Differentiate conjugated and unconjugated hyperbilirubinemia
Conjugated hyperbilirubinemia refers to a condition where there is an elevation in the levels of conjugated bilirubin in the blood. Conjugated bilirubin is the water-soluble form of bilirubin that has been metabolized by the liver and is bound to other substances for excretion into the bile. Causes of conjugated hyperbilirubinemia include liver diseases such as viral hepatitis, alcoholic hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis.
Unconjugated hyperbilirubinemia, on the other hand, refers to a condition where there is an elevation in the levels of unconjugated bilirubin in the blood. Unconjugated bilirubin is the lipid-soluble form of bilirubin that is produced during the breakdown of heme in red blood cells. Causes of unconjugated hyperbilirubinemia include increased production of bilirubin, decreased uptake of bilirubin by the liver, decreased conjugation of bilirubin, or increased reabsorption of unconjugated bilirubin from the intestine. Conditions such as hemolytic anemia, Gilbert syndrome, Crigler-Najjar syndrome, and drugs that interfere with bilirubin metabolism can lead to unconjugated hyperbilirubinemia.