Measurement and clinical usefulness of bilirubin in liver disease

Elevated plasma bilirubin levels are a frequent clinical finding. It can be secondary to alterations in any stage of its metabolism: (a) excess bilirubin production (i.e., pathologic hemolysis); (b) impaired liver uptake, with elevation of indirect bilirubin; (c) impaired conjugation, prompted by a...

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Autores principales:	Guerra Ruiz Armando Raúl, Crespo Javier, López Martínez Rosa Maria, Iruzubieta Paula, Casals Mercadal Gregori, Lalana Garcés Marta, Lavin Bernardo, Morales Ruiz Manuel
Formato:	article
Lenguaje:	EN ES
Publicado:	De Gruyter 2021
Materias:	biomarker bilirubin cholestasis diazo method liver disease Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/dc12e774090f45309948d2dabece0c03
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spelling	oai:doaj.org-article:dc12e774090f45309948d2dabece0c032021-12-05T14:10:40ZMeasurement and clinical usefulness of bilirubin in liver disease2628-491X10.1515/almed-2021-0047https://doaj.org/article/dc12e774090f45309948d2dabece0c032021-07-01T00:00:00Zhttps://doi.org/10.1515/almed-2021-0047https://doaj.org/toc/2628-491XElevated plasma bilirubin levels are a frequent clinical finding. It can be secondary to alterations in any stage of its metabolism: (a) excess bilirubin production (i.e., pathologic hemolysis); (b) impaired liver uptake, with elevation of indirect bilirubin; (c) impaired conjugation, prompted by a defect in the UDP-glucuronosyltransferase; and (d) bile clearance defect, with elevation of direct bilirubin secondary to defects in clearance proteins, or inability of the bile to reach the small bowel through bile ducts. A liver lesion of any cause reduces hepatocyte cell number and may impair the uptake of indirect bilirubin from plasma and diminish direct bilirubin transport and clearance through the bile ducts. Various analytical methods are currently available for measuring bilirubin and its metabolites in serum, urine and feces. Serum bilirubin is determined by (1) diazo transfer reaction, currently, the gold-standard; (2) high-performance liquid chromatography (HPLC); (3) oxidative, enzymatic, and chemical methods; (4) direct spectrophotometry; and (5) transcutaneous methods. Although bilirubin is a well-established marker of liver function, it does not always identify a lesion in this organ. Therefore, for accurate diagnosis, alterations in bilirubin concentrations should be assessed in relation to patient anamnesis, the degree of the alteration, and the pattern of concurrent biochemical alterations.Guerra Ruiz Armando RaúlCrespo JavierLópez Martínez Rosa MariaIruzubieta PaulaCasals Mercadal GregoriLalana Garcés MartaLavin BernardoMorales Ruiz ManuelDe Gruyterarticlebiomarkerbilirubincholestasisdiazo methodliver diseaseMedical technologyR855-855.5ENESAdvances in Laboratory Medicine, Vol 2, Iss 3, Pp 352-361 (2021)
institution	DOAJ
collection	DOAJ
language	EN ES
topic	biomarker bilirubin cholestasis diazo method liver disease Medical technology R855-855.5
spellingShingle	biomarker bilirubin cholestasis diazo method liver disease Medical technology R855-855.5 Guerra Ruiz Armando Raúl Crespo Javier López Martínez Rosa Maria Iruzubieta Paula Casals Mercadal Gregori Lalana Garcés Marta Lavin Bernardo Morales Ruiz Manuel Measurement and clinical usefulness of bilirubin in liver disease
description	Elevated plasma bilirubin levels are a frequent clinical finding. It can be secondary to alterations in any stage of its metabolism: (a) excess bilirubin production (i.e., pathologic hemolysis); (b) impaired liver uptake, with elevation of indirect bilirubin; (c) impaired conjugation, prompted by a defect in the UDP-glucuronosyltransferase; and (d) bile clearance defect, with elevation of direct bilirubin secondary to defects in clearance proteins, or inability of the bile to reach the small bowel through bile ducts. A liver lesion of any cause reduces hepatocyte cell number and may impair the uptake of indirect bilirubin from plasma and diminish direct bilirubin transport and clearance through the bile ducts. Various analytical methods are currently available for measuring bilirubin and its metabolites in serum, urine and feces. Serum bilirubin is determined by (1) diazo transfer reaction, currently, the gold-standard; (2) high-performance liquid chromatography (HPLC); (3) oxidative, enzymatic, and chemical methods; (4) direct spectrophotometry; and (5) transcutaneous methods. Although bilirubin is a well-established marker of liver function, it does not always identify a lesion in this organ. Therefore, for accurate diagnosis, alterations in bilirubin concentrations should be assessed in relation to patient anamnesis, the degree of the alteration, and the pattern of concurrent biochemical alterations.
format	article
author	Guerra Ruiz Armando Raúl Crespo Javier López Martínez Rosa Maria Iruzubieta Paula Casals Mercadal Gregori Lalana Garcés Marta Lavin Bernardo Morales Ruiz Manuel
author_facet	Guerra Ruiz Armando Raúl Crespo Javier López Martínez Rosa Maria Iruzubieta Paula Casals Mercadal Gregori Lalana Garcés Marta Lavin Bernardo Morales Ruiz Manuel
author_sort	Guerra Ruiz Armando Raúl
title	Measurement and clinical usefulness of bilirubin in liver disease
title_short	Measurement and clinical usefulness of bilirubin in liver disease
title_full	Measurement and clinical usefulness of bilirubin in liver disease
title_fullStr	Measurement and clinical usefulness of bilirubin in liver disease
title_full_unstemmed	Measurement and clinical usefulness of bilirubin in liver disease
title_sort	measurement and clinical usefulness of bilirubin in liver disease
publisher	De Gruyter
publishDate	2021
url	https://doaj.org/article/dc12e774090f45309948d2dabece0c03
work_keys_str_mv	AT guerraruizarmandoraul measurementandclinicalusefulnessofbilirubininliverdisease AT crespojavier measurementandclinicalusefulnessofbilirubininliverdisease AT lopezmartinezrosamaria measurementandclinicalusefulnessofbilirubininliverdisease AT iruzubietapaula measurementandclinicalusefulnessofbilirubininliverdisease AT casalsmercadalgregori measurementandclinicalusefulnessofbilirubininliverdisease AT lalanagarcesmarta measurementandclinicalusefulnessofbilirubininliverdisease AT lavinbernardo measurementandclinicalusefulnessofbilirubininliverdisease AT moralesruizmanuel measurementandclinicalusefulnessofbilirubininliverdisease
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Measurement and clinical usefulness of bilirubin in liver disease

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