Bilirubin: examination can diagnose cirrhosis and hepatitis

The bilirubin test is used to diagnose and / or monitor liver disease, such as cirrhosis, hepatitis, or gallstones. Bilirubin is an orange substance produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool and a small portion in the urine.

The bilirubin dosage in the blood therefore serves to assess liver function. If there is an excess of this substance in the blood, it is a sign that it is not being properly filtered and discarded by the liver.

Bilirubin circulates in the bloodstream in two forms:

• Indirect (or unconjugated) bilirubin: this form does not dissolves in water and is the bilirubin that travels in the bloodstream to the liver, where it is transformed into a soluble substance.
• Direct (or conjugated) bilirubin: when indirect bilirubin reaches the liver it is excreted as bile, constituting a of bile pigments. This substance then returns to the bloodstream to be excreted in the faeces. Because it is water soluble, conjugated bilirubin is found in small amounts in the urine.

Total bilirubin and direct bilirubin levels are measured in the blood, whereas indirect bilirubin levels are derived from measurements of total bilirubin and

Indications

The bilirubin test is usually ordered to evaluate liver function. Factors that warrant the dosage of bilirubin are:

• Jaundice
• Alcoholism
• Suspected drug intoxication
• Exposure to hepatitis virus
• Tachycardia

Other symptoms that may be present include:

• Dark or orange urine
• Nausea and vomiting
• Abdominal pain, especially in the upper right quadrant
• Fatigue and malaise, usually accompanied by chronic liver disease.

The examination can also be ordered if hemolytic anemia is suspected. In this case, bilirubin dosing is done along with other tests, such as complete blood count, reticulocyte count, haptoglobin, and total cholesterol.

In newborns, bilirubin can be measured to investigate the cause of jaundice. Excess bilirubin in the baby's body can impair the development of brain cells and cause cognitive, learning and developmental impairment, as well as loss or problems with eye movement and hearing. It is important that a high level of bilirubin in the newborn is identified and treated rapidly.

Contraindications

There are no express contraindications for a bilirubin test. However, the doctor or doctor can tell you whether you are fit to take the test or not.

Pregnancy can do?

There are no contraindications to the bilirubin test during pregnancy. Examination

For the bilirubin test a minimum fast of three is required. In infants, collection should be done before the next feeding.

It may be necessary to discontinue use of certain medications before the test is performed, but only the doctor or doctor can state that. That way it is important to tell which medications you take regularly. Examples of medications that may affect bilirubin levels include antibiotics, sedatives, diuretics, and asthma medications.

How it is done

In a hospital or laboratory, the creatinine test is performed by a healthcare professional as follows :

With the patient seated, a rubber band is tied around his arm to stop the flow of blood. This causes the veins to become wider, helping the practitioner to hit one of them.

• The professional cleans the area of ​​the arm to be penetrated by the needle
• The needle is inserted into the vein. This procedure can be done more than once until the health care provider hits the vein and is able to remove the blood.
• Blood collected in the syringe and placed in a tube
• The elastic is removed and a gauze is placed on the where the health professional inserted the needle, to prevent any bleeding. He or she can press on the bandage to staunch the blood
• A bandage is placed on the spot.
• In the case of babies, the blood sample can be drawn at the heel. The heel skin is first sanitized with alcohol and then punctured with a small sterile lancet. Several drops of blood are collected in a small tube. When sufficient blood has been collected, a portion of gauze or cotton is placed over the puncture site. A slight pressure is applied on the area and then a small bandage is applied.

Instead of the heel test, some hospitals may use a device called transcutaneous to check the level of bilirubin in the newborn. This small portable device measures bilirubin levels when it is gently placed on the skin. With this device, there may be no need to pierce the baby's skin. This is a screening test, and a blood sample will be needed if the baby's bilirubin level is high.

Examination time

The bilirubin test takes a few minutes to complete and may take longer.

Post-examination recommendations

There are no special recommendations after the examination. The patient can do his / her activities normally. Since it is necessary to fast for at least 3 hours, the patient may eat after collection.

Frequency of the test

There is no periodicity for bilirubin dosing. It will depend on the physician's guidelines and the presence or absence of diseases that must be followed up by the examination, such as hepatitis.

Risks

The risks involved in the bilirubin test are extremely rare. At most, there may be a hematoma at the site where blood was withdrawn. In some cases, the vein may become swollen after the blood sample is collected (phlebitis), but this can be reversed by making a compress several times a day.

People who use anticoagulant medications or have coagulation problems may suffer from a bleeding after collection. In these cases, it is important to inform the health care professional of the problem in advance.

Results

The results of the bilirubin test may take a few hours or a few days to be ready. Bilirubin levels in the blood may show liver function and indicate possible liver diseases.

The reference values ​​shown here are just a guide, as they may change from laboratory to laboratory. In addition, the physician or physician will evaluate the results according to the patient and their characteristics, such as age and related diseases.

Normal results

In adults:

Direct: 0.00 to 0.30 mg / dL

• Indirect: 0.20 to 0.80 mg / dL
• Total: 0.20 to 1.10 mg / dL
• Total bilirubin in preterm newborn:

1 day: 1.00 to 8.00 mg / dL

• 2 days: 6.00 to 12.00 mg / dL
• 3 to 5 days: 10.00 to 14.00 mg / dL
• Total bilirubin in full-term newborn:

1 day: 2.00 to 6.00 mg / dL

• 2 days: 6.00 to 10.00 mg / dL
• 3 to 5 days: 4.00 to 8.00 mg / dL
• Abnormal results

In adults and children, high levels of total or indirect bilirubin may indicate:

Hemolytic anemia

• Cirrhosis
• Gilbert syndrome or Gilbert's disease .
• If direct bilirubin is higher than indirect bilirubin, it may be a problem associated with elimination of the substance from the liver. Some conditions that cause this reaction are:

Viral hepatitis

• Drug intoxication
• Alcoholic liver disease
• Increased bilirubin may also be related to biliary obstruction or hepatic injury. This condition can be caused by:

Gallstones

• Tumors
• Fibrosis in the bile ducts
• Bilirubin levels lower than normal rarely indicate a serious condition and are not a cause for concern.

Newborn

Elevated levels of bilirubin in newborns may be temporary and normalize within up to two weeks. However, if bilirubin is above a critical threshold or increases rapidly, more detailed investigation is needed. The high level of bilirubin can result from the accelerated degradation of red blood cells due to an incompatibility between the blood type of the mother and her newborn. Other causes include congenital infections, hypoxia, genetic diseases, and diseases that affect the liver. In most of these conditions, only indirect bilirubin is increased.

Elevated direct bilirubin is seen in rare conditions of biliary atresia and neonatal hepatitis. Biliary atresia requires surgical intervention to prevent damage to the liver.

Color of urine may reveal kidney or liver disease

The color of the pee can tell a lot about your health and it is good to be aware of some changes that we can recognize just by looking at it, especially if the toilet is attention to the color of the urine should be a simple habit that can prevent diseases from developing without a diagnosis. A urine approaching water may mean that you drank too much fluid or your kidneys lost the ability to concentrate the urine.

(Health)

Zika virus can spread throughout the Americas, alert authorities

The British medical journal The Lancet has issued an alert regarding the outbreak of zika virus infections in Brazil and the possibility of an epidemic in the Americas and the Caribbean. The risk, according to the publication, is still increased because of the Olympic Games, which will take place in Rio de Janeiro in August 2016.

(Health)