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Direct bilirubin | Laboratory research

Known as: Direct bilirubin | Laboratory research
SKU: 1049


Study material: Venous blood
Response time (working day): 1
The test is done on an empty stomach: Yes
Home call service: Yes
Country: Georgia

General Information

Bilirubin - One of the main components of bile, is produced mainly from hemoglobin of erythrocytes. Another source of bilirubin is myoglobin, cytochromes and heme pigments. When hemoglobin is broken down, free (indirect) bilirubin is initially produced. Free bilirubin travels from the spleen to the liver along with albumin. In the liver, it binds to glucuronic acid - it conjugates. The result is conjugated (direct) bilirubin, which is actively secreted into the bile ducts. Depending on which type of bilirubin concentration increases in plasma, hyperbilirubinemia is classified as both unconjugated and conjugated.

When should we take the test?

  • Identify and assess the degree of bilirubinemia;
  • Differential diagnostics of different types of jaundice;
  • Liver and biliary tract diseases, hemolytic anemia.

Possible interpretation of the results

Increased direct bilirubin concentration:

  • Hepatitis of various etiologies (acute viral hepatitis, cytomegalovirus-induced hepatitis, infectious mononucleosis, amebiasis, actinomycosis, secondary and tertiary syphilis, acute toxic hepatitis);
  • Taking hepatotoxic medications;
  • Biliary tract pathology (cholangitis, cholecystitis);
  • Oncopathology (primary hepatocarcinoma, metastatic liver damage);
  • Hereditary hyperbilirubinemia (Dubin-Johnson syndrome, Rotor syndrome);
  • Hypothyroidism in newborns;
  • Obstructive jaundice (gallstones, tumors of the pancreas, helminthic invasion);
  • Biliary cirrhosis (primary or secondary).

Additional information

Direct (conjugated) bilirubin - Combination of free bilirubin with glucuronic acid, makes up 25% of total bilirubin. It is a less toxic, water-soluble fraction that forms in the liver. Elevated levels of direct bilirubin in blood serum are associated with decreased excretion of conjugated pigment from the liver and bile ducts and manifest as cholestatic or hepatocellular jaundice. Abnormal increase in direct bilirubin levels leads to the appearance of this pigment in the urine. Since indirect bilirubin is not excreted in the urine, the presence of bilirubin in the urine emphasizes an increase in serum conjugated bilirubin levels.


How to prepare for the test?

Preferably for the test on empty stomach Presence.

It is recommended to limit alcohol intake, smoking and strenuous physical activity for at least 12 hours before the test.

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