The clinical importance of a protein-bound fraction of serum bilirubin in patients with hyperbilirubinemia.
A directly reacting fraction of bilirubin that is probably covalently bound to albumin (albumin-bound bilirubin) has recently been described. To determine its clinical importance we used a new high-performance liquid-chromatography technique to measure it in the serum of 200 patients with hyperbilirubinemia from various causes. Albumin-bound bilirubin was an important fraction (8 to 90 per cent) of total bilirubin in patients with hepatocellular and cholestatic jaundice as well as in patients with the Dubin-Johnson syndrome. It was not detected in normal volunteers, neonates with physiologic jaundice, or patients with Gilbert's disease or hemolysis. Thus, albumin-bound bilirubin appears in serum when hepatic excretion of conjugated bilirubin is impaired. It becomes a larger component of serum bilirubin as jaundice subsides, delaying resolution of this disorder and causing bilirubin to persist in plasma after it has disappeared from the urine.
D001663:Bilirubin / Q000097:blood*; D002851:Chromatography, High Pressure Liquid; D005878:Gilbert Disease / Q000097:blood; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood*; D007231:Infant, Newborn; D007565:Jaundice / Q000097:blood; D007566:Jaundice, Chronic Idiopathic / Q000097:blood; D011485:Protein Binding; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin; D001663:Bilirubin