12 Facts About Conjugated bilirubin

Elevation of both alanine aminotransferase and Conjugated bilirubin is more indicative of serious liver injury than is elevation in ALT alone, as postulated in Hy's law that elucidates the relation between the lab test results and drug-induced liver injury.

Measurement of unconjugated bilirubin is underestimated by measurement of indirect bilirubin, as unconjugated bilirubin reacts with diazosulfanilic acid to create azobilirubin which is measured as direct bilirubin.

Furthermore, direct bilirubin tends to overestimate conjugated bilirubin levels due to unconjugated bilirubin that has reacted with diazosulfanilic acid, leading to increased azobilirubin levels .

Studies have revealed that levels of serum Conjugated bilirubin are inversely related to risk of certain heart diseases.

Note: Conjugated bilirubin is often incorrectly called "direct bilirubin" and unconjugated bilirubin is incorrectly called "indirect bilirubin".

Direct bilirubin is any form of bilirubin which is water-soluble and is available in solution to react with assay reagents; direct bilirubin is often made up largely of conjugated bilirubin, but some unconjugated bilirubin can still be part of the "direct" bilirubin fraction.

Likewise, not all conjugated bilirubin is readily available in solution for reaction or detection and therefore would not be included in the direct bilirubin fraction.

Jaundice is classified, depending upon whether the bilirubin is free or conjugated to glucuronic acid, into conjugated jaundice or unconjugated jaundice.

Unconjugated bilirubin is not water-soluble and so is not excreted in the urine.

Conjugated bilirubin observed dilated bile ducts were full of yellow magma, which he isolated and found to be insoluble in water.

The term "Conjugated bilirubin" was thought to have become mainstream based on the works of Staedeler in 1864 who crystallized Conjugated bilirubin from cattle gallstones.

Origins pertaining to the physiological activity of Conjugated bilirubin were described by Ernst Stadelmann in 1891, who may have observed the biotransformation of infused hemoglobin into Conjugated bilirubin possibly inspired by Ivan Tarkhanov's 1874 works.