Abstract
The peroxidase assay measures the apparent unbound bilirubin concentration (AUBC) throughout the total bilirubin concentration (TBC) range observed clinically. The AUBC has been shown to correlate with cell uptake and toxicity of bilirubin in vitro and presumably would be a better predictor of the risk for kernicterus than would TBC. We have automated the assay on the Gilford 3500 Computer Directed Analyzer reducing the time for analysis from 30 minutes (manual method) to 4 minutes per patient sample using the automated system. The within-day and day-to-day coefficients of variation in AUBC were 2.8 and 4.9 percent, respectively, compared to 3.7 and 10.9 percent for the manual assay.
In a study of 46 serum samples from 22 jaundiced Greek infants, the automated assay correlated well with the manual method (r = .92). Sixteen of the infants had TBC's in excess of 20 mg/dl (max. 33 mg/dl), 11 were Sephadex positive, 8 had AUBC's in excess of 20 nmol/l and 4 had AUBC's greater than 25 nmol/l (measured at 27°C). The single case of kernicterus had a TBC of 29 mg/dl, AUBC of 29 nmol/l and was Sephadex positive.
Automation allows the peroxidase assay to be useful as an adjunct in evaluating the risk for kernicterus.
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Rasmussen, L., Wennberg, R., Ahlfors, C. et al. 1014 AUTOMATION OF THE PEROXIDASE ASSAY FOR MEASUREMENT OF APPARENT UNBOUND BILIRUBIN CONCENTRATION. Pediatr Res 12 (Suppl 4), 533 (1978). https://doi.org/10.1203/00006450-197804001-01020
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DOI: https://doi.org/10.1203/00006450-197804001-01020