Bilirubin formation, conjugation, and jaundice
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A 34-year-old woman has fatigue and yellowing of her eyes. Hemoglobin is 8.8 g/dL, the reticulocyte count is 9%, and serum haptoglobin is below the laboratory detection limit. Total bilirubin is 4.2 mg/dL, with direct bilirubin of 0.4 mg/dL. Aminotransferases and alkaline phosphatase are normal. Urine testing detects increased urobilinogen but no bilirubin.