The Origins of Bilirubin

Abstract

JAUNDICE has classically been considered to be due either to impaired excretion of bilirubin by the liver or to overproduction of this pigment as the result of hemolytic disease. Recent advances in this area are amplifying this traditional concept. Although most of the bile pigment produced under normal conditions is derived from hemoglobin heme in senescent red blood cells, it is now recognized that some bilirubin originates from other sources, each of which is a potential cause of hyperbilirubinemia. Disordered erythropoiesis in the bone marrow has been implicated as a mechanism of jaundice in several clinical studies, and recent experiments . . .