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Does raised bilirubin level in blood indicate any liver dysfunction?

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General & Family Physician
Practicing since : 2005
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Hi, I am a 35 year old female, presenting with general pruritis and pale stools. Blood tests have shown raised bilirubin levels, high cholesterol, high sgot, and high alkaline phosphatase (see table below) Which type of liver dysfunction does this signal?

Bilirubin:      30 mmol/L
AST (SGOT):      45 iu/L
Albumin:      32 g/L
Alkaline phosphatase:     712 iu/L
Cholesterol:      11.2 mmol/L

Posted Thu, 26 Apr 2012 in Liver and Gall Bladder
Answered by Dr. Prasad 22 hours later

Thanks for your query.

The bilirubin levels at 30mmol/l. Is this the total bilirubin level or the direct bilirubin levels?

Alkaline phosphatase is way above the limits while SGOT levels are borderline high. Elevated alkaline phosphatase suggest bile duct disease.

Increased bilirubin is clinically referred to as "Jaundice."
Jaundice is catergorised based on the cause as prehepatic (increased degradation seen in hemolytic condition), hepatic(liver dysfunctions) and posthepatic(obstruction). This can be differentiated by looking at the direct bilirubin levels - high direct bilirubin levels with high total bilirubin indicates a post hepatic/obstructive causes while a normal direct bilirubin with high total bilirubin levels prehepatic and hepatic causes.

Since I am not sure if it is the total bilirubin or direct bilirubin values that you have mentioned, I shall presume it to be the total bilirubin values.

Your clinicial symptoms, raised bilirubin levels and way above normal alkaline phosphatase points towards the diagnosis of obstruction in the bile duct.

Further evaluation such as Ultrasound scans, CT/MRI scans and ERCP may be required to determine the cause of obstruction and there by the treatmetn protocols.

I hope I have answered your query.

If you have any doubts or queries, you may write back to me. I will be available to answer them as well.

Warm Regards
Above answer was peer-reviewed by
Follow-up: Does raised bilirubin level in blood indicate any liver dysfunction? 7 hours later

Thank you so much for you detailed and analytical reply.

I have one more question, is it possible that these results may signal primary biliary cirrhosis?

Best wishes,
Answered by Dr. Prasad 15 hours later

Thanks for following up.

Primary biliary Cirrhosis as you might know is an autoimmune condition where there is progressive damage on the biliary system (canaliculi).

With just these reports, it is hard to predict if the condition is associated with this autoimmune condition. Based on the given reports, all I can say is that there is 'bile outflow system pathology' either an inflammatory or obstructive cause is likely.

Further evaluation alone can give the answers to what exactly is the condition. Hence I suggest that you get the tests done which probably will start of with abdominal examination and ultrasound scans. Other tests will follow.

Hope it is clear to you.

Wish you good health.

Above answer was peer-reviewed by
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