* Haemolytic anaemias often result in a degree of hyperbilirubinaemia which, if sufficiently severe, will be evident as icterus. RBC destruction leads to an increased level of unconjugated bilirubin which exceeds the rate of hepatic excretion. Acute severe anaemia may also cause hypoxic or toxic hepatic injury, resulting in decreased bilirubin metabolism and cholestasis. Although hyperbilirubinaemia results primarily from increased unconjugated bilirubin, conjugated bilirubin also increases and leads to bilirubinuria. Evaluation of unconjugated versus conjugated bilirubin is often not helpful when trying to differentiate between pre-hepatic and hepatic jaundice. | * Haemolytic anaemias often result in a degree of hyperbilirubinaemia which, if sufficiently severe, will be evident as icterus. RBC destruction leads to an increased level of unconjugated bilirubin which exceeds the rate of hepatic excretion. Acute severe anaemia may also cause hypoxic or toxic hepatic injury, resulting in decreased bilirubin metabolism and cholestasis. Although hyperbilirubinaemia results primarily from increased unconjugated bilirubin, conjugated bilirubin also increases and leads to bilirubinuria. Evaluation of unconjugated versus conjugated bilirubin is often not helpful when trying to differentiate between pre-hepatic and hepatic jaundice. |