Description
Total bilirubin is direct and indirect bilirubin together.Bilirubin attached by the liver to glucuronic acid, a glucose-derived acid, is called direct, or conjugated, bilirubin. Bilirubin not attached to glucuronic acid is called indirect, or unconjugated, bilirubin. If conjugated (direct) bilirubin is elevated more than unconjugated (indirect) bilirubin, there typically is a problem associated with decreased elimination of bilirubin by the liver cells. Some conditions that may cause this include: Viral hepatitis (hepatitis A, hepatitis B, hepatitis C).Thus measuring the level of bilirubin helps in diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gallbladder obstructive disease.
Liver disease: hepatitis, cholangitis, cirrhosis, other types of liver disease (including primary or secondary neoplasia); alcoholism (usually with high AST (SGOT), GGT, MCV, or some combination of these findings); biliary obstruction (intrahepatic or extrahepatic); infectious mononucleosis (look also for increased LD (LDH), lymphocytosis); Dubin-Johnson syndrome; Gilbert disease1 (familial hyperbilirubinemia) causes high bilirubin.
