Bilirubinemia

Bilirubinemia, the content of bile pigment in the blood. The blood of a healthy person contains bilirubin in the amount of 0.3-0.6 mg%. For its determination, the ability of bilirubin to give a red-violet coloration with Ehrlich's diazo reagent is used. In some cases, the color change occurs immediately after adding the diazo reagent (direct reaction), in others - the coloring appears only after preliminary addition of alcohol to the serum (indirect reaction) according to Hymans van den Bergh. Formed in the body as a result of the breakdown of the hemoglobin molecule, bilirubin is excreted by the liver with bile into the intestine. The main site of bilirubin formation should be considered the reticulo-endothelial system, with Kupffer cells of the liver playing a primary role. The possibility of bilirubin formation outside the liver has been confirmed by brilliant experiments by American authors Mann and Magath. They succeeded in producing bilirubinemia in dogs after liver removal. In various types of jaundice, the amount of bilirubin in the blood significantly increases (up to 60 mg%). B. reaches high figures in "mechanical" jaundices on the basis of obstruction of the bile ducts; in these cases, the blood of patients gives a direct reaction for bilirubin; hemolytic type jaundices proceed with a lesser increase in the amount of bilirubin, which in this case gives an indirect reaction.