Analysis index

1 ml serum, protect from light, avoid hemolysis (Stability of sample at 4°C – 8°C: 7 days)

For newborns and babies: At least 1 ml blood or 500 µl serum for total bilirubin and conjugated as well as non-conjugated bilirubin.

Adults: < 1,3 mg/dl

Babies: please refer to findings report

Diagnosis, differential diagnosis as well as progress checks of jaundice/icterus

Bilirubin is a degradation product of heme and is produced in the reticulo-endothelial system of the spleen and liver. The produced unconjugated (indirect) bilirubin is bound to albumin and transported to the liver. There, it is glucuronidated (soluble, direct bilirubin). Following this, it is excreted via the bile and partially the urine (urobilinogen). The total bilirubin consist of direct and indirect fractions. In case of increased production due to hemolysis, liver damage, impaired glucuronidation or problems of bile drainage, bilirubin increasingly appears in the blood and tissue and is responsible for the characteristic jaundice.  

By differentiation into direct and indirect bilirubin, a conclusion can be drawn as to its genesis. In newborns, considerably higher levels are seen in comparison to older children and adults, due to the neonatal glucuronidation weakness of the liver. Depending on the method used, multiple disruptive factors, such as uremia or drugs such as p-amino salicylic acid, tetracycline or propranolol are described.