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:Normal range

Up to 1.0 mg/dl up to 17.1 mmol/L

:Comment

:Causes of high bilirubin

Hepatobiliary disease: hepatitis, cholangitis, cholecystitis, even without common duct calculi; cirrhosis, other types of liver disease including primary or secondary neoplasia

alcoholism (usually with high AST (Sgot), GGT, MCV, or some combination of these findings); cholestasis (intrahepatic or extrahepatic); infectious mononucleosis (look also for increased LD (LDH), lymphocytosis); Dubin-Johnson syndrome; Gilbert disease (familial hyper bilirubinemia). If > 80% of total bilirubin is indirect and total bilirubin is < 6.0 mg/dL hemolysis or Gilbert syndrome is suggested

Malnutrition, anorexia, or prolonged fasting: 36 hours or more may cause moderate rise

Pernicious anemia, hemolytic anemia, erythroblastosis fetalis, other neonatal jaundice, hematoma and following a blood transfusion, especially if several units are given in a short time or with delayed hemolytic transfusion reaction. The major source of bilirubin is hemoglobin catabolism from lysis of red blood cells

Pulmonary embolism/ infract

Congestive heart failure

Drugs: A large number of drugs can cause jaundice by in vivo action. Drugs which may cause cholestasis and/or hepatocellular damage include acetaminophen, aminosalicylic acid, anabolic steroids, azathioprine, chlorpromazine, Clindamycin, erythromycin, esterified estrogens, gentamicin, indinavir, indomethacin, isoniazid, MAO inhibitors, methyldopa, nortriptyline, oleandomycin oral contraceptives, penicillin, phenothiazines, procainamide, progesterone, pyrazinamides, sulfonamides, valproic acid, warfarin, drugs of abuse (eg, 3.4 methylenedioxymethamphetamine –MDMA), and many other agents. A few drugs can cause analytical decreases (eg, Amikacin, high doses of ascorbic acid, theophyline) and a large number of drugs can cause analytic, physiologic, or pathologic increases

Sample: Serum, protect from light