Increased total bilirubin - what does it mean?

Often after receiving the results of an analysis of venous blood, the patient learns that he has increased total bilirubin - which means only to determine the total value is impossible. The fact is that the total concentration of this pigment is a set of indicators of direct and unbound bilirubin. It is these results that make it possible to find out in which system of the organism the failure occurred, and what is the reason for the deviation of the analysis from the norm.

Why can general bilirubin be raised in a blood test?

All factors provoking excess of normal values ​​of bilirubin are classified into 4 categories. Differentiation is based on the stages of exchange of the substance in question, as well as 2 defining criteria:

1. Localization of the cause by which the concentration of the yellow-green pigment increases (in the liver or outside this organ).
2. The form of increased bilirubin (direct or indirect).

According to this classification method, the following groups of reasons for increasing the amount of total yellow-green pigment are distinguished:

1. Hepatic elevation of bound bilirubin - in the cells of the liver, the production of bile is disrupted, as a result of which its outflow has deteriorated directly in the bile ducts inside the liver.
2. Extrahepatic increase of bound bilirubin - outflow of bile is disturbed in extrahepatic ducts.
3. Hepatic elevation of free bilirubin - in the liver cells there is an incorrect conversion of free pigment into a direct form.
4. Extrahepatic increase in free bilirubin - outside the liver, too much free yellow-green pigment is produced.

Each of these groups has characteristic clinical manifestations, due to which it is possible to put a preliminary diagnosis.

It is worth noting that even if the total bilirubin is increased slightly, more research is needed. Not only the numerical indicator of the amount of bound and free pigment is important, but also its percentage ratio to the total concentration of the substance.

What is the increased total bilirubin in the blood with an increase in the direct fraction?

Diseases accompanied by the described condition can be intrahepatic and extrahepatic.

The first group includes:

• hepatitis:
• acute viral;
• bacterial;
• chronic;
• medicinal;
• toxic;
• autoimmune;
• liver tumors;
• intrahepatic cholestasis;
• biliary primary cirrhosis;
• jaundice of pregnant women;
• Rotor syndrome;
• Dabin-Johnson syndrome.

The second group consists of such diseases:

• acute and chronic pancreatitis;
• echinococcosis of the liver ;
• aneurysm of the hepatic artery;
• diverticulitis of the duodenum;
• a pancreas tumor;
• chronic, acute and segmental cholangitis;
• cholelithiasis;
• swelling of the duodenum;
• neoplasm in the bile duct.

Increased total bilirubin with signs of an increase in the indirect pigment - what does it mean?

If the concentration of free bilirubin is increased with a simultaneous increase in the total amount of pigment, the causes can also be covered both inside the liver tissue and outside it.

In the first case, there are such diseases:

• the Kriegler-Nayyar syndrome;
• acquired non-hemolytic jaundice;
• Gilbert's syndrome;
• Lucy-Driscola syndrome.

Extrahepatic diseases include:

• acquired hemolytic anemia, usually of an autoimmune origin;
• congenital hemolytic anemia
• sepsis ;
• hemolysis of erythrocytes in newborns;
• malaria;
• toxic hemolytic anemia;
• medicinal hemolytic anemia.