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liver test results

  My daughter, 31, just got some blood work/urinalysis done.  Her doctor saw the test results and said that they were satisfactory but she asked to have them faxed to her.  She drinks everyday and that has been a concern of hers and mine.  Her bilirubins came back in the normal range  (Total 1.80 and direct .2)  However there was a small amount of bilirubins that showed up in her urine.  Should we be concerned?  She is on Accupril for blood pressure also.  Thanks.
Dear Jen,
I am glad to see that you are involved in your daughter's care. Bilirubin is not normally present in the urine but can be detected when the blood levels of "direct" bilirubin are high. The "direct" bilirubin is the water-soluble portion of bilirubin and is usually elevated when outflow of bile from the liver is affected. This can happen due to problems with the liver itself or due to a blockage of the draining ducts of the liver.
In your daughter's case the "direct" bilirubin level appears to be normal. However the total bilirubin appears to be slightly high. The upper limit of normal is usually 1.0 mg%. However, individual laboratories have different ranges of normal values. You need to check again with her doctor if this value of 1.8 mg% of total bilirubin is normal.
Sometimes the urine test for bilirubin can be positive due to the presence of other substances in the urine. Examples of these substances are certain prescription drugs, pain medication etc.  Therefore, doctors do not pay much attention to the urine bilirubin unless the bilirubin level in the blood is concurrently elevated.
I am sure you must be thinking why is bilirubin present in the urine when her serum "direct" bilirubin is normal? This could be due to a false positive test as I have explained before. Another possibility is that what you are actually looking at is the urine urobilinogen which can be present in the urine when the total serum bilirubin is elevated.
In your daughter's case the total serum bilirubin level appears to be slightly elevated. This could be due to any number of reasons. At this time I do not have the information I need to make a specific diagnosis. Since you have mentioned that your daughter drinks alcohol daily it is possible that the serum bilirubin may be elevated due to the effects of alcohol on the liver. However, with the information at hand it is not possible to conclude that alcohol consumption alone is the reason for the elevated bilirubin.
I would recommend that your daughter speak to her docotr to confirm that all the other liver tests are normal.
This information Is presented for educatioanl purposes only.  Always ask specific questions to your personal physician.
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