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.
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:
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 |
Bilirubin, direct. Unit: mg/dL [umol/L]
Possible responses:
→ Don't know→ 0.0 to 0.3 [0-5] (normal) → Recently elevated → Chronically elevated |
Certain medicines can damage the liver. Examples include many antibiotics, some types of birth control pill (sex hormones), antipsychotic drugs, and many others.
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.
One common – and harmless – cause of elevated bilirubin is Gilbert's syndrome, a deficiency in an enzyme that helps break down bilirubin.
Certain conditions, such as hemolytic anemia, can cause increased destruction of red blood cells and therefore increased bilirubin production.
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.
Sickle cell disease causes rapid destruction of red blood cells in the blood, leading to increased bilirubin levels.