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5.1.3.1 Direct suppression of the immune micro-environment by bilirubin Bilirubin acts as an inhibitor at many sites in the immune system, including immune cell proliferation, antibody secretion, and complement activation

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While surgery provides a rapid means of alleviating symptoms and allows for histological examination of tissues, it is invasive and carries risks such as recurrent laryngeal nerve injury or hypoparathyroidism (Jhajharia 2018)