Bilirubin direct
The name bilirubin comes from the Latin words bilis (bile) and ruber (red). It is produced in organs that are involved in breaking down red blood cells – the spleen, liver and some lymph nodes. It is also known as bile pigment, and it is the breakdown product of haemoglobin, which is yellow in colour. During its lifetime, it binds to proteins in the blood plasma, from where it is transported to the liver and then to the bile. Stool colour is affected by the amount of bilirubin.
In case of liver disease or increased breakdown of red blood cells, its levels may increase. It causes itching and yellowing of the skin, mucous membranes, and the white of the eyes.
What does the test show?
Laboratory testing may indicate the presence of some form of liver disease. The amount of bilirubin in the blood is measured.
In which cases is it recommended to perform the test?
Your doctor will order an examination if they notice any symptoms suggestive of liver disease or biliary obstruction.
What sample is needed for the test?
A blood sample taken from a vein is needed for the test.
What can the result indicate?
In newborns, due to the immature enzyme system, bilirubin builds up (neonatal jaundice) when haemoglobin is broken down. It is a physiological process that takes place in 1-3 weeks. If jaundice persists, a thorough investigation is required due to suspicion of biliary malformation.
The increase in isolated bilirubin may be due to the so-called Gilbert’s disease or Gilbert’s syndrome, which is a congenital bile secretion disorder that affects about 5% of the population in Hungary. However, the result alone is not a diagnosis, it is worth examining liver function along with other values.
What to do after the test?
The test alone cannot diagnose any disease, and in all cases consult an internist or haematologist to determine the exact diagnosis and required therapy.
