Lab

Indirect Bilirubin

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Indirect Bilirubin, Unconjugated Bilirubin, Hemolytic Jaundice, Unconjugated Hyperbilirubinemia

  • Interpretation
  1. Normal: <1.0 mg/dl
  • Causes
  • Increased (Unconjugated Hyperbilirubinemia)
  1. Increased Bilirubin production
    1. Hemolytic Anemia (typically mild Hyperbilirubinemia)
    2. Large heme load (e.g. large hematoma reabsorption)
    3. Rhabdomyolysis
    4. Hyperthyroidism (Thyrotoxicosis)
    5. Ineffective Erythropoiesis (increased RBC destruction in marrow)
      1. Thalassemia
      2. Pernicious Anemia
      3. Sickle Cell Anemia
      4. Lead Poisoning
      5. Iron Deficiency Anemia
      6. Myeloproliferative Disorder
  2. Defective Bilirubin conjugation
    1. Neonatal Jaundice (immature liver)
    2. Gilbert's disease
    3. Crigler-Najjar syndrome
  3. Impaired hepatic uptake of Bilirubin
    1. Medications (e.g. Gemfibrozil, Indinavir)
    2. Portosystemic shunt
    3. Hepatic congestion (e.g .CHF, liver disease)