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Approximately 80-85% of serum bilirubin is the product of the heme moiety in hemoglobin, which is released from old and worn red blood cells in reticulocyte cells. Bilirubin is bound to albumin, enters the liver, where it is immediately conjugated with glucuronium acid to increase its solubility, then it is poured into the bile duct and finally hydrolyzed in the intestine.
Serum unconjugated bilirubin concentration in case of increased production of bilirubin (in acute and chronic hemolytic anemias), disorder in bilirubin metabolism and its transport (defects in uptake by liver cells: Gilbert syndrome; disorder in bilirubin conjugation: Crigler-Najjar syndrome ) increases.
Reduced excretion (as a result of damage to liver cells: hepatitis, cirrhosis, etc., Dubin-Johnson syndrome and Rotor syndrome) and blockage of bile ducts (which is often caused by gallstones or tumors) to a significant amount of conjugated bilirubin and in A lower amount raises unconjugated rubin, which is called "conjugated hyperbilirubinemia."
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