According to AAP guidelines laboratory investigation for jaundice include total serum bilirubin, blood Type and coombs test and if the baby has an elevation of direct reacting or
conjugated bilirubin, there should be a urine analysis and urine culture.
Although BL22P1B11-Rh binds unconjugated bilirubin with high affinity ([K.sub.d] = 16 nmol/L), it binds ditaurobilirubin, a model for
conjugated bilirubin (17), with a [K.sub.d] of 300 nmol/L (see online Supplemental Data and Supplemental Fig.
Bacterial infection and septicemia is a frequent cause of an increase in
conjugated bilirubin. Escherichia coli have been the most common organism reported.
Anonymized icteric sera (n = 73) with Creatinine concentrations <150 [micro]mol/L were stored at -20 [degrees]C for [greater than or equal to] 2 weeks, and total and
conjugated bilirubin were determined by the Roche liquid diazonium ion and Jendrassik-Grof based assays, respectively.
We tested the mesometals (undiluted and as 1:1 mixtures with saline or pooled serum) for interference in a range of automated assays on a Vitros[R] Model 950 AT: glucose, blood urea nitrogen, creatinine, ammonia, sodium, potassium, chloride, total [CO.sub.2], amylase, lipase, calcium, magnesium, phosphate, cholesterol, triglycerides, uric acid, albumin, aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase (LD), creatine kinase, alkaline phosphatase, [gamma]-glutamyl transpeptidase,
conjugated bilirubin, and unconjugated bilirubin.
For common chemistry tests (glucose, urea, creatinine, sodium, potassium, chloride, iron, carbon dioxide, amylase, lipase, calcium, magnesium, phosphate, cholesterol, triglycerides, uric acid, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatine kinase, [gamma]-glutamyl transpeptidase, alkaline phosphatase, total bilirubin,
conjugated bilirubin, and unconjugated bilirubin) performed on the Vitros 950AT (Ortho Clinical Diagnostics), we observed no differences between results for the control analyzed directly or after processing in the current or in the variant lot of SST tubes.
The initial step in investigation of jaundice should be to determine the
conjugated bilirubin fraction; if this is increased, then hepatobiliary pathology should be further investigated.
Here we describe interference in the measurement of
conjugated bilirubin by a different analyzer in sera from 3 patients (A, B, and C) with IgG-[kappa]-type myeloma.
If Gilbert syndrome is confirmed, the FT-AT score can be calculated with
conjugated bilirubin instead of total bilirubin.
The mean total bilirubin level was 12.3[+ or -]5.5 mg/dL (range: 3.6-37.1); the
conjugated bilirubin level was 8.7[+ or -]3.9 mg/dL (range: 2.7-24.3); and the prothrombin time (INR) was 1.37[+ or -]0.71 (range: 0.88-5.65).
Liver functions were abnormal with alanine aminotransferase 103.5 U/L, aspartate aminotransferase 138.4 U/L, a-glutamyltransferase 259.9 U/L, alkaline phosphate 567.1 U/L, serum total bilirubin 137.2 [micro]mol/L,
conjugated bilirubin 85.9 [micro]mol/L, total bile acid 46.2 [micro]mol/L, albumin 26.4 g/L, prothrombin time 15.6 s, and prothrombin activity 58%.
Vanita Patil and Samarin Musaad from Labtests Auckland present a case study of elevated
conjugated bilirubin arising from giant cell neonatal hepatitis.