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High direct bilirubin: when to worry

High direct bilirubin: when to worry


There bilirubin is a substance contained in the bile that derives from the demolition of Red blood cells now at the end of their life cycle.

When is the bilirubin test prescribed?
THEvalues ​​of bilirubin they are used to assess the presence or absence of liver disease or anemia. The examination helps to understand the state of health of the liver and gallbladder.

For this reason, once the analysis results, it is important to contact your doctor to get a diagnosis. For information purposes only, I will bring you some information oncauseswhich could determine thehigh bilirubinand what does it meandirect or indirect bilirubin.

Direct, indirect bilirubin and total bilirubin

By indirect acquaintance (in the movies, due to clinical experiences in the family ...) you will surely have heard ofjaundice. When the coloring of the ocular conjunctiva and skin turn yellow, it is calledjaundice: it's right therehigh bilirubinto cause this medical condition.

When doing blood tests, there are two types of bilirubin: direct and indirect.

Indirect bilirubin is the one that has not yet reached the liver. On the contrary the direct bilirubin (or conjugated) is the bilirubin that has already been processed by the liver.

We then talk abouttotal bilirubinto indicate both components.

The normal values, ie found in good health conditions, for thetotal bilirubin, amount to: 0.1 - 1.3 mg / dl.

High indirect bilirubin: causes

Thecauseswhich lead to values ​​higher than normal and therefore to make you register values ​​ofhigh indirect bilirubinI'm:

  • hepatitis,
  • haemolytic anemia,
  • pernicious anemia,
  • congenital hyperbilirubinemia,
  • Gilbert's syndrome,
  • cirrhosis of the liver.

Normal values: 0.0 - 1.2 mg / dl

Thereindirect bilirubinit is also called "free bilirubin" or "unconjugated bilirubin". Albumin intervenes in the transport of numerous endogenous substances such as unconjugated bilirubin or indirect bilirubin.

High Direct Bilirubin: Causes

Thecauseswhich can lead to the raising ofdirect bilirubin valuesthey can be:

  • biliary obstructions,
  • cirrhosis of the liver,
  • jaundice,
  • hyperthyroidism,
  • toxoplasmosis,
  • lues syndrome,
  • listeriasis.

Normal values: 0.0 -0.3 mg / dl

Theredirect bilirubin it is also calledconjugated bilirubin.

Talk, in general, ofhigh bilirubinit does not give us much information about the patient's health status. For this reason, specialists tend to prescribe fractional bilirubin tests, that islive (or free) edirect (or conjugated).

High direct bilirubin: when to worry

The values ​​ofconjugated bilirubin(or direct) tend to increase above normal in the case of Dubin Jhonson's disease (rare condition). Dubin Jhonson disease is a hereditary disease that causes high amounts ofdirect bilirubin without affecting the indirect bilirubin values.

High direct bilirubin, even more than indirect bilirubin, can occur in a particular case of jaundice, in the mechanical jaundice that occurs in the case ofhepatic colic caused by gallstones.

If thedirect bilirubinit is generally higher than the indirect onemeans thatliver cells (hepatocytes) fail to eliminate bilirubin well. The most common diseases that can cause this problem are:

  • Viral hepatitis,
  • Alcoholic
  • Reaction to drugs

Furthermore, in certain cases, the values ​​of thedirect bilirubin they can be higher than thatlive due to an obstruction of the bile ducts, which occurs in various circumstances known asmechanical jaundice. This problem, already mentioned, occurs in the case of:

  • Stones of the bile ducts
  • Lesions of the bile ducts
  • Tumor

When both bilirubins are elevated (high direct and indirect bilirubinone can come to speak of "hepatocellular jaundice". This disease occurs in the case of infections or intoxications that compromise the liver's ability to secrete bilirubin.

In the case of direct and indirect high bilirubin, it could also be chronic mechanical jaundice (this disease is caused by an obstruction that does not allow the normal passage of bile from the liver to the intestine.

When to worry?

It is clear that everything is proportional to the values ​​found. If thedirect bilirubinand much morehighof normal values, medical intervention becomes urgent. Even in the case ofslightly higher direct bilirubinClose monitoring is appropriate to test for liver health.

In the case of drug abuse, alcohol, especially if in conjunction with obesity, liver health could be put to the test.

In any case it is advisable to contact your doctor.


Video: Bilirubin Metabolism Simplified (May 2021).