Blood biochemistry: total bilirubin
Synonym(s): Direct and indirect bilirubin conjugated and unconjugated bilirubin
Overview
- Peripheral breakdown of red blood cells and myoglobin → unconjugated (indirect) bilirubin → bound to albumin → transported to liver → conjugated with glucuronic acid → excreted in bile.
- Jaundice, with an increase in total bilirubin, may be primarily due to an increase in direct, or indirect bilirubin or both.
Uses
In combination
- Hemolytic crisis Anemia: immune-mediated hemolytic.
- Internal hemorrhage.
- Intrahepatic and post-hepatic biliary obstruction.
Sampling
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Tests
Methodologies
- Van den Bergh method.
- Measure [total bilirubin] minus [direct bilirubin] = [indirect bilirubin].
Availability
- Routine test.
Technique intrinsic limitations
- Interpret results in conjunction with other laboratory results.
Technician extrinsic limitations
- Routine test.
Result Data
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Further Reading
Publications
Refereed papers
- Recent references from VetMedResource and PubMed.
Other sources of information
- Ettinger S J & Feldman E C (2000) Eds. Textbook of Veterinary Internal Medicine. 5th edn. W B Saunders & Co, USA.
- Kaneko J J, Harvey J W & Brass M L (eds) (1997) Clinical Biochemistry of Domestic Animals. 5th edn. Academic Press, USA.
- Duncan J R, Prasse K W & Mahaffey E A (1994) Veterinary Laboratory Medicine. Clinical Pathology. 3rd edn. Iowa University Press, USA.