Current Concepts of Bilirubin Metabolism in Jaundice

Abstract

Studies of the metabolism of bilirubin have shown that bilirubin may be added to the already-known metabolites and exogenous substances which are excreted by the liver as glucuronides.

From experiments in animals, it seems likely that bilirubin undergoes conjugation to pigment I (monoglucuronide) outside the liver or to pigment I and then to pigment II (diglucuronide) within the liver. The transformation of lipid-soluble bilirubin to water-soluble pigments is thought to be responsible for the chemical and physiologic differences between indirect and direct bilirubin in various forms of jaundice.