Direct bilirubin in the blood is one type of important bile tetrapyrrole pigment. Besides direct bilirubin, there is another type—indirect bilirubin. First, let's recap what bilirubin actually is.
An increase in serum bilirubin concentration above 17.1 μmol/L is called hyperbilirubinemia. This condition can result from the formation of bilirubin in quantities exceeding the normal liver's ability to excrete it, or from liver damage that impairs bilirubin excretion in normal amounts.
Bile pigments are the breakdown products of hemoglobin and other chromoproteins—myoglobin, cytochromes, and heme-containing enzymes. Bile pigments include bilirubin and urobilin bodies (urobilinoids).
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