Bilirubin Levels Chart is a table of common bilirubin levels that cause jaundice yellowish color of the skin and eyes sclera, includes normal bilirubin levels, high bilirubin levels, and low bilirubin levels in the same place.
Where bilirubin comes from and where bilirubin goes to?
Bilirubin comes from degradation of hemoglobin and cells breakdown by spleen or other organs, bilirubin enters blood stream as large insoluble molecule which has the term (unconjugated), when reaches the liver, hepatic cells perform chemical reaction to make bilirubin soluble in the blood by bound it to the glucuronic acid by the enzyme glucuronyltransferase which then called (conjugated), conjugated bilirubin go from the liver to the intestine and undergoes reduction to the form called stercobilirubin which give the stool its yellowish color, another part of direct bilirubin go to urine through the kidney after being transformed to a compound called urobilinogen (urine dye) which gives the urine the yellowish color.
Measuring Bilirubin at the lab: scientists measure conjugated bilirubin and report it as (direct bilirubin), and measures total bilirubin values, then calculated the unconjugated bilirubin by subtracting direct from total, the result is the estimated indirect bilirubin (unconjugated)
When your doctor requests bilirubin test, this means direct bilirubin (DBil), indirect bilirubin, and total-value bilirubin (TBil), the bilirubin test for the newborns is “total bilirubin and/or indirect bilirubin”
Hyperbilirubinemia, Jaundice, icterus are medical terms for high bilirubin level in the blood and urine, clearly, jaundice means a yellow discoloration of the skin and icterus means discoloration of the eyes, while kernicterus is a medical condition means brain cells damage due to high bilirubin lev
els in the blood, usually at levels such as 30 mg/dl, Bilirubin is a highly neurotoxic substance.
Medical short codes for TSB, DSB, ISB are total, direct, indirect serum bilirubin respectively.
Total bilirubin is the sum of all bilirubin forms in the blood, and not representing different type of bilirubin in the body.
The bilirubin shown in urine and skin at serum bilirubin levels between 3.0 to 5.0 mg/dl, skin jaundice and eyes yellowish discoloration appear, urine color become dark yellow or as light tea when direct bilirubin is high in the blood, when indirect bilirubin is higher than 25mg/dl in the blood, it may show greenish plasma color as a result of sever elevation of indirect bilirubin (due to increased activity of biliverdin reductase enzyme which reduce biliverdin to bilirubin).
Low levels of bilirubin are generally not concerning and are not monitored as there is no studies confirm a risk for flow level of bilirubin.
Bilirubin results like:
Normal bilirubin level is a bilirubin value that means there is no diseases could be found in the sources of synthesis, processing, and removing of bilirubin.
Recommendation: if it’s the first time you take a bilirubin test, there is no further investigation when results is normal, if you’re on medication, then you’re just fine and continue to keep it normal.
Borderline Bilirubin results:
Are the bilirubin levels that reach the normal upper limits or slightly above, can’t be taken seriously as jaundice, and need for new test after few days, sometimes borderline bilirubin levels shown up when the person is on medications.
False bilirubin results:
Lab errors must be confirmed by retest bilirubin after few days, physiological causes as dehydration show pale yellow skin and deep yellow eye’s white area which may be confused with jaundice, results may be as:
Causes of hyperbilirubinemia:
High bilirubin (total) is either due to:
2. High direct Bilirubin level with normal or slightly elevated indirect bilirubin, commonly seen in results of obstructive jaundice due to hepatitis A for children or stones, for example:
3. Both conjugated and unconjugated bilirubin are elevated, values are almost the same, commonly results from hepatic diseases, for instance:
Common bilirubin levels in infant newborns:
High bilirubin with no visible disease
Gilbert, Crigler-Najjar syndrome, and alcohols are common reasons of high bilirubin levels without an obvious disease.
Remarks: Hereditary jaundice show steady bilirubin levels and continuous follow up.
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