The gallstones in hemolytic anemia are:
|D||Any of the above|
a. Black stones account for a high percentage of gallstones in Asian countries such as Japan compared with the Western hemisphere.
b. Brown pigment stones are soft and earthy in texture and are typically found in bile ducts, especially in Asian populations.
c. Brown stones often contain more cholesterol and calcium palmitate and occur as primary common duct stones in Western patients with disorders of biliary motility and associated bacterial infection.
d. Bacteria producing slime such as E. coli secrete β-glucuronidase that causes enzymatic hydrolysis of soluble conjugated bilirubin glucuronide to produce insoluble free bilirubin, which then precipitates with calcium.[9