Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice

Aim: The aim of this study is to find out the percentage of variation of bilirubin values in neonates by two different techniques: Dry chemistry versus wet chemistry method, and also to establish that unconjugated bilirubin ≠ indirect bilirubin and conjugated bilirubin ≠ direct bilirubin. Materials...

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Main Authors: Kaushal Kishor Singh, Kalpana Singh, Mala Kumar
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-01-01
Series:Indian Journal of Medical Biochemistry
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Online Access:https://www.ijmb.in/doi/IJMB/pdf/10.5005/jp-journals-10054-0200
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author Kaushal Kishor Singh
Kalpana Singh
Mala Kumar
author_facet Kaushal Kishor Singh
Kalpana Singh
Mala Kumar
author_sort Kaushal Kishor Singh
collection DOAJ
description Aim: The aim of this study is to find out the percentage of variation of bilirubin values in neonates by two different techniques: Dry chemistry versus wet chemistry method, and also to establish that unconjugated bilirubin ≠ indirect bilirubin and conjugated bilirubin ≠ direct bilirubin. Materials and methods: This comparative study was conducted over a period of 6 months from October 2019 to March 2020. Ethical approval was taken from Institutional Ethical Committee. Informed and written consent were taken from the parents of the enrolled neonates. A total of 195 blood samples were randomly collected from neonates (<14 days) admitted with neonatal hyperbilirubinemia in Department of Pediatrics for estimation of serum bilirubin fractions by two techniques, i.e., traditional wet chemistry and dry chemistry. The statistical analysis of data was performed by using software package SPSS version 16 and Microsoft Excel 2019. Results: In our study, mean total bilirubin measured by dry chemistry method Total bilirubin (TBil<sub>d</sub>), neonatal bilirubin (BuBc/NBil) estimated by dry chemistry method, and total bilirubin estimated by wet chemistry method (TBil<sub>w</sub>) were 12.42 mg/dL, 12.21 mg/dL, and 11.72 mg/dL, respectively. Conclusion: Total bilirubin estimated by dry and wet chemistry methods differ due to difference in the principle of methods by which they are estimated in laboratories. Neonatal bilirubin (BuBc/NBil) may be preferred over total bilirubin estimated by wet chemistry as dry chemistry is estimating unconjugated and conjugated fractions of bilirubin, while in wet chemistry, direct bilirubin is estimated and indirect bilirubin is calculated. Hence, the term unconjugated bilirubin cannot be interchanged with indirect bilirubin and conjugated bilirubin as direct bilirubin. Clinical significance: Measurement of serum bilirubin among neonates with hyperbilirubinemia is an essential part for diagnosis and monitoring of neonatal jaundice. Both dry and wet chemistry methods correlated well, any method can be used for measurement of bilirubin, but switching the method while monitoring serum bilirubin levels during treatment must be discouraged.
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spelling doaj-art-1e6dd6265b744ce2a6c3a4c1bdb97e6c2025-08-20T02:17:41ZengJaypee Brothers Medical PublisherIndian Journal of Medical Biochemistry0972-12072456-51642023-01-0126191410.5005/jp-journals-10054-02002Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal JaundiceKaushal Kishor Singh0https://orcid.org/0000-0002-6457-0606Kalpana Singh1https://orcid.org/0000-0002-9029-1002Mala Kumar2Kaushal Kishor Singh, Faculty of Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India, Phone: +91 6387768187Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, IndiaDepartment of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, IndiaAim: The aim of this study is to find out the percentage of variation of bilirubin values in neonates by two different techniques: Dry chemistry versus wet chemistry method, and also to establish that unconjugated bilirubin ≠ indirect bilirubin and conjugated bilirubin ≠ direct bilirubin. Materials and methods: This comparative study was conducted over a period of 6 months from October 2019 to March 2020. Ethical approval was taken from Institutional Ethical Committee. Informed and written consent were taken from the parents of the enrolled neonates. A total of 195 blood samples were randomly collected from neonates (<14 days) admitted with neonatal hyperbilirubinemia in Department of Pediatrics for estimation of serum bilirubin fractions by two techniques, i.e., traditional wet chemistry and dry chemistry. The statistical analysis of data was performed by using software package SPSS version 16 and Microsoft Excel 2019. Results: In our study, mean total bilirubin measured by dry chemistry method Total bilirubin (TBil<sub>d</sub>), neonatal bilirubin (BuBc/NBil) estimated by dry chemistry method, and total bilirubin estimated by wet chemistry method (TBil<sub>w</sub>) were 12.42 mg/dL, 12.21 mg/dL, and 11.72 mg/dL, respectively. Conclusion: Total bilirubin estimated by dry and wet chemistry methods differ due to difference in the principle of methods by which they are estimated in laboratories. Neonatal bilirubin (BuBc/NBil) may be preferred over total bilirubin estimated by wet chemistry as dry chemistry is estimating unconjugated and conjugated fractions of bilirubin, while in wet chemistry, direct bilirubin is estimated and indirect bilirubin is calculated. Hence, the term unconjugated bilirubin cannot be interchanged with indirect bilirubin and conjugated bilirubin as direct bilirubin. Clinical significance: Measurement of serum bilirubin among neonates with hyperbilirubinemia is an essential part for diagnosis and monitoring of neonatal jaundice. Both dry and wet chemistry methods correlated well, any method can be used for measurement of bilirubin, but switching the method while monitoring serum bilirubin levels during treatment must be discouraged.https://www.ijmb.in/doi/IJMB/pdf/10.5005/jp-journals-10054-0200conjugated bilirubindry chemistryhyperbilirubinemiaserum bilirubinunconjugated bilirubinwet chemistry
spellingShingle Kaushal Kishor Singh
Kalpana Singh
Mala Kumar
Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice
Indian Journal of Medical Biochemistry
conjugated bilirubin
dry chemistry
hyperbilirubinemia
serum bilirubin
unconjugated bilirubin
wet chemistry
title Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice
title_full Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice
title_fullStr Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice
title_full_unstemmed Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice
title_short Understanding the Difference in Various Fractions of Serum Bilirubin while Estimated by Wet Chemistry and Dry Chemistry Method and its Importance in Neonatal Jaundice
title_sort understanding the difference in various fractions of serum bilirubin while estimated by wet chemistry and dry chemistry method and its importance in neonatal jaundice
topic conjugated bilirubin
dry chemistry
hyperbilirubinemia
serum bilirubin
unconjugated bilirubin
wet chemistry
url https://www.ijmb.in/doi/IJMB/pdf/10.5005/jp-journals-10054-0200
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AT malakumar understandingthedifferenceinvariousfractionsofserumbilirubinwhileestimatedbywetchemistryanddrychemistrymethodanditsimportanceinneonataljaundice