The direct van den bergh reaction in mixtures of normal and jaundiced serum

Abstract

When samples of serum from patients with obstructive and hemolytic jaundice are mixed in varying proportions with one another or with normal serum or concentrated normal plasma, the actual proportion of direct-reacting bilirubin in the mixture does not coincide with the theoretical, calculated from the quantities present in the components of the mixture. With decreasing bilirubinemia in such mixtures, the actual rose progressively above the theoretical in the case of hemolytic jaundice serum and fell progressively below the latter in the case of obstructive jaundice serum. These findings suggest that the capacity of serum bilirubin for reacting with the van den Bergh reagent in aqueous acid is dependent, in part at least, on factors in the serum other than the bilirubin molecule or the nature of its combination with albumin.