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a conjugated water-soluble form of bilirubin, formed in the liver by esterification of two molecules of glucuronide to the bilirubin molecule; this is the usual form in which bilirubin is found in the bile.
an orange bile pigment produced by the breakdown of heme and reduction of biliverdin; it normally circulates in plasma and is taken up by liver cells and conjugated to form bilirubin diglucuronide, the water-soluble pigment excreted in the bile. Failure of the liver cells to excrete bile, or obstruction of the bile ducts, can cause an increased amount of bilirubin in the body fluids and thus lead to obstructive or regurgitation jaundice.
Another type of jaundice results from excessive destruction of erythrocytes (hemolytic or retention jaundice). The more rapid the destruction of red blood cells and the degradation of hemoglobin, the greater the amount of bilirubin in the body fluids.
Most bilirubin is excreted in the feces. A small amount is excreted in the urine as urobilinogen.
bilirubin that has been conjugated, mainly to glucuronic acid, in the liver and gives a direct result to the van den bergh test. High blood levels indicate obstructive or hepatocellular origin of the jaundice.
see conjugated bilirubin (above).
see unconjugated bilirubin (below).
bilirubin that has not been conjugated in the liver. It gives an indirect reaction to the van den bergh test. A high level of it in the blood is indicative of hemolysis or a lack of bilirubin clearance by the liver. Called also free bilirubin.