Bilirubin in clinical practice: a review

@article{Fevery2008BilirubinIC,
  title={Bilirubin in clinical practice: a review},
  author={Johan Fevery},
  journal={Liver International},
  year={2008},
  volume={28}
}
  • J. Fevery
  • Published 1 May 2008
  • Medicine, Biology
  • Liver International
Bilirubin is an endogenous compound that can be toxic under certain conditions but, on the other hand, mild unconjugated hyperbilirubinaemia might protect against cardiovascular diseases and tumour development. Serum bilirubin levels are often enhanced under a variety of clinical conditions. These are discussed and the mechanisms are outlined. 

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References

SHOWING 1-10 OF 119 REFERENCES

Chemoprevention of severe neonatal hyperbilirubinemia.

The uses of synthetic heme analogues that are competitive inhibitors of heme oxygenase, the rate-limiting enzyme in the production of bilirubin, represent a novel means of controlling severe

Glucuronidation of bilirubin and the occurrence of pigment gallstones in patients with chronic haemolytic diseases

A clearcut separation from normal values was not obtained, suggesting at least in the present group of patients that Gilbert's syndrome represents only one end of a continuum of bilirubin conjugation rates and not a separate entity.

Unconjugated hyperbilirubinemia. Physiologic evaluation and experimental approaches to therapy.

Of the hereditary disorders of bilirubin metabolism, Gilbert's syndrome is common but innocuous, whereas Crigler-Najjar syndrome is rare but devastating, and various modalities used in an attempt to reduce her plasma bilIRubin concentration by either increasing bilirubsin clearance or reducing bilirUBin turnover are described.

Serum bilirubins in hepatobiliary disease: Comparison with other liver function tests and changes in the postobstructive period

Using this criterion, the AMHPLC result in the clinical anicteric patients (n = 39) was more frequently abnormal than the corresponding value of fasting serum bile acids, SGPT, total bilirubins, alkaline phosphatase, or γ‐glutamyl transpeptidase.

Enterohepatic cycling of bilirubin: a putative mechanism for pigment gallstone formation in ileal Crohn's disease.

Intestinal colonization leading to fecal urobilinoid excretion may play a role in the pathogenesis of neonatal jaundice.

The urobilinoid production during the first week of life is quantitatively insufficient to contribute significantly to the removal of bilirubin, but enhancement of the microbial conversion of bilIRubin could decrease the intestinal concentration of bil irubin and may decrease the degree or enhance the removalof neonatal hyperbilirubinemia.

Renal bilirubin clearance in liver patients.

Serum bilirubin levels in the U.S. Population: Gender effect and inverse correlation with colorectal cancer

The observed inverse correlation between serum bilirubin concentrations and a history of nondermatological malignancy, particularly colorectal cancer, warrants further investigation of a potentially important chemopreventive function of bilirUBin.

Hepatic uptake of organic anions affects the plasma bilirubin level in subjects with Gilbert's syndrome mutations in UGT1A1

The lower BSP uptake in Gilbert's syndrome is not secondary to the hyperbilirubinemia, but probably caused by an independent, genetically determined defect in hepatic transport mechanism(s), shared by BSP and bilirubin, that is likely necessary for phenotypic expression of GS.

Molecular basis of bilirubin-induced neurotoxicity.

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