Consult your doctor if the levels are raised insignificantly. Depending on the results the clinician can proceed with the further treatment.

Diagnostic Centers Near You Will  Offer Below Mentioned Tests for Jaundice

A diagnostic centre near you can provide you free home blood sample collection facility for your convenience with 100% accuracy in the reports.

n for convenience and efficiency, they can provide 

  • Urinalysis to measure the amount of certain substances in your urine.

  • Blood tests, such as a cbc blood test, antibody tests, or LFT to measure bilirubin and other substances in the blood 

  • Imaging tests, including

  • An MRI 

  • Ultrasound, for your gallbladder, liver, and bile ducts for rulinig out other causes

  • A HIDA scan to diagnose blockage presence in the gallbladder, liver, small intestine, bile ducts, etc.

  • an endoscopy, that helps examine your liver along with a tissue sample (biopsy) analysis if  necessary.

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