What Could be Causing Elevated Direct Bilirubin Levels?

What Causes Elevated Direct Bilirubin Levels?

Elevated direct bilirubin levels can have various causes, ranging in severity from 'worrying' to 'generally fatal'. Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms. In order to diagnose elevated direct bilirubin levels, we could:

Research the topic
Find a doctor with the time
Use a diagnostic computer system.

The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "elevated direct bilirubin levels" as a symptom. Here are eight of many possibilities (more below):

Cirrhosis Of The Liver
Hepatitis
Gilbert's Syndrome
Pancreatic Cancer
Bile Duct Cancer
Drug Side-Effects
Liver Cancer
Hemochromatosis

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:

mild abdominal discomfort

frequent sleepwalking

nausea for 1-3 months

African ethnicity

mild unexplained fevers

gout

significant abdominal distension

light body hair

no blood in nipple discharge

pale fingernails

confirmed liver cirrhosis

sugar/sweet craving

... and more than 60 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of elevated direct bilirubin levels:

Cause	Probability	Status
Cirrhosis Of The Liver	98%	Confirm
Hepatitis	20%	Unlikely
Drug Side-Effects	16%	Unlikely
Liver Cancer	5%	Ruled out
Bile Duct Cancer	5%	Ruled out
Gilbert's Syndrome	1%	Ruled out
Pancreatic Cancer	0%	Ruled out
Hemochromatosis	0%	Ruled out

* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate having had recent lab tests, The Analyst™ will ask further questions including this one:

Bilirubin, direct. Unit: mg/dL [umol/L]

Possible responses:

→ Don't know
→ 0.0 to 0.3 [0-5] (normal)
→ Recently elevated
→ Chronically elevated

Based on your response to this question, which may indicate either normal direct bilirubin level or high direct bilirubin level, The Analyst™ will consider possibilities such as:

(Prescription) Drug Side-Effects

Certain medicines can damage the liver. Examples include many antibiotics, some types of birth control pill (sex hormones), antipsychotic drugs, and many others.

Bile Duct Cancer

Chemotherapy Side-Effects

Cirrhosis of the Liver

Diseases that cause liver damage can lead to increased bilirubin levels. Cirrhosis may cause normal, moderately high or high levels of bilirubin, depending on the type of cirrhosis.

Gilbert's Syndrome

One common – and harmless – cause of elevated bilirubin is Gilbert's syndrome, a deficiency in an enzyme that helps break down bilirubin.

Hemochromatosis (Iron overload)

Hemolytic Anemia

Certain conditions, such as hemolytic anemia, can cause increased destruction of red blood cells and therefore increased bilirubin production.

Hepatitis

Diseases that cause liver damage can lead to increased bilirubin levels. To further investigate the cause of jaundice or increased bilirubin levels, liver function tests or other evidence of infective hepatitis (hepatitis A, B, C, delta, E, etc.) are commonly used.

Liver Cancer

Sickle Cell Trait / Disease

Sickle cell disease causes rapid destruction of red blood cells in the blood, leading to increased bilirubin levels.

Concerned or curious about your health? Try The Analyst™