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What is delta bilirubin?
             by

       Dr. Ketan Vagholkar
          MS, DNB, MRCS, FACS
        Consultant General Surgeon
Delta Bilirubin

   Glucoronides are chemically reactive
    metabolites.
   In adults, with prolonged cholestasis especially if
    it is accompanied by renal failure, a fraction of
    the bilirubin conjugates readily non enzymatic
    ally and irreversibly with serum albumin to give
    yellow billiproteins in which bilirubin is
    covalently bound to albumin.
   This fraction increases with the duration of
    cholestasis and is designated as delta bilirubin.
Delta bilirubin

   Delta bilirubin retains its direct reading properties.
   As delta bilirubin is irreversibly bound to albumin it is
    not filtered at the glomerulus and its half life reflects that
    of albumin.(14 days)
   Consequently it remains in plasma long after other
    bilirubin esters have been eliminated giving rise to
    conjugated hyperbilirubinemia in the absence of
    bilirubinuria and is particularly evident in the recovery
    phase of cholestasis.
   Delta bilirubin= Total bilirubin-(Conjugated +
    Unconjugated bilirubin)

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What is delta bilirubin?

  • 1. What is delta bilirubin? by Dr. Ketan Vagholkar MS, DNB, MRCS, FACS Consultant General Surgeon
  • 2. Delta Bilirubin  Glucoronides are chemically reactive metabolites.  In adults, with prolonged cholestasis especially if it is accompanied by renal failure, a fraction of the bilirubin conjugates readily non enzymatic ally and irreversibly with serum albumin to give yellow billiproteins in which bilirubin is covalently bound to albumin.  This fraction increases with the duration of cholestasis and is designated as delta bilirubin.
  • 3. Delta bilirubin  Delta bilirubin retains its direct reading properties.  As delta bilirubin is irreversibly bound to albumin it is not filtered at the glomerulus and its half life reflects that of albumin.(14 days)  Consequently it remains in plasma long after other bilirubin esters have been eliminated giving rise to conjugated hyperbilirubinemia in the absence of bilirubinuria and is particularly evident in the recovery phase of cholestasis.  Delta bilirubin= Total bilirubin-(Conjugated + Unconjugated bilirubin)