Reconsideration of Jaundice, August 6, 1998

Reconsideration of Jaundice, August 6, 1998

The total bilirubin level in the blood should not exceed 1 mg, with direct bilirubin no more than 0.2 mg and indirect bilirubin no more than 0.8 mg, meaning indirect bilirubin is about four times that of direct bilirubin. Direct bilirubin refers to conjugated bilirubin, which is processed by the liver and then combines with two molecules of glucose. It can be filtered through the glomeruli, and this type of bilirubin is usually associated with obstructive jaundice. Indirect bilirubin, on the other hand, is unconjugated bilirubin, which is free bilirubin released when red blood cells break down without combining with glucose molecules. This type of bilirubin is usually associated with hemolytic jaundice. Hepatic jaundice is characterized by both direct and indirect bilirubin, with a ratio of about four to one between the two.