Bab ii proses metabolisme pemecahan heme sangatlah. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Bilirubin comes from degradation of hemoglobin and cells. It is the major metabolic breakdown product of heme, the prosthetic group of hemoglobin in red blood cells, and other chromoproteins such as myoglobin, cytochrome, and catalase. Bilirubin displacement sulfonamides, warfarin, antiinflamatory drugs, and cholecystographic contrast media also bind albumin at same site as bilirubin so can precipitate bilirubin encephalopathy in the newborn with the same total bilirubin conc bilirubin is bound to albumin or hdls to make it soluble only small amount in free state. The metabolism of bilirubin has been under intense investigation for many years. It is formed by the enzymatic reduction of biliverdin. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Bilirubin levels chart normal, low, high bilirubin levels. Pdf bilirubininduced neurologic damage mechanisms and. Summary of test principle and clinical relevance the lx20 uses a timedendpoint diazo method to measure the concentration of total bilirubin in serum or plasma.
Bilirubin is the potentially toxic catabolic product of heme metabolism. The classic definition of jaundice is a serum bilirubin level greater than 2. In the reaction, bilirubin reacts with diazo reagent in the presence of caffeine. Unusual presentation of gilbert disease with high levels of. Winner of the standing ovation award for best powerpoint templates from presentations magazine. There are no pathologic processes causing abnormally low bilirubin levels. Bilirubin metabolism article about bilirubin metabolism by. The monoanion is present at approximately 17% and the dianion is. Formation, transport, metabolism and excretion of bilirubin.
Bilirubin br is a yellow compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates. Consider that your liver is a massive organ with so many crucial responsibilities, including. Get a printable copy pdf file of the complete article 2. Bilirubin metabolism albert einstein college of medicine. Furthermore, because bilirubin shares its metabolic pathway with various other sparingly water soluble substances that are excreted in bile, understanding bilirubin metabolism also provides insight into the mechanisms of transport, detoxification, and elimination of many other organic anions. Bilirubin is produced from the catabolism of the heme molecule. Bilirubin is conjugated to two molecules of glucuronic acid, creating bilirubin diglucuronide. Oct 14, 20 bilirubin, a major end product of heme breakdown, is an important constituent of bile, responsible for its characteristic colour. Free bilirubin is not soluble in acqueous media, but this reagent contains an. Determine quantity of total bilirubin in serum in vitro with thermo scientific total bilirubin reagents. For instance, no increase in serum bilirubin was observed after 48 weeks of treatment with atorvastatin or simvastatin 14, and in a large crosssectional study statin treatment was unexpectedly. Bilirubin formerly referred to as haematoidin is a yellow compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates. Jaundice is usually present clinically when the plasma.
Total bilirubin consists of both conjugated direct and unconjugated indirect fractions. Bilirubin is left after these older blood cells are removed. Neonatal jaundice is principally the result of an increased synthesis of bilirubin, of a transient deficiency of bilirubin conjugation, of a partial deficiency of hepatic bilirubin uptake and intracellular transport, and of an increased. Total bilirubin consists of both conjugated direct and. Get a printable copy pdf file of the complete article 589k, or click on a page image below to browse page by page. Laboratory for research of liver diseases and heme metabolism, central research laboratories, institute of medical biochemistry and laboratory diagnostics, first faculty of medicine, charles university and general university hospital in prague, czech republic. Bilirubin free download as powerpoint presentation. Over recent decades, our understanding of bilirubin metabolism has expanded along with the processes of elimination of other endogenous and exogenous anionic substrates, mediated by the action of multiple transport systems at the sinusoidal and canalicular membrane. Bilirubin metabolism, unconjugated hyperbilirubinemia, and. Very recently, bilirubin has been shown to possess important functions as an antioxidant, but it also serves simply as a means to excrete unwanted heme, derived from various hemecontaining proteins such as hemoglobin, myoglobin, and various p450 enzymes. Bilirubin is the normal byproduct of the breakdown of hemoglobin. Jaundice, or icterus from the greek ikteros, refers to the yellow discoloration of the skin, sclerae, and other tissues caused by deposition of the bile pigment bilirubin.
Bilirubin diglucuronide is transported out of the hepatocytes into the bile canaliculi and is thus excreted in bile. Bilirubin tak terkonjugasi hematobilirubin merupakan bilirubin bebas yang terikat albumin, bilirubin yang sukar larut dalam air sehingga untuk memudahkan bereaksi dalam pemeriksaan harus lebih dulu dicampur dengan alkohol, kafein atau pelarut lain sebelum dapat bereaksi, karena itu dinamakan bilirubin indirek. C hb globin cells of the reticular endothelial system. The formation of bilirubin and its elimination from the body as a waste product of heme catabolism require a series of metabolic alterations and transport processes. Metabolism of bilirubin tapeshwar yadav lecturer bmlt, dnhe, m. The liver helps break down bilirubin so that it can be removed from the body in the stool. Bilirubin is the end product of the catabolism of heme, the major source of which is circulating hemoglobin see fig. Fortunately, there are elaborate physiologic mechanisms for its detoxification and disposition. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that. Archived from the original pdf on 18 december 2014. Jaundice is the most common reason to check bilirubin level. Bilirubin is an important metabolite of heme ferroprotoporphyrin ix, a coordination complex that serves to coordinate iron in various proteins.
Links to pubmed are also available for selected references. The direct bilirubin assay is used for the quantitative analysis of direct bilirubin in human serum or plasma. These two fractions were discovered by labeling hemoglobin with a radioactive glycin, and. Setelah kurang lebih 120 hari, eritrosit diambil dan didegradasi oleh sistem res terutama di hati dan limpa. This quiz and corresponding worksheet gauge your understanding of what bilirubin is and what happens with a body when bilirubin is not excreted the proper way. Bilirubin is degraded in the intestine by bacteria into urobilinogens, which are partly excreted in the urine. Bilirubin levels chart is a table of common bilirubin levels that cause jaundice yellowish color of the skin and eyes sclera, includes normal bilirubin levels, high bilirubin levels, and low bilirubin levels in the same place. Bilirubin metabolism, unconjugated hyperbilirubinemia, and physiologic neonatal jaundice. This catabolism is a necessary process in the bodys clearance of waste products that arise from the destruction of aged or abnormal red blood cells. What are your other liver numbers, like ast, alt, and so on. Bilirubin is an endogenous compound that can be toxic under certain conditions but, on the other hand, mild unconjugated hyperbilirubinaemia might protect. The pancreas can also be a source of elevated bilirubin and there are pancreatic enzymes that could be checked along with a repeat bilirubin that might be helpful. Doc metabolisme bilirubin fironika ariyanti academia.
Increased levels are associated with conditions causing obstruction of the bile duct, hepatitis, cirrhosis, hemolytic disorders, physiological jaundice of the newborn and several inherited. Bilirubin circulates in the blood bound to albumin and is taken up by. Jaundice is a sign that the serum bilirubin concentration has risen above normal levels approximately 1. Please check my bilirubin level and advise bilirubin t 0. Since some of the things that cause high bilirubin can be serious, i. Disorders in bilirubin metabolism the medical biochemistry page. Metabolism of bilirubin and its biological properties valaskova, p.
It is present in small quantities in the plasma of vertebrate animals and man 0. Bilirubin metabolism article about bilirubin metabolism. High total bilirubin levels in adults doctor answers. Over recent decades, our understanding of bilirubin metabolism has expanded along with the processes of elimination of other endogenous and exogenous anionic substrates, mediated by the action of multiple transport systems at the. Over recent decades, our understanding of bilirubin metabolism has expanded along with the processes of elimination of other. Increased production, reduced uptake and low glucuronidation capacity can increase plasma unconjugated bilirubin levels. Where bilirubin comes from and where bilirubin goes to.
Total bilirubin fl bilirubin reacts with diazotized 3,5dichloroaniline to produce an intensely colored diazo compound 490520 nm. Bilirubin serum, plasma association for clinical biochemistry and. Bilirubin, a degradation product of heme, is produced largely by metabolism of hemoglobin released from senescent red blood cells. Bilirubin, a major end product of heme breakdown, is an important constituent of bile, responsible for its characteristic colour. Biochemistry of bilirubin online medical course lecturio. Your doctor can order a fractionalized bilirubin test which gives values for each component rather than merely the sum of the two.
Jaundicejaundice it is characterized by a yellow appearance of the 1 skin 2 mucous membranes and 3 sclera caused by bilirubin deposition. Ppt bilirubin powerpoint presentation free to view. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Bilirubin metabolism begins with the breakdown of red blood cells. 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. C biliverdin biliverdin reductase hb in the plasma bilirubin haptoglobin extravascular hemolysis unconjugated bilirubin bilirubin in blood blood intravascular hemolysis 10. Berkurangnya kapasitas pengambilan hepatik bilirubin yang tak terkonjugasi akan berpengaruh terhadap pembentukan ikterus fisiologis. Bilirubin glucuronides are actively transported into the bile canaliculi by the atputilizing pump mrp2. Bilirubin is an intermediate product of the decomposition of hemoglobin that takes place in the macrophages of the spleen, liver, and bone marrow.
If you ever get another blood test and the bilirubin is elevated, while the rest of the numbers are good, it may be. The most popular abbreviation for total bilirubin is. This page provides links to pages that discuss the genetics and clinical features of diseases related to defects in bilirubin metabolism. Ppt bilirubin powerpoint presentation free to view id. Metabolism of bilirubin and its biological properties. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Jaundicejaundice it is characterized by a yellow appearance of the 1 skin 2 mucous membranes and 3. High direct bilirubin high direct bilirubin with normal.
Nov 06, 2016 bilirubin levels chart is a table of common bilirubin levels that cause jaundice yellowish color of the skin and eyes sclera, includes normal bilirubin levels, high bilirubin levels, and low bilirubin levels in the same place. Shunt bilirubin is called that portion that does not originate from senescent circulating red cells but originates from immature and defective red cells 7% and from non hemoglobin heme compounds, particularly from hepatic cytochromes and from myoglobin. It is the most specific clinical manifestation of hepatic dysfunction. Sep 05, 2016 bilirubin formerly referred to as haematoidin is a yellow compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates. Sekitar 85% heme yang didegradasi berasal dari eritrosit dan 15% berasal dari jaringan ekstraeritroid. Many causes, but in absence of other symptoms and a history of elevated bili in past this is likely a benign genetic disorder. Bilirubin br is a yellow compound that occurs in the normal catabolic pathway that breaks. Jaundice is a yellow color in the skin, mucus membranes, or eyes. The normal total bilirubin ranges in a healthy patient varies between. Bilirubin is a metabolite of heme, a compound that serves to coordinate iron in various proteins. For instance, no increase in serum bilirubin was observed after 48 weeks of treatment with atorvastatin or simvastatin 14, and in a large crosssectional study. In the newborn infant, the normal destruction of circulating red blood cells in the reticuloendothelial system accounts for approximately 75% of the daily production of bilirubin. Thus this fact must be taken into consideration when assessing the individual risk of a patient and also accounts for ushape relationship between serum bilirubin and cardiovascular diseases observed in some studies breimer et al. Full text full text is available as a scanned copy of the original print version.
Chemistry of the formation of bilirubin from heme protein 2. Understanding these mechanisms is necessary for interpretation of the clinical significance of. Bilirubin metabolism an overview sciencedirect topics. Evaluating elevated bilirubin levels in asymptomatic adults ncbi. The intensity of color of this dye in solution is proportional to the concentration of total bilirubin. Total bilirubin in refrigerated serum nhanes 20012002 collaborative laboratory services, l. Is due to a very mild deficiency of glucuronyl transferase.