Jaundice laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laboratory Findings

  • Laboratory findings consistent with the diagnosis of jaundice include:
    • An elevated concentration of serum total bilirubin. the upper limit of normal is >1 mg/dL or >1.3 mg/d in some laboratories. Jaundice usually becomes clinically apparent when the serum total bilirubin concentration is greater than 2 to 3 mg/dL , but threshold for clinically apparent jaundice may vary among patients.  
  • 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), or 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, or less than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).  
  • Total and unconjugated Bilirubin
    • Bilirubin is the major breakdown product of hemoglobin that is released from dying or damaged erythrocytes
    • The normal Bilirubin range is 0.3-1.0 mg/dL
  • Aspartate transaminase(AST) (or) SGOT
  • Alanine transaminase(ALT) (or) SGPT
  • Albumin
  • Alkaline phosphatase
  • HIV serologies
  • Hepatitis serologies
  • Antinuclear antibody (ANA)
  • Antimitochondrial antibodies
  • Haptoglobin
  • Reticulocyte count
  • Leukocytosis
  • Lactic dehydrogenase (LDH)

Inalcoholic hepatitis the aspartate aminotransferase:alanine aminotransferase ratio is > 2 (AST:ALT)

References

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