ملاحظات حول
▶Bilirubin
●Total bilirubin is < 1 mg/dl
●direct ≤0.3 mg/dl
●Free direct bilirubin (half life = 4 h)
●Delta conjugated bilirubin (T1/2 = 12-14 d)
● Hemolysis gives T. bilirubin ≤ 5 mg/dl, mostly
indirect (no bilirubin in urine)
▶Bilirubin
●Total bilirubin is < 1 mg/dl
●direct ≤0.3 mg/dl
●Free direct bilirubin (half life = 4 h)
●Delta conjugated bilirubin (T1/2 = 12-14 d)
● Hemolysis gives T. bilirubin ≤ 5 mg/dl, mostly
indirect (no bilirubin in urine)
●Bilirubin in urine usually indicates hepatobiliary
disease (direct bilirubin)
●Urobilinogen (in urine) is decreased in biliary
obstruction
disease (direct bilirubin)
●Urobilinogen (in urine) is decreased in biliary
obstruction
Causes of Hyperbilirubinemia
Indirect (Isolated)
● Gilbert’s Syndrome (< 6 mg/dl)
●Crigler Najjar 1 (25 -48 mg/dl)
●Crigler Najjar II (6-25 mg/dl)
●Hemolysis (< 5 mg/dl)
●Neonatal jaundice
Indirect (Isolated)
● Gilbert’s Syndrome (< 6 mg/dl)
●Crigler Najjar 1 (25 -48 mg/dl)
●Crigler Najjar II (6-25 mg/dl)
●Hemolysis (< 5 mg/dl)
●Neonatal jaundice
Causes of Isolated Hyperbilirubinemia
Direct+indirect (Isolated)
● Dubin -Johnson.. syndrome
●Rotor syndrome
● Hepatic Storage Disease
Dr. Haidar Almamari
Direct+indirect (Isolated)
● Dubin -Johnson.. syndrome
●Rotor syndrome
● Hepatic Storage Disease
Dr. Haidar Almamari
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