Higher Bilirrubins

[TiagoRodrigues]

Hello.

My liver function exams are the following:

Aspartato Aminotransferase (AST/TGO) 16 U/L < 40
Alanina Aminotransferase (ALT/TGP)         10 U/L < 41
Gama-Glutamiltranspeptidase (GGT)         21 U/L < 60
Fosfatase Alcalina                                 58     U/L < 129

Bilirrubins:
Total 2.77 mg/dL                  < 1.20
Conjugada 0.45 mg/dL          < 0.30
Não Conjugada 2.32 mg/dL < 0.90

Why only my bilirrubins are anormal? What should I do?

Thank you for your help.
Tiago Rodrigues

[HectorSF]

Addition thought thanks to Randy -

It could be Gilbert's Syndrome also. Bilirubin levels in Gilbert syndrome in most patients are lower than 3 mg/dL and bilirubin levels occasionally may be normal in as many as one third of patients. An increase in the serum alkaline phosphatase (ALP) level may appear when a person has Gilbert's.

A reticulocyte count and a blood smear, is a useful screening test for excluding hemolysis!

Once the diagnosis of Gilbert syndrome is established,it should be made clear to the patient by the doctor that the syndrome is essentially benign, is not associated with increased morbidity, has an excellent prognosis, and is associated with normal life expectancy. I have had Gilbert's all my life and it has no symptoms or effects.

Please see your doctor for followup.

hector

[HectorSF]

Hello and welcome.

Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool (feces) and gives stool its normal brown color.

When bilirubin levels are high, the skin and whites of the eyes may appear yellow (jaundice). Jaundice may be caused by liver disease (hepatitis), blood disorders (hemolytic anemia), or blockage of the tubes (bile ducts) that allow bile to pass from the liver to the small intestine.

When Indirect (or unconjugated) bilirubin (Nao Conjugada) is greater than 90% of the total bilirubin as yours is it can indicate your abnormal bilirubin levels are related to 'Hemolysis Anemia'.

Hemolytic anemia is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular). It has numerous possible causes, ranging from relatively harmless to life-threatening. The general classification of hemolytic anemia is either inherited or acquired. Treatment depends on the cause and nature of the breakdown.

This is a blood disease NOT a liver disease.

In general, signs of anemia are pallor, fatigue, shortness of breath, and potential for heart failure.

To learn what is causing this condition your family doctor should refer you to a Hematologist. This is a doctor who specializes in diagnosing and treating blood diseases and disorders.

Doctors and clinics that specialize in treating inherited blood disorders, such as sickle cell anemia and thalassemias, also may be involved.

In summary -
Ask your doctor to see a Hematologist to learn what is causing these abnormal findings. More testing will probably be required.

To learn more about Hemolytic Anemia....

http://www.nhlbi.nih.gov/health/health-topics/topics/ha/

Best of luck to you!
Hector