Jaundice laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]

Overview

An elevated concentration of serum total bilirubin is diagnostic for jaundice. The upper limit of normal is >1 mg/dL or >1.3 mg/d in some laboratories. Hyperbilirubinemia can be further categorized as conjugated or unconjugated. Serum conjugated bilirubin concentration >0.4 mg/dL (6.8 micromol/L) revealed conjugated hyperbilirubinemia. In unconjugated hyperbilirubinemia conjugated bilirubin is <1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL, or less than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).

Laboratory Findings

Laboratory findings consistent with the diagnosis of jaundice include:[1][2]

Elevated biliribin

  • An elevated concentration of serum total bilirubin (Normal 0 - 1 mg/dL).
  • Hyperbilirubinemia can be further categorized as conjugated or unconjugated:
    • Conjugated hyperbilirubinemia:
      • Serum conjugated bilirubin concentration >0.4 mg/dL (6.8 micromol/L).
      • Direct bilirubin >1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL (85 micromol/L).
      • More than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).
    • Unconjugated hyperbilirubinemia:
      • Conjugated bilirubin is <1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL.
      • Less than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).

Liver function tests

Complete blood count

Erythrocyte sedimentation rate

Lactate dehydrogenase levels

Serology:

Hepatitis serology

  • For more information about viral hepatitis serology click here.

Autoimmune antibodies

Serum electrophoresis

Enzyme levels

Alpha-1-antitrypsin levels:

  • Decreased alpha-1-antitrypsin may suggests cirrhosis as the underlying disease for jaundice.[10]

References

  1. Walker HK, Hall WD, Hurst JW, Stillman AE. PMID 21250253. 
  2. Roche SP, Kobos R (January 2004). "Jaundice in the adult patient". Am Fam Physician. 69 (2): 299–304. PMID 14765767. 
  3. Ellis G, Goldberg DM, Spooner RJ, Ward AM (1978). "Serum enzyme tests in diseases of the liver and biliary tree". Am. J. Clin. Pathol. 70 (2): 248–58. PMID 696683. 
  4. Pratt DS, Kaplan MM (2000). "Evaluation of abnormal liver-enzyme results in asymptomatic patients". N. Engl. J. Med. 342 (17): 1266–71. PMID 10781624. doi:10.1056/NEJM200004273421707. 
  5. Ellis G, Goldberg DM, Spooner RJ, Ward AM (1978). "Serum enzyme tests in diseases of the liver and biliary tree". Am. J. Clin. Pathol. 70 (2): 248–58. PMID 696683. 
  6. Goldberg DM (1980). "Structural, functional, and clinical aspects of gamma-glutamyltransferase". CRC Crit Rev Clin Lab Sci. 12 (1): 1–58. PMID 6104563. 
  7. 7.0 7.1 7.2 7.3 Kumagi T, Heathcote EJ (2008). "Primary biliary cirrhosis". Orphanet J Rare Dis. 3: 1. PMC 2266722Freely accessible. PMID 18215315. doi:10.1186/1750-1172-3-1. 
  8. Tomizawa Y, Noishiki Y, Okoshi T, Koyanagi H (May 1992). "[A rabbit model for evaluation of a small-caliber vascular graft]". Kokyu To Junkan (in Japanese). 40 (5): 481–4. PMID 1589647. 
  9. Fallatah HI, Akbar HO (January 2010). "Elevated serum immunoglobulin G levels in patients with chronic liver disease in comparison to patients with autoimmune hepatitis". Libyan J Med. 5. PMC 3071169Freely accessible. PMID 21483590. doi:10.3402/ljm.v5i0.4857. 
  10. Greene DN, Elliott-Jelf MC, Straseski JA, Grenache DG (February 2013). "Facilitating the laboratory diagnosis of α1-antitrypsin deficiency". Am. J. Clin. Pathol. 139 (2): 184–91. PMID 23355203. doi:10.1309/AJCP6XBK8ULZXWFP. 



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