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July 1988

Bilirubin Subfractions-Reply

Am J Dis Child. 1988;142(7):700-701. doi:10.1001/archpedi.1988.02150070014007

In Reply—I am gratified that Drs Argyle and Rutledge agree that pediatricians can benefit from the use of bilirubin fractionation. It was my intent to point out the inadequacies present in many of the routine methods employed for bilirubin analysis. As indicated in my article, my purpose was not to advocate HPLC for routine bilirubin fractionation but to heighten physician awareness of the fact that it is necessary to determine whether the method utilized by the laboratory for bilirubin analysis is capable of distinguishing patients with unconjugated hyperbilirubinemia. My own hospital's clinical laboratory has recently begun to utilize the Ektachem slide method for routine bilirubin fractionation, and we are in the process of evaluating the accuracy of results obtained with this method.1 It should be noted that the Ektachem method may also be subject to error. Determination of bilirubin-protein conjugates (Δ bilirubin) by the Ektachem method is not directly measured