The blood test of bilirubin can detect liver disease and hemolysis.
Bilirubin is a pigment from the breakdown of hemoglobin, unconjugated or indirect. It undergoes hepatic conjugation to be secreted and then eliminated in the bile and stool. So that, in the normal state, the serum is minimal or zero.
Sampling 3 mL of blood in a dry tube, absolutely avoiding hemolysis.
Do not expose the sample to light.
The assay is done on the serum by colorimetry.
Normal values in adults:
– Total bilirubin: 3 to 14 mg / L, 5 to 24 mol / L;
– Conjugated bilirubin 0.5 to 2.4 mg / L, 0.8 to 4 mmol / L.
(To make the conversion. X 1.7 mg = ĩmol; micromol x 0.58 = mg)
– Predominance of indirect free form:
– In case of excess production: hemolytic anemia, disease Minkowski-Chauffard, G6PD deficiency, transfusion accident, maternal-fetal incompatibility, and toxic drug, infectious and parasitic hemolysis;
– Conjugation deficit: Gilbert’s syndrome, jaundice of the newborn, rifampicin treatment;
– Predominance of conjugated form:
– Constitutional conditions: Dubin-Johnson syndrome;
– Extrahepatic cholestasis: gallstones, tumors or cysts: primary biliary cirrhosis, hepatitis, amyloidosis, contraceptives, chlorpromazine;
– Intrahepatic cholestasis: viral hepatitis, cirrhosis, alcoholic hepatitis, liver cancer, toxic hepatitis.
B15 to B25.
A false elevation rate may be due to a removal of hemolysis, in a solar exposure but also with hypertriglyceridemia or a dopamine derivatives consumption.
Fasting also increases blood levels of total bilirubin.