conjugated bilirubin
connectec bilirubin

More specifically, it determines the amount of conjugated bilirubin in the blood.

Kernicterus is a condition not associated with increased conjugated bilirubin.

Liver function tests will therefore show increased serum bilirubin, with high conjugated bilirubin.

It is a distinct disorder, yet similar to Dubin-Johnson syndrome - both diseases cause an increase in conjugated bilirubin.

High amounts of the soluble conjugated bilirubin enter the circulation where they are excreted via the kidneys.

Conjugated bilirubin is released into the bile by the liver and stored in the gallbladder, or transferred directly to the small intestines.

When this occurs, conjugated bilirubin and the waste products that usually would be cleared in bile reflux back into the bloodstream.

In the gut, brush border β-glucuronidase converts conjugated bilirubin to the unconjugated form for reabsorption.

This allows the escape of conjugated bilirubin into the circulation as occurs in hepatitis and hepatic cirrhosis).

The blood contains abnormally raised amount of conjugated bilirubin and bile salts which are excreted in the urine.

Hence in hepatocellular jaundice, concentration of both unconjugated and conjugated bilirubin rises in the blood.

This conjugated bilirubin does not normally appear in the urine as it is excreted directly from the intestine in bile.

Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and conjugated bilirubin.

In biliary obstruction, below-normal amounts of conjugated bilirubin reach the intestine for conversion to urobilinogen.

Direct bilirubin (conjugated bilirubin)

This condition is associated with a defect in the ability of hepatocytes to secrete conjugated bilirubin into the bile, and is similar to Rotor syndrome.

The bacteria in the adult gut convert conjugated bilirubin to stercobilinogen which is then oxidized to stercobilin and excreted in the stool.

Instead the conjugated bilirubin is converted back into the unconjugated form by the enzyme glucuronidase and a large proportion is reabsorbed through the enterohepatic circulation.

Intestinal bacteria convert the conjugated bilirubin that is excreted by the bile duct into the intestine into urobilinogen and stercobilinogen.

People with GS predominantly have elevated unconjugated bilirubin, while conjugated bilirubin is usually within the normal range and is less than 20% of the total.

Relatively low activity of the enzyme glucuronosyltransferase which normally converts unconjugated bilirubin to conjugated bilirubin that can be excreted into the gastrointestinal tract.

Cholestasis can be excluded by the absence of lactate dehydrogenase, low levels of conjugated bilirubin and ultrasound scan of the bile ducts.

Liver function tests can show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, γ-glutamyl transpeptidase and alkaline phosphatase levels).

Dubin-Johnson syndrome and Rotor syndrome, which are rarer autosomal recessive disorders that are characterized by an increase of conjugated bilirubin.

This obstruction may lead to jaundice, elevation in alkaline phosphatase, increase in conjugated bilirubin in the blood and increase in cholesterol in the blood.