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Gastroenterology (Expert Forum)
Elevated Bilirubin
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Elevated Bilirubin
by Lisa Whitaker, Feb 06, 2004 12:00AM
I recently had lab work done for my cholesterol check. In with it was a routine metabolic panel. It came back with the following:
glucose 88
bun 10
creatine 0.9
sodium 144
Potassium 3.8
Chloride 106
Co225
Amion Gap 13.0
Oemolality 285
Calcium 9.4
Bilirubin Total: 1.8 "H"
Bili Direct: 0.2
Bili Indirect: 1.6
Total Protine 7.6
Albuni 4.4
Globulin 3.2
A/G Ratio 1.4
ALK 46
ALT 16
AST 19
All my other general chemistry blood work came out within normal with the execption of a low mchc of 32.8 although some labs still consider this within normal range. Should I be worried about Liver Disease with the elevated Bilirubin? Seems to me that the indirect was the culprit in the elevated total serum levels. My doctor was pretty confident that it is not cancer but is scheduling an ultrasound and a re-run just to double check.
glucose 88
bun 10
creatine 0.9
sodium 144
Potassium 3.8
Chloride 106
Co225
Amion Gap 13.0
Oemolality 285
Calcium 9.4
Bilirubin Total: 1.8 "H"
Bili Direct: 0.2
Bili Indirect: 1.6
Total Protine 7.6
Albuni 4.4
Globulin 3.2
A/G Ratio 1.4
ALK 46
ALT 16
AST 19
All my other general chemistry blood work came out within normal with the execption of a low mchc of 32.8 although some labs still consider this within normal range. Should I be worried about Liver Disease with the elevated Bilirubin? Seems to me that the indirect was the culprit in the elevated total serum levels. My doctor was pretty confident that it is not cancer but is scheduling an ultrasound and a re-run just to double check.
Doctor's Answer
by Kevin Pho, MD, Feb 06, 2004 12:00AM
, Feb 06, 2004 12:00AM
There are many benign causes of an isolated elevated bilirubin. An ultrasound would be a reasonable first step to determine if there is any over gall bladder disease.
It is also noted that the other liver enzymes are also negative - making it less likely it is a liver disease.
Other potential causes would include hemolysis (breakdown of red blood cells). This can be evaluated with several other tests such as reticulocyte count, anemia, and LDH level.
Medications can also elevated isolated bilirubin. Make sure that this is not a side effect of any medications you are taking.
If all the testing is negative, hereditary disorders such as Gilbert's Syndrome can be considered. This is a benign disease of bilirubin metabolism. No specific therapy is required for patients who are diagnosed with Gilbert's syndrome. The most important aspect of the care of these patients is recognition of the disorder and its inconsequential nature.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
It is also noted that the other liver enzymes are also negative - making it less likely it is a liver disease.
Other potential causes would include hemolysis (breakdown of red blood cells). This can be evaluated with several other tests such as reticulocyte count, anemia, and LDH level.
Medications can also elevated isolated bilirubin. Make sure that this is not a side effect of any medications you are taking.
If all the testing is negative, hereditary disorders such as Gilbert's Syndrome can be considered. This is a benign disease of bilirubin metabolism. No specific therapy is required for patients who are diagnosed with Gilbert's syndrome. The most important aspect of the care of these patients is recognition of the disorder and its inconsequential nature.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
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