Lab Tests/Bilirubin

Advertisement


Question
My father had jaundice (yellowing of skin and eyes). He went to doctor and the doctor asked to have Live Function Test performed. The total Bilirubin turned out to be 6.5 mg/dl. However after one week when the same test was performed the total Bilirubin was elevated to 18.9 mg/dl. The doctor asked to have ultrasound of abdomen. It stated that he has obstructivw hepatitis (multiple stones in gall bladder and Common Bile duct was mildly dilated). Then my father underwent Cholecystectomy (removal of Gall Bladder with incission of T-Tubes).. After 3 to 4 days of surgery the Bilirubin level elevated to 22.5 mg/dl and on the very next day it became 25.2 mg/dl. Why is it still increasing? And what are the risks of Bilirubin higher than 25 mg/dl?? His age is 61 years old. Can he undergo ultrasound? Or it needs about a month after surgery to have Ultrasound? Kindly help me understand the cause of this increasing Bilirubin even after the obstruction is removed. And what harm can this elevated bilirubin cause? Liver is totally normal in its size shape and everything

Answer
Sorry to hear about your father's health issue.  A couple of questions:  When you say your father's physician, are you referring to his Gastroenterologist?  What was his PT and Direct and Total Bilirubin?  

Indirect (unconjugated) Bilirubin is calculated by subtracting Direct (conjugated) from Total Bilirubin.  If the Direct Bilirubin is increased, this points to obstruction as the cause.  If the Direct (conjugated) Bilirubin is increased, this points to red blood cells being broken down by the body faster than the liver can conjugate the RBC breakdown products into bilirubin.

Bilirubin is the product of the breakdown of RBCs by the spleen and liver.  There are 2 types of Bilirubin, Direct and Indirect. Elevated levels of Direct and Indirect bilirubin are diagnostic of different medical conditions.  

Bilirubin is a product of the breakdown of heme, a compound that is part of the hemoglobin molecule in RBCs.  Heme is the yellow pigment responsible for the yellowish discoloration of the sclera and skin in jaundice.

Normally, old and worn out RBCs are taken out of the bloodstream by the spleen, where macrophages destroy them and the heme is broken down into unconjugated bilirubin.  Most of unconjugated bilirubin is then transported to the liver where it undergoes a biochemical process called conjugation, making it water soluble.  The resulting product, bile, is secreted via the biliary ducts into the small intestine.

An increase in serum bilirubin could occur if the patient is making too much bilirubin because of increased red cell breakdown or because they are not able to remove bilirubin from the system due to obstruction of the bile ducts or liver problems such as cirrhosis, hepatitis, or genetic conditions that interfere with bilirubin processing.

Ask if your father had Coag Labwork done and if so ask the physician for the lab results.  If not, you may want to ask the physician to run a PT.  The liver makes all Coagulation factors, and a PT (Prothrombon Time) is a coagulation test which measures extrinsic coagulation factors and is the best overall indicator of liver function.

What was the result of the Infectious disease screen?  There are different types of Hepatitis, i.e., Hepatitis A, B, C, D, E.

Elizabeth

Lab Tests

All Answers


Answers by Expert:


Ask Experts

Volunteer


Elizabeth, MSCIT, BSMT (ASCP)

Expertise

I can answer questions about the purpose of specific laboratory tests, and can suggest specific questions the patient may want to ask their physician regarding the interpretation of their laboratory testing results. I cannot diagnose diseases or be held responsible for any information or suggestions offered. The final authority and informational resource regarding the patient's medical treatment should be their own physician.

Experience

Clinical Systems Analyst at LALGC. 2 years of experience as an Allied Health Instructor teaching clinical lab skills at a Technical college for Associate Degree Clinical Medical Assisting students.

Organizations
ASCP, licensed as a Medical Technologist in the state of AR and in the state of HI.

Education/Credentials
BS in Medical Technology (ASCP), Licensed as a Medical Technologist in the state of HI, MS in Computer Information Technology, BA in Art

Awards and Honors
AR Children's Hospital Scholarship for Medical Technology Students

©2016 About.com. All rights reserved.