Elevated Bilirubin

A total serum bilirubin concentration above the laboratory reference range (adults: 3-21 μmol/L or 0.1-1.2 mg/dL), indicating increased bilirubin production, impaired hepatic processing, or reduced biliary excretion.

Causes

• Physiologic elevation in newborn jaundice

• Pre-hepatic causes (high unconjugated bilirubin)

  • Hemolytic anemia

  • Sickle cell disease

  • Blood transfusion

• Hepatic disease

  • Hepatitis

  • Cirrhosis

• Post-hepatic causes (impaired biliary excretion --> high conjugated bilirubin)

  • Choledocholithiasis

  • Cholangitis

  • Cholangiocarcinoma

• Genetic disorders

  • Gilbert's syndrome

  • Dubin–Johnson syndrome