Elevated indirect 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 indirect bilirubin levels, we could:
Cause | Probability | Status |
---|---|---|
Bile Duct Cancer | 93% | Confirm |
Gallbladder Disease | 20% | Unlikely |
Hemolytic Anemia | 12% | Unlikely |
Sickle Cell Disease | 3% | Ruled out |
Drug Side-Effects | 2% | Ruled out |
Gilbert's Syndrome | 2% | Ruled out |
Liver Cancer | 0% | Ruled out |
Pancreatic Cancer | 0% | Ruled out |
Bilirubin, indirect. Unit: mg/dL [umol/L]
Possible responses:
→ Don't know→ 0.1 to 1.0 [2-17] (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.
Certain health conditions, such as gallstones or an infected gallbladder, can block the bile ducts and lead to an accumulation of bile in the body.
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.
Certain diseases, such as pancreatic cancer, can block the bile ducts and lead to an accumulation of bile in the body.
Sickle cell disease causes rapid destruction of red blood cells in the blood, leading to increased bilirubin levels.