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Old 02-24-2012
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Default gall stones,hemolysis

Why does "EXTRAVASCULAR" hemolysis only produce gall stones..?
when bilirubun increases in both intra and extra vascular hemolysis ?
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Old 02-24-2012
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Not sure but
if you have an extravascular one, the massive release of unconjugated bilirubin in the spleen will head back to the liver in high conc. beyond the livers ability to metabolize all of it and thus higher conc. in gall bladder.
In intravascular you also have unconjugated bilirubin but it will reach the liver at a lower rate also they can bind to plasma proteins so the liver can metabloize them and thus lower thier conc. in gallbadder
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Old 02-24-2012
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Well what i feel is that hemopexin comes into action in case of intravascular haemolysis and some heme is kept in circulation in bound form while liver excretes the heme and bilirubin brought to it..but no such thing happen in extravascular heomolysis..so u see liver getting xtra load of metabolising heme and thus gall stone happens in eV hemolysis..well thats what i feel..gud qs...
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Old 02-24-2012
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Quote:
Originally Posted by Jasmine1 View Post
Why does "EXTRAVASCULAR" hemolysis only produce gall stones..?
when bilirubun increases in both intra and extra vascular hemolysis ?
When intravascular hemolysis occurs, haptoglobins bind to released hemoglobin and take it to the Spleen for further breakdown into bilirubin. But there is only a limited amount of Haptoglobins, so once they are depleted then the rest of hemoglobin ends up coming out in the urine. In this process not all the hemoglobin which is released can be taken to the spleen and cannot be broken down into bilirubin. So basically there is less bilirubin to deal with. Decreased Haptoglobin levels are an important indicator for intravascular hemolysis


In Extravascular hemolysis all the hemoglobin is broken down to bilirubin and this is sent to the liver to be excreted in the bile. If there is too much bilirubin due to excessive extravascular hemolysis then it will conjugate in the bile and cause Pigment / Calcium Bilirubinate stones. Haptoglobin levels will be normal here.
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The above post was thanked by:
danrubi (02-07-2016), DocSikorski (02-24-2012), Jasmine1 (02-25-2012), rigbbm (07-04-2013)



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