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Gastroenterology  (Expert Forum)
 | 
If I had elevated bilirubin is it 100% certain I also had inflammation of liver?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.

If I had elevated bilirubin is it 100% certain I also had inflammation of liver?

by rcarryl, May 18, 2006 12:00AM
Hi,  

I am applying for life insurance.  I am a male, 42 yrs old, healthy, walk/run 10-15 mi/week, 6ft, 210lbs.
Never had any health problems, never spent a night in the hospital until May of 2005. I had flu like symptoms.  I treated it at home for 2-3 days by taking ibuprofen (unfortunately on an empty stomach because I had no appetite).  On the 3rd day I noticed I was jaundice in my eyes. I was informed that the juandice condition could have been related to the ibuprofen.  I went to the emergency room - kept me for several days - never figured out what it was. All blood work was negative for all types of hepatitis.  I fully recovered and never went back to the doctor or hospital until I was applying for insurance recently and they requested follow up blood work.  I had the blood work and it came back negative again.

They are requesting an APS (attending physicians statement) with the blood work - my doctor wrote "He is in good health...He had a nonspecific viral illness...he had hepatitis with that illness...He recovered and has no sequalea..."

I have had no problem getting life insurance in the past and don't want future problems.  I want to be very precise in declaring what I did and did not have.

My concern is the statement "he had hepatitis with that illness".  I understand that the literal meaning of the word hepatitis is "inflammation of the liver".  However, I would like it clarified to say "his tests came back negative for hepatitis a,b,c etc..".  

1. Is this a reasonable request (my doctor is very nice and accomodating - so I don't think this will be a problem but wanted to get advice before bothering him again).

2. I don't ever remember him or anyone else telling me that my liver was inflamed - I do specifically remember them telling me that my bilirubin was elevated. If I had elevated bilirubin is it 100% certain I also had inflammation of liver (hepatitus (hepatitis))?

Thanks!

Rob

by Kevin Pho, MD, May 19, 2006 12:00AM
To answer your questions:
1) That clarification seems to be perfectly reasonable, considering you were indeed negative for hepatitis A, B, and C.

2) You can have an elevated bilirubin without inflammation of the liver (this can occur in familial syndromes like Gilbert's disease).  

Further evaluation can be done with liver imaging tests - like a hepatic ultrasound.

These options can be discussed with your personal physician.

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.

Kevin, M.D.
kevinmd_
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