An Rh -ve woman became pregnant with Rh +ve fetus. Within few days after bih, the infant developed jaundice, ascites, hepatomegaly and edema. The likely substance(s) deposited in skin and sclera in jaundice is/are given below. Which is the best possible answer?
It is a case of erythroblastosis fetalis. (type II Hypersensitivity reaction) In erythroblastosis fetalis this IgG anti-red blood cell antibodies from the mother cross the placenta and cause destruction of fetal RBC's leading to increased production of bilirubin in the blood. This increased bilirubin is predominantly unconjugated but the level of conjugated bilirubin will also increase because of compensatory increase in bilirubin conjugation process by the liver. So, both unconjugated bilirubin and bilirubin glucuronides may accumulate systemically and deposit in tissues, giving rise to the yellow discoloration of jaundice. Paicularly seen in yellowing of the sclera (because of presence of elastin fibers).
Biliverdin
Conjugated and unconjugated bilirubin
Unconjugated bilirubin
Conjugated bilirubin
Hypersensitivity