What is the difference between conjugated and unconjugated hyperbilirubinemia
Conjugated hyperbilirubinemia, also known as direct hyperbilirubinemia, occurs when there is an increase in the levels of conjugated bilirubin in the blood. Conjugated bilirubin is water-soluble and is formed when unconjugated bilirubin, which is fat-soluble, undergoes a chemical reaction in the liver involving the addition of glucuronic acid. Conjugated hyperbilirubinemia is primarily caused by liver diseases, such as hepatitis or cirrhosis, where the impaired liver function prevents the conversion of unconjugated bilirubin into its conjugated form and its subsequent excretion.
On the other hand, unconjugated hyperbilirubinemia, also known as indirect hyperbilirubinemia, occurs when there is an increase in the levels of unconjugated bilirubin in the blood. Unconjugated bilirubin is produced from the breakdown of heme in red blood cells and is usually bound to albumin for transport to the liver. Unconjugated hyperbilirubinemia can be caused by various conditions, such as hemolytic anemia (increased breakdown of red blood cells), Gilbert's syndrome (a genetic condition affecting bilirubin metabolism), or any condition that disrupts the normal processing or uptake of bilirubin by the liver.
In summary, the main difference between conjugated and unconjugated hyperbilirubinemia lies in the underlying cause and the type of bilirubin present in the blood. Conjugated hyperbilirubinemia is caused by liver dysfunction and is characterized by increased levels of conjugated bilirubin, while unconjugated hyperbilirubinemia is often due to increased bilirubin production or decreased bilirubin processing by the liver and is characterized by increased levels of unconjugated bilirubin.