BILIRRUBINA: METABOLISMO, PRUEBAS DE LABORATORIO E HIPERBILIRRUBINEMIA
Palabras clave:
Bilirrubina, hiperbilirrubinemia, ictericia, conjugación
Resumen
La bilirrubina es el producto final de la degradación del grupo hem. La bilirrubina no conjugada (BNC) se forma en las células retículoendoteliales, transportada al hígado, donde es conjugada a glucurónidos y secretada a los canalículos. La BNC se solubiliza en el suero por medio de su fuerte unión con la albúmina. La unión bilirrubina-albúmina es una función de las concentraciones de la albúmina y de la bilirrubina y de la afinidad de unión por la bilirrubina. La fracción de bilirrubina no unida o bilirrubina libre plasmática (Bf) se incrementa significativamente conforme el nivel de bilirrubina sérica total (BST) alcanza la capacidad de unión de la albúmina. La Bf es considerada un mejor indicador de neurotoxicidad que la BST, a causa de que solamente la bilirrubina libre puede cruzar la barrera hematoencefálica. En la práctica médica la bilirrubina es un marcador de disfunción hepática, colestasis o enfermedad hemolítica. Una variedad de factores limita la sensibilidad y la especificidad de la medición de la bilirrubina para detectar anormalidades: lipemia, hemólisis, exposición a la luz visible y el estado de ayuno. La hiperbilirrubinemia puede ser clasificada como prehepática, hepática y poshepática, y esto brinda un marco útil para identificar la causa subyacente. Además, hay bilirrubina conjugada y no conjugada. La hiperbilirrubinemia y la ictericia neonatales se presentan en casi todos los recién nacidos y puede ser benigna si su progresión a hiperbilirrubinemia es reconocida, monitoreada y prevenida o tratada en una manera oportuna.
Citas
1. Bouchier, I.(1981). Diagnosis of jaundice. British Med J, 1282-1284.
2. Spencer, A. Bagai, I., Becker, D., Zuiderweg, E. & Ragsdale, S. (2014). Protein / Protein interactions in the mammalian heme degradation pathway. Heme oxigenase-2, cytochrome P450, and biliverdin reductase. J Biol Chem, 289(43), 29836-29858.
3. Hemmati, F., Saki, F. & Haghighat, M. (2010).Gilbert syndrome in Iran, Fars Province. Ann Saudi Med, 30(1), 1-4.
4. Sticova, E. & Jirsa, M. (2013). New insights in bilirubin metabolism and their clinical implications. World J Gastroenterology, 19(38), 6398-6407.
5. Levitt, D. & Levitt, M. (2014). Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease. Clinical and Experimental Gastroenterology, 7, 307-328.
6. Erlinger, S., Arias, IM. & Dhumeaux, D.
(2014). Inherited disorders of bilirubin transport and conjugation: new insights into molecular mechanisms and consequences. Gastroenterology, 146, 1625–38. [PubMed: 24704527].
7. Sumida, K., Kawana, M., Kouno, E., Itoh, T., Takano, S., et al. (2013). Importance of UDPglucuronosyltransferase 1ª1 expression in skin and its induction by UVB in neonatal hyperbilirubinemia. Molecular Pharmacology, 84, 679-686.
8. Bilirubin glucuronidation revisited: proper assay conditions to estimate enzyme Kinetics with recombinant UGT1A1. Drug Metabolism and deposition, 38(11), 1907-1911.
9. Deng, F., Sjöstedt, N. & Kidron, H. (2016). The effect of albumin on MRP2 and BCRP in the vesicular transport assay. PLoS ONE, 11(10), 1-15.
10. Vlaming, ML., Pala, Z., van Esch A, et al. (2009). Functionally overlapping roles of Abcg2 (Bcrp1) and Abcc2 (Mrp2) in the elimination of methotrexate and its main toxic metabolite 7- hydroxymethotrexate in vivo. Clin Cancer Res, 15,3084–93. [PubMed: 19383815].
11. Rodwell, V. (2010). Porfirias y pigmentos biliares. En: Murray R. Bender D. Botham K. Kennelly P. Rodwell V. Weil A. (Eds.). Harper Bioquímica Ilustrada (pp: 271-284). México DF, México: McGraw Hill.
12. Dutt, M. K., Murphy, G. M. & Thompson, R. P. H. (2003). Unconjugated bilirubin in human bile: the nucleating factor in cholesterol cholelithiasis? J Clin Pathol, 56, 596-598.
13. Lakovic, K., Ai, J., D´Abbondanza, J., Tariq, A., Sabri, M., et al. (2014). Bilirubin and its oxidation products damage brain white matter. J Cerebral Blood Flow & Metabolism. 34, 1837-1847.
14. Nascimento, H., Alves, A. I., Coimbra, S., Catarino, C., Gomes, D., et al. (2015). Bilirubin is independently associated with oxidized LDL levels in young obese patients. Diabetology & Metabolic Syndrome. 7, 1-5.
15. Beckman Coulter. Total and direct bilirubin. Data on samples collected from 200 blood donors in North Texas. 2012.
16. Moon, J. S. (2015). Role of bilirubin in diabetic vascular complications: can bilirubin predict more than just liver disease? Diabetes Metabolism, 39, 384-386.
17. Inoguchi, T., Kobayashi, K., Takayanagi, R. & Yamada, T. (2007). Relationship between Gilbert syndrome and prevalence of vascular complications in patients with diabetes. JAMA, 298, 1398-400.
18. Kwak, M-S., Kim, D., Chung, G. E., Kang, S. J., Park, M. J., et al. (2012). Serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease. Clinical and Molecular Hepatology, 18, 383-390.
19. Tran, CD. & Beddard, G. (1982). Interactions between bilirubin and albumins using picosecond fluorescence and circularly polarized luminescence spectroscopy. J Am Chem Soc, 104, 6741–6747.
20. Amin, S. & Lamola, A. (2011). Newborn jaundice technologies; unbound bilirubin and bilirubin capacity in neonates. Sem Perinatol, 35(3), 134-140.
21. Amin, SB. (2004). Clinical assessment of bilirubin-induced neurotoxicity in premature infants. Semin Perinatol, 28(5), 340–347. [PubMed: 15686265].
22. Wells, R., Hammond, K., Lamola, AA. & Blumberg, WE. (1982). Relationships of bilirubin binding parameters. Clin Chem, 28(3), 432–439. [PubMed: 7067082].
23. Amin, S., Harte, T., Scholer, L. & Wang, H. Intravenous lipid and bilirubin-albumin binding variables in premature infants. Pediatrics, 124(1), 211-217.
24. Amin, S. (2010). Effect of free fatty acids on bilirubin-albumin binding affinity and unbound bilirubin in premature infants. J Parenter Enteral Nutr, 34(4), 414-420.
25. Iskander, I., Gamaleldin, R., El Houchi, S., El Shenawy, A., Seoud, I., et al. (2014). Serum bolirubin and bilirubin / albumin ratio as predictors of bilirubin encephalopathy. Pediatrics, 134, e1330-e1339.
26. Calligaris, SD., Bellarosa, C., Giraudi, P., Wennberg, RP., Ostrow, JD. & Tiribelli, C. (2007). Cytotoxicity is predicted by unbound and not total bilirubin concentration. Pediatr Res, 62(5), 576–580. [PubMed: 18049372].
27. Ali, R., Ahmed, S., Qadir, M. & Ahmad, K. (2012). Icterus neonatorum in near-term and term infants. SQU Med J, 12(2), 153-160.
28. Wennberg, R. (2007). Unbound bilirubin: a better predictor of kernicterus? Clinical Chemistry, 54(1), 207-208.
29. Jacobsen, J. & Wennberg, R. (1974). Determination of unbound bilirubin in the serum of newborns. Clinical Chemistry, 20(7), 783-789.
30. Ahlfors, C., Wennberg, R. Ostrow, D. & Tiribelli, C. (2009). Unbound (free) bilirubin: improving the paradigm for evaluating neonatal jaundice. Clinical Chemistry, 55(7), 1288-1299.
31. Zucker, S., Horn, P. & Sherman, K. (2004). Serum bilirubin levels in the U. S. population: gender effect and inverse correlation with colorectal gender cancer. Hepatology, 40, 827-835.
32. Rehak, N., Cecco, S. & Hortin, G. (2008). Photolysis of bilirubin in serum specimens exposed t room lighting. Clin Chem Acta, 387(1-2), 181-183.
33. Travan, L., Crovella, S., Montico, M., Panontin, E.& Demarini, S. (2014). Severe neonatal hyperbilirubinemia and UGT1A1 promoter polymorphism. J Pediatr, 165, 42-45. [PubMed: 24726540].
34. Davis, A. R., Rosenthal, P., Escobar, G. & Newman, T. (2011). Interpreting conjugated bilirubin levels in newborn. J Pediatr, 158(4), 562-565.
35. Beckingham, I. & Ryder, S. (2001). Investigation of liver and biliary disease. BMJ, 322, 33-37.
36. Kaga, A., Ohkubo, Y., Watanabe, Y., Saito, S., Matsuki, T., et al. (2013). Development of icterus gravis in a preterm infant with G71R UGT1A1 polymorphism. BMC Research Notes, 6(51), 1-4.
37. Hashmi, S., Allison, M., McCurdy, M. & Reed, R. (2014). Hyperbilirubinaemia and haemolytic anemia: there´s oil in them thar veins. BMJ Case Report, doi: 10.1136/bcr-2014-203804.
38. Abbott, R. J., Carter, N. W., Clee, M. D. & Bouchier, I. (1979). A study of hyperbilirubinaemia in clinical practice. Postgraduate Medical Journal, 55, 787.790.
39. Kaspar, M. & Sterling, R. (2015). Hyperbilirubinaemia in HIV-HCV co-infected patients on antiretroviral therapy: Drug effect or liver dosease severity? BMJ Open Gastro, doi: 10.1136/bmjgast-2015-000072
40. Pothuri, P., Ahuja, K., Kumar, V., Lal, S., Tumarinson, T. & Mahmood, K. (2016). Leptospirosis presenting with rapidly progressing acute renal failure and conjugated hyperbilirubinaemia: a case report. Am J Case Rep, 17, 567-569.
41. Viriyavejakul, P., Khachonsaksumet, V. & Punsawad, C. (2014). Liver changes in severe Plasmodium falciparum malaria: histopathology, apoptosis and nuclear factor kappa B expression. Malaria Journal, 13, 1-9
42. Pratt, E., Sissung, T. & Figg, W. (2012). Loss of oatp1b3 function causes rotor syndrome. Cancer Biology & Therapy, 13(14), 1374-1375.
43. Li, P., Wang, Y., Zhang, J., Geng, M. & Li, Z. (2013). Dubin-Johnson syndrome with multiple liver cavernous hemangiomas: report of a familial case. Int J Clin Exp Pathol, 6(11), 2636-2639.
44. Garcea, G., Ngu, W., Neal, C., Dennison, A. & Berry, D. (2011). Bilirubin levels predict malignancy in patients with obstructive jaundice. HPB, 13, 426-430.
45. Bandi, C., Vanaki, R., Badakali, A., Pol, R., Yelamali, B. (2016). Predictive value of total serum bilirubin within 6 hour of birth for the development of hyperbilirubinemia after 72 hours of birth. J Clinical and Diagnosis Research, 10(9), SC01-SC04.
46. Siyah, B., Atun, O., Yalaz, M., Karaman, S. & Kultursay, N. (2013). Factors affecting bilirubin levels during First 48 hours of life in healthy infants. BioMed Research Int, 2013, 1-6.
47. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. (2004) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114, 297-316.
48. Xie, B., da Silva, O. & Zaric, G. (2012). Costeffectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario. Paediatr Child Health, 17(1), 11-16.
49. American Academy of Pediatrics. (2004). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), 297-316.
50. Benchimol, E., Walsh, C.& Ling, S. (2009). Early diagnosis of neonatal cholestatic jaundice. Can Fam Physician, 55, 1184-1192.
51. Feldman, A. & Sokol, R. (2013). Neonatal cholestasis. Neoreviews, 14(2), 1-21
52. Gazzin, S., Strazielle, N., Tiribelli, C. & Ghersi-Egea, J-F. (2012). Transport and metabolism at blood-barrier interfaces and in neural cells: relevance to bilirubin-induced encephalopathy. Frontiers of Pharmacology, 3, 1-13.
53. Gamaleldin, R., Iskander, I., Seoud, I., Aboraya, H., Aravkin, A., et al. (2011). Risk factors for neurotoxicity in newborns with severe neonatal hyperbilirubinemia. Pediatrics, 128, e925-e931.
54. Bhutani, V., Zipursky, A., Blencowe, H., Khanna, R., Sgros, M., et al. (2013). Neonatal hyperbilirubinaemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatric Research, 74(s1), 86-100.
55. Taheri, P., Sadeghi, M. & Sajjadian, N. (2014). Severe neonatal hyperbilirubinemia leading to Exchange transfusión. Med J Islam Rep Iran, 28, 1-5.
56. Huzebos, C., Dijk, P., van Imhoff, D., Boss, A., Lopriore, E., et al. (2014). The bilirubin albumin ratio in the management of hyperbilirubinemia in preterms infants to improve neurodevelopmental outcome: a randomized controlled trial-BARTrial. PLOS ONE, 9(6), 1-7.
57. Doré, S. & Snyder, S. H. (1999). Neuroprotective action of bilirubin against oxidative stress in primary hippocampal cultures. Ann N Y Acad Sci, 890, 167-172.
2. Spencer, A. Bagai, I., Becker, D., Zuiderweg, E. & Ragsdale, S. (2014). Protein / Protein interactions in the mammalian heme degradation pathway. Heme oxigenase-2, cytochrome P450, and biliverdin reductase. J Biol Chem, 289(43), 29836-29858.
3. Hemmati, F., Saki, F. & Haghighat, M. (2010).Gilbert syndrome in Iran, Fars Province. Ann Saudi Med, 30(1), 1-4.
4. Sticova, E. & Jirsa, M. (2013). New insights in bilirubin metabolism and their clinical implications. World J Gastroenterology, 19(38), 6398-6407.
5. Levitt, D. & Levitt, M. (2014). Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease. Clinical and Experimental Gastroenterology, 7, 307-328.
6. Erlinger, S., Arias, IM. & Dhumeaux, D.
(2014). Inherited disorders of bilirubin transport and conjugation: new insights into molecular mechanisms and consequences. Gastroenterology, 146, 1625–38. [PubMed: 24704527].
7. Sumida, K., Kawana, M., Kouno, E., Itoh, T., Takano, S., et al. (2013). Importance of UDPglucuronosyltransferase 1ª1 expression in skin and its induction by UVB in neonatal hyperbilirubinemia. Molecular Pharmacology, 84, 679-686.
8. Bilirubin glucuronidation revisited: proper assay conditions to estimate enzyme Kinetics with recombinant UGT1A1. Drug Metabolism and deposition, 38(11), 1907-1911.
9. Deng, F., Sjöstedt, N. & Kidron, H. (2016). The effect of albumin on MRP2 and BCRP in the vesicular transport assay. PLoS ONE, 11(10), 1-15.
10. Vlaming, ML., Pala, Z., van Esch A, et al. (2009). Functionally overlapping roles of Abcg2 (Bcrp1) and Abcc2 (Mrp2) in the elimination of methotrexate and its main toxic metabolite 7- hydroxymethotrexate in vivo. Clin Cancer Res, 15,3084–93. [PubMed: 19383815].
11. Rodwell, V. (2010). Porfirias y pigmentos biliares. En: Murray R. Bender D. Botham K. Kennelly P. Rodwell V. Weil A. (Eds.). Harper Bioquímica Ilustrada (pp: 271-284). México DF, México: McGraw Hill.
12. Dutt, M. K., Murphy, G. M. & Thompson, R. P. H. (2003). Unconjugated bilirubin in human bile: the nucleating factor in cholesterol cholelithiasis? J Clin Pathol, 56, 596-598.
13. Lakovic, K., Ai, J., D´Abbondanza, J., Tariq, A., Sabri, M., et al. (2014). Bilirubin and its oxidation products damage brain white matter. J Cerebral Blood Flow & Metabolism. 34, 1837-1847.
14. Nascimento, H., Alves, A. I., Coimbra, S., Catarino, C., Gomes, D., et al. (2015). Bilirubin is independently associated with oxidized LDL levels in young obese patients. Diabetology & Metabolic Syndrome. 7, 1-5.
15. Beckman Coulter. Total and direct bilirubin. Data on samples collected from 200 blood donors in North Texas. 2012.
16. Moon, J. S. (2015). Role of bilirubin in diabetic vascular complications: can bilirubin predict more than just liver disease? Diabetes Metabolism, 39, 384-386.
17. Inoguchi, T., Kobayashi, K., Takayanagi, R. & Yamada, T. (2007). Relationship between Gilbert syndrome and prevalence of vascular complications in patients with diabetes. JAMA, 298, 1398-400.
18. Kwak, M-S., Kim, D., Chung, G. E., Kang, S. J., Park, M. J., et al. (2012). Serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease. Clinical and Molecular Hepatology, 18, 383-390.
19. Tran, CD. & Beddard, G. (1982). Interactions between bilirubin and albumins using picosecond fluorescence and circularly polarized luminescence spectroscopy. J Am Chem Soc, 104, 6741–6747.
20. Amin, S. & Lamola, A. (2011). Newborn jaundice technologies; unbound bilirubin and bilirubin capacity in neonates. Sem Perinatol, 35(3), 134-140.
21. Amin, SB. (2004). Clinical assessment of bilirubin-induced neurotoxicity in premature infants. Semin Perinatol, 28(5), 340–347. [PubMed: 15686265].
22. Wells, R., Hammond, K., Lamola, AA. & Blumberg, WE. (1982). Relationships of bilirubin binding parameters. Clin Chem, 28(3), 432–439. [PubMed: 7067082].
23. Amin, S., Harte, T., Scholer, L. & Wang, H. Intravenous lipid and bilirubin-albumin binding variables in premature infants. Pediatrics, 124(1), 211-217.
24. Amin, S. (2010). Effect of free fatty acids on bilirubin-albumin binding affinity and unbound bilirubin in premature infants. J Parenter Enteral Nutr, 34(4), 414-420.
25. Iskander, I., Gamaleldin, R., El Houchi, S., El Shenawy, A., Seoud, I., et al. (2014). Serum bolirubin and bilirubin / albumin ratio as predictors of bilirubin encephalopathy. Pediatrics, 134, e1330-e1339.
26. Calligaris, SD., Bellarosa, C., Giraudi, P., Wennberg, RP., Ostrow, JD. & Tiribelli, C. (2007). Cytotoxicity is predicted by unbound and not total bilirubin concentration. Pediatr Res, 62(5), 576–580. [PubMed: 18049372].
27. Ali, R., Ahmed, S., Qadir, M. & Ahmad, K. (2012). Icterus neonatorum in near-term and term infants. SQU Med J, 12(2), 153-160.
28. Wennberg, R. (2007). Unbound bilirubin: a better predictor of kernicterus? Clinical Chemistry, 54(1), 207-208.
29. Jacobsen, J. & Wennberg, R. (1974). Determination of unbound bilirubin in the serum of newborns. Clinical Chemistry, 20(7), 783-789.
30. Ahlfors, C., Wennberg, R. Ostrow, D. & Tiribelli, C. (2009). Unbound (free) bilirubin: improving the paradigm for evaluating neonatal jaundice. Clinical Chemistry, 55(7), 1288-1299.
31. Zucker, S., Horn, P. & Sherman, K. (2004). Serum bilirubin levels in the U. S. population: gender effect and inverse correlation with colorectal gender cancer. Hepatology, 40, 827-835.
32. Rehak, N., Cecco, S. & Hortin, G. (2008). Photolysis of bilirubin in serum specimens exposed t room lighting. Clin Chem Acta, 387(1-2), 181-183.
33. Travan, L., Crovella, S., Montico, M., Panontin, E.& Demarini, S. (2014). Severe neonatal hyperbilirubinemia and UGT1A1 promoter polymorphism. J Pediatr, 165, 42-45. [PubMed: 24726540].
34. Davis, A. R., Rosenthal, P., Escobar, G. & Newman, T. (2011). Interpreting conjugated bilirubin levels in newborn. J Pediatr, 158(4), 562-565.
35. Beckingham, I. & Ryder, S. (2001). Investigation of liver and biliary disease. BMJ, 322, 33-37.
36. Kaga, A., Ohkubo, Y., Watanabe, Y., Saito, S., Matsuki, T., et al. (2013). Development of icterus gravis in a preterm infant with G71R UGT1A1 polymorphism. BMC Research Notes, 6(51), 1-4.
37. Hashmi, S., Allison, M., McCurdy, M. & Reed, R. (2014). Hyperbilirubinaemia and haemolytic anemia: there´s oil in them thar veins. BMJ Case Report, doi: 10.1136/bcr-2014-203804.
38. Abbott, R. J., Carter, N. W., Clee, M. D. & Bouchier, I. (1979). A study of hyperbilirubinaemia in clinical practice. Postgraduate Medical Journal, 55, 787.790.
39. Kaspar, M. & Sterling, R. (2015). Hyperbilirubinaemia in HIV-HCV co-infected patients on antiretroviral therapy: Drug effect or liver dosease severity? BMJ Open Gastro, doi: 10.1136/bmjgast-2015-000072
40. Pothuri, P., Ahuja, K., Kumar, V., Lal, S., Tumarinson, T. & Mahmood, K. (2016). Leptospirosis presenting with rapidly progressing acute renal failure and conjugated hyperbilirubinaemia: a case report. Am J Case Rep, 17, 567-569.
41. Viriyavejakul, P., Khachonsaksumet, V. & Punsawad, C. (2014). Liver changes in severe Plasmodium falciparum malaria: histopathology, apoptosis and nuclear factor kappa B expression. Malaria Journal, 13, 1-9
42. Pratt, E., Sissung, T. & Figg, W. (2012). Loss of oatp1b3 function causes rotor syndrome. Cancer Biology & Therapy, 13(14), 1374-1375.
43. Li, P., Wang, Y., Zhang, J., Geng, M. & Li, Z. (2013). Dubin-Johnson syndrome with multiple liver cavernous hemangiomas: report of a familial case. Int J Clin Exp Pathol, 6(11), 2636-2639.
44. Garcea, G., Ngu, W., Neal, C., Dennison, A. & Berry, D. (2011). Bilirubin levels predict malignancy in patients with obstructive jaundice. HPB, 13, 426-430.
45. Bandi, C., Vanaki, R., Badakali, A., Pol, R., Yelamali, B. (2016). Predictive value of total serum bilirubin within 6 hour of birth for the development of hyperbilirubinemia after 72 hours of birth. J Clinical and Diagnosis Research, 10(9), SC01-SC04.
46. Siyah, B., Atun, O., Yalaz, M., Karaman, S. & Kultursay, N. (2013). Factors affecting bilirubin levels during First 48 hours of life in healthy infants. BioMed Research Int, 2013, 1-6.
47. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. (2004) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114, 297-316.
48. Xie, B., da Silva, O. & Zaric, G. (2012). Costeffectiveness analysis of a system-based approach for managing neonatal jaundice and preventing kernicterus in Ontario. Paediatr Child Health, 17(1), 11-16.
49. American Academy of Pediatrics. (2004). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), 297-316.
50. Benchimol, E., Walsh, C.& Ling, S. (2009). Early diagnosis of neonatal cholestatic jaundice. Can Fam Physician, 55, 1184-1192.
51. Feldman, A. & Sokol, R. (2013). Neonatal cholestasis. Neoreviews, 14(2), 1-21
52. Gazzin, S., Strazielle, N., Tiribelli, C. & Ghersi-Egea, J-F. (2012). Transport and metabolism at blood-barrier interfaces and in neural cells: relevance to bilirubin-induced encephalopathy. Frontiers of Pharmacology, 3, 1-13.
53. Gamaleldin, R., Iskander, I., Seoud, I., Aboraya, H., Aravkin, A., et al. (2011). Risk factors for neurotoxicity in newborns with severe neonatal hyperbilirubinemia. Pediatrics, 128, e925-e931.
54. Bhutani, V., Zipursky, A., Blencowe, H., Khanna, R., Sgros, M., et al. (2013). Neonatal hyperbilirubinaemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatric Research, 74(s1), 86-100.
55. Taheri, P., Sadeghi, M. & Sajjadian, N. (2014). Severe neonatal hyperbilirubinemia leading to Exchange transfusión. Med J Islam Rep Iran, 28, 1-5.
56. Huzebos, C., Dijk, P., van Imhoff, D., Boss, A., Lopriore, E., et al. (2014). The bilirubin albumin ratio in the management of hyperbilirubinemia in preterms infants to improve neurodevelopmental outcome: a randomized controlled trial-BARTrial. PLOS ONE, 9(6), 1-7.
57. Doré, S. & Snyder, S. H. (1999). Neuroprotective action of bilirubin against oxidative stress in primary hippocampal cultures. Ann N Y Acad Sci, 890, 167-172.
Publicado
2020-11-16
Cómo citar
Carvajal Carvajal, C. (2020). BILIRRUBINA: METABOLISMO, PRUEBAS DE LABORATORIO E HIPERBILIRRUBINEMIA. Medicina Legal De Costa Rica, 36(1). Recuperado a partir de //www.binasss.sa.cr/ojssalud/index.php/mlcr/article/view/114
Sección
Revisiones de literatura
La propiedad intelectual de los trabajos aceptados es de sus autores, no obstante el acceso a ellos es totalmente abierto y gratuito, por lo que podrán ser reproducidos total o parcialmente con la única limitación de reconocer la autoría y la fuente de publicación ( Revista Medicina Legal de Costa Rica), siempre y cuando dicha explotación no tenga carácter comercial.
