Bilirubin
Clinical Significance :- Bilirubin is mainly formed from the heme portion of aged or damaged RBC's. It then combines with albumin to from a complex which is not water soluble . This is referred to as indirect or unconjugated Bilirubin . In the liver this Bilirubin complex is combined with glucuronic acid into a water soluble conjugate. This is referred to as conjugated or direct Bilirubin . Elevated levels of bilirubin are found in liver disease ( Hepatitis, cirrhosis) excessive hemolysis / destruction of RBC (hemolytic ( ) obstruction of biliary tract and in drug induced reactions. The differentiation between the direct and indirect bilirubin is important in diagnosis the cause of hyperbilirubinemia. Principle :- Bilirubin react with diazotised sulphanilic acid to form a coloured azobilirubin compound. The unconjugated bilirubin couples with s...