Definition

• Bilirubin, AKA hematoidin, is the yellowish byproduct of heme catabolism, the normal physiological breakdown of iron in the hemoglobin of red blood cells. It's usually visible as jaundice or in the yellow coloration of certain types of bruises. Bilirubinuria is when abnormal amounts of bilirubin are found in excreted urine, when it is normally excreted in bile. Higher amounts generally indicate the presence of disease. Once detected, doctors know the main culprit, although there are deviations from this norm.
  
  

Known Causes

• Hepatocellular disease is the primary known cause of bilirubinuria. This condition is defined by abnormal copper buildup in the liver. Eventually, traces of the copper are distributed throughout the body, causing much damage, especially when received by the brain. The additional copper affects the sensitive brain tissues, often resulting in uncontrollable muscle tremors, dementia or apparent speech deficiencies. Cirrohsis of the liver is common once the copper reaches the liver.
  
  

Dubin-Johnson Syndrome

• Although rare, this genetically inherited disease inhibits bilirubin excretion in bile, thus resulting in the abnormal amounts found in the urine. Symptomatically similar to hepatocellular disease, DJS patients have no complications, unlike those diagnosed with the former, although the yellowed jaundice skin hue will likely last a lifetime. The affects are worsened in many patients by excess alcohol consumption, pregnancy or regular usage of birth control pills. While the condition isn't fatal, patients are advised to seek attention in the event the jaundice worsens.
  
  

Rotor Syndrome

• Identical to Dubin-Johnson syndrome and just as rare, Rotor's is also an inherited condition that also results in chronic and irreversible jaundice. The only distinguishable characteristic between the two diseases is the fact that Rotor's patients do not have any discoloration in the liver pigment as with DJS patients, and the fact that despite that same symptoms, the amount of excreted bilirubin in the urine is considerably less.
  
  

Prognosis

• Since there are no serious health risks associated with either DJS or Rotor syndrome, nearly every patient lives a normal lifespan. The same cannot be said of hepatocellular disease. Due to the negative consequences of copper on the brain, dementia patients often do not recover, like those who experience the often fatal cirrhotic liver damages. If diagnosed early, and under a physician's close supervision, patients can modify their diet to dramatically reduce the amount of copper consumed and adhere to a prescription of penicillamine and other various drugs that effectively bind the free-roaming copper together.