Heamolysis
Haemolysis
Red blood cells normally live for 120 days.
Some diseases cause premature breakdown of red blood cells.
At the end, cell is too fragile.
Cell membrane rupture.
Destroyed by macrophages in the spleen and bone marrow – Reticuloendothelial system.
Haemoglobin splits and globin and heme release.
Heme consists of four pyrrole rings.
Heme ring open and release pyrrole rings.
Pyrrole will under go several reaction and bilirubin form.
Unconjugated bilirubin enter to hepatic cells.
Conjugate
80% - bilirubin glucuronide.
10% - bilirubin sulfate.
10% - other substances.
Form biliverdin.
Further reduced to bilirubin.
First form is unconjugated/free bilirubin.
Release from macrophage to plasma.
Not soluble and bind to protein.