Release Date: Apr 2018
CC: PC, MK, PBL, SBP
Trefor Higgins, MSc
Division Head of Medical Biochemistry, University of Alberta Hospital, Edmonton, AB, Canada; Clinical Professor, University of Alberta, Edmonton, AB, Canada
Bilirubin is the final product of the catabolism of heme-containing proteins such as hemoglobin. Increased concentration of bilirubin in plasma is an indicator of increased catabolism of red blood cells or of decreased hepatic clearance. Several named syndromes including Dubin-Johnson, Crigler-Nijjar, and Gilbert’s syndromes are found and the diagnosis of these syndromes is dependent on measurement of different bilirubin fractions in plasma including direct (uncongested), indirect (conjugated), and delta as well as the total bilirubin. Different techniques of measuring bilirubin are available and the method of choice is dependent on patient age and clinical reason for the test. In early life, reflectance or spectrophotometric measurements may be used, while in later childhood and in the adult, the measurement may be made by colorimetric methods. In this presentation, the formation of bilirubin and nomenclature of fractions, as well a review of the different analytical methods and the clinical circumstances in which they are used, will be discussed as well as the distribution of fractions found in the named syndromes.
After attending this session, participants will be able to:
- Identify the current methods available for bilirubin analysis.
- Recognize which method is referred in different situations.
- List the clinical reasons for elevated bilirubin in serum.
Who should attend? Practicing Pathologists, Residents, Doctoral Scientists, Laboratory Managers, Bench Supervisors, Bench Technologists and Technicians