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Bilirubin production, metabolism, and excretion

Bilirubin production, metabolism, and excretion
Schematic diagram demonstrating the production, metabolism, and excretion of bilirubin.
*Physiologic mechanisms that reduce the movement of free bilirubin across the blood-brain barrier include binding to plasma albumin and rapid uptake, conjugation, and clearance by the liver. These protective mechanisms are less efficient in neonates (especially preterm infants) and individuals with inherited disorders of bilirubin conjugation. As a result, these patients are at risk for bilirubin-induced neurotoxicity.
Adapted from: Hansen TWR, Bratlid D. Physiology of neonatal unconjugated hyperbilirubinemia. In: Care of the Jaundiced Neonate, Stevenson DK, Maisels MJ, Watchko JF (Eds), McGraw-Hill Companies, New York 2012.
Graphic 121543 Version 4.0