Possible Causes for direct bilirubin increased Cholelithiasis Pediatr Emerg Care. 2012 Jan;28(1):68-76; quiz 77-8. doi: 10.1097/PEC.0b013e31823f5b1e. Abstract In recent years, gallbladder disease, primarily in the form of cholelithiasis, has been on the rise among infants and children. Although pediatric gallbladder disease is still less prevalent than adult gallbladder disease,[…] [ncbi.nlm.nih.gov] Toxoplasmosis We report a case of intrauterine infection by Toxoplasma gondii, Chikungunya and Zika viruses in a Colombian woman from the southern part of the country. The patient attended prenatal care in the second trimester of her pregnancy and she informed that in the first trimester she had presented with clinical[…] [ncbi.nlm.nih.gov] Choledocholithiasis Still, the most statistically significant and useful predictor found in our study was a ratio of direct bilirubin to total bilirubin greater than 30%. [scielo.org.co] bilirubin to total bilirubin ratios greater than 30%. [scielo.org.co] The presence of this predictor increased the probability of choledocholithiasis by 9.25 times (95% CI 1.20 to 65.69) and increased the probability of common bile duct dilation [scielo.org.co] Hemochromatosis Hereditary hemochromatosis causes iron overload and is associated with a variety of genetic and phenotypic conditions. Early diagnosis is important so that effective treatment can be administered and the risk of tissue damage avoided. Most patients are homozygous for the c.845G A (p.C282Y) mutation in the HFE[…] [ncbi.nlm.nih.gov] Cholestasis Up to 60% of patients will have elevated transaminases and 20% of patients will have increased direct bilirubin levels. [smfm.org] AST and ALT may be increased 2 - 20 fold. Total and direct bilirubin may also be significantly elevated. [clinicaladvisor.com] AST and ALT may be increased 2 – 20 fold. Total and direct bilirubin may also be significantly elevated. [cancertherapyadvisor.com] Cryptogenic Cirrhosis This is mainly directed at evaluating the presence of increased liver enzymes (alanine aminotrans-ferase, aspartate aminotransferase, alkaline phosphatase, and gamma glutamyl [elsevier.es] […] transferase), the integrity of the hepatic functions (e.g. prothrombin time, bilirubin, and albumin), as well as liver stiffness measurement as a surrogate for liver fibrosis [elsevier.es] Acute Cholecystitis In the uncomplicated cholecystitis, usually there are no increase of serum total and direct bilirubin and alkaline phosphatase (cholestasis indexes). [intechopen.com] Portal Cirrhosis Laennec's cirrhosis Specialty Gastroenterology Laennec's cirrhosis, also known as portal cirrhosis, alcoholic cirrhosis, fatty cirrhosis, or atrophic cirrhosis,[1] is named after René Laennec,[2] a French physician and the inventor of the stethoscope. It is a disease of the liver in which the normal lobular architecture[…] [en.wikipedia.org] Acute Pancreatitis Pancreas. 25(4):331-335, NOV 2002 PMID: 12409825 Issn Print: 0885-3177 Publication Date: 2002/11/01 Constantinos Chatzicostas;Maria Roussomoustakaki;Ioannis Vlachonikolis;Georgios Notas;Ioannis Mouzas;Dimitrios Samonakis;Elias Kouroumalis; Checking for direct PDF access through Ovid Abstract Acute pancreatitis runs[…] [doi.org] Viral Hepatitis The most striking laboratory findings include increases of serum aminotransferase activities, serum bilirubin (both total and direct), and serum alkaline phosphatase activity [academic.oup.com] Serum ALT is usually increased more than serum aspartate aminotransferase. [academic.oup.com] Liver Failure These findings translated to tests of upscaled adsorbents in a dynamic model for liver failure: upscaled Hepalbin adsorbent removes bile acids, direct bilirubin and indirect [ncbi.nlm.nih.gov] – measures all of the bilirubin in the blood; levels are increased with many liver diseases Direct bilirubin – measures a form of bilirubin that is conjugated (combined with [labtestsonline.org] […] bilirubin significantly better than MARS adsorbents and significantly increases ABiC. [ncbi.nlm.nih.gov] Macronodular Cirrhosis BACKGROUND/AIMS: Incomplete septal cirrhosis (ISC) is a form of macronodular cirrhosis characterized by slender, incomplete septa that demarcate inconspicuous nodules. Its clinical features have not been investigated in a large series. The aims of this study were to review the clinical symptoms and evolution of ISC in[…] [ncbi.nlm.nih.gov] Bile Duct Stricture Abstract Patients with recurrent high bile duct strictures pose special problems for management. Relief of obstruction by hepaticojejunostomy is usually possible but the standard technique does not permit long term access. Six patients with benign strictures involving hepatic ducts have been treated by a simple[…] [ncbi.nlm.nih.gov] Hepatocellular Carcinoma Exp Mol Pathol. 2017 Oct;103(2):200-203. doi: 10.1016/j.yexmp.2017.09.004. Epub 2017 Sep 20. Author information 1 Harbor UCLA Medical Center, Department of Pathology, 1000 West Carson Street, Torrance, CA 90502, United States. Electronic address: jlu3@dhs.lacounty.gov. 2 Department of Radiology, 1000 West Carson[…] [ncbi.nlm.nih.gov] Acute Fatty Liver of Pregnancy […] levels were 4.97 mg% (direct) and 6.63 mg% (indirect). [doi.org] There were moderately increased blood levels of urea and creatinine but a pronounced increase of uric acid (13.4 mg%). [doi.org] Twenty‐four hours after delivery the urinary output was 1.2 l/day and laboratory tests showed a minimal proteinuria, pronounced anaemia but with a normal platelet count and bilirubin [doi.org] Ascending Cholangitis Abstract An intussusception-type antireflux valve was created in the Roux-en-Y loop in 23 infants with biliary atresia (17 new cases, and six others after episodes of ascending cholangitis) and 10 patients with congenital bile duct dilatation, in order to prevent ascending cholangitis after hepatic portojejunostomy.[…] [ncbi.nlm.nih.gov] Primary Sclerosing Cholangitis Primary sclerosing cholangitis is a progressive, cholestatic hepatic disease of unknown etiology. It is characterized by progressive inflammation, destruction, and fibrosis of the intrahepatic and extrahepatic bile ducts. Several medical therapies have been tried such as penicilamin, colchicine, methatraxate, cyclosporine,[…] [ncbi.nlm.nih.gov] Massive Hepatic Necrosis Early - features of cholangiohepatitis and cholestasis (increased ALP, AST, direct bilirubin, cholesterol); hepatomegaly, jaundice, and pruritis (destructive phase) Late - [quizlet.com] […] mg/dL Increased Increased Increased Increased Urine bilirubin None Increased Increased Serum albumin/ total protein Alb, 3.5-5.5 g/dL Tot, 6.5-8.4 g/dL Albumin decreased [slideshare.net] Symptoms related to etiology Cholestasis symptoms (increased ALP, direct bilirubin, cholesterol; hepatomegaly, janduice, pruritis) Symptoms of secondary infection (frequent [quizlet.com] Paroxysmal Cold Hemoglobinuria Total bilirubin is only modestly increased (up to 5 mg/dL) and, with rare exceptions, the conjugated (direct) fraction constitutes less than 15 percent of the total. [errolozdalga.com] […] indirect bilirubin level A positive direct antiglobulin test with a broad-spectrum antibody against immunoglobulin and complement. [omicsonline.org] In addition to the usual findings associated with hemolytic anemia (RBC polychromasia, increased unconjugated bilirubin, Decreased haptoglobin, and hemoglobinuria) there is [med-ed.virginia.edu] Pancreatic Adenocarcinoma In this case report we detail the treatment of a patient with pancreatic ductal adenocarcinoma and a solitary liver metastasis who received nine cycles of FOLFIRINOX therapy with favourable response. The patient subsequently underwent synchronous distal pancreatectomy and hepatectomy with an R0 resection[…] [ncbi.nlm.nih.gov] Progressive Familial Intrahepatic Cholestasis During the hospital admission the direct bilirubin increased to 8.2 mg/dL out of a total of 10.4 mg/dL. [scielo.org.mx] While evaluating a jaundiced infant, the initial step is measuring the serum total (TB) and direct bilirubin. [dovepress.com] In PFICs, laboratory abnormalities include increased serum alkaline phosphatase (ALP), variable elevation of bilirubin, decreased/increased gamma-glutamyltransferase (GGT) [dovepress.com] Malignant Neoplasm of the Pancreas Pancreatic cancer is a type of cancer that starts in the pancreas. (Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer? ) Pancreatic adenocarcinoma is the most common type of pancreatic cancer. Pancreatic neuroendocrine[…] [cancer.org] Isoniazid Hepatitis Abstract Two patients with liver failure secondary to isoniazid hepatotoxicity were successfully treated with orthotopic liver transplantation. A 49-year-old man received isoniazid prophylaxis for a positive tuberculin test, and a 60-year-old woman was treated for active pulmonary tuberculosis with isoniazid, rifampin,[…] [ncbi.nlm.nih.gov] Drug-induced Toxic Hepatitis Published on Sep 14, 2010 2. Inhalation, Ingestion, parenteral administration Industrial toxins (CCl4, yellow phosphorus) Mushroom poisoning (Amenita, Galerina) Pharmacologic agents 3. Direct toxic Carbon tetrachloride Acetaminophen Halothane Idiosyncratic 4. Hepatitis occurs with predictable regularity Dose-dependent[…] [slideshare.net] Acute Liver Failure Author, Article, and Disclosure Information Acknowledgment: The authors thank the site coordinators and nurses for their support. Grant Support: By the National Institutes of Health (RO3 DK52827, RO1 DK58369) and the U.S. Food and Drug Administration Orphan Products Program (FD-R-001661). Dr. Schiødt was[…] [doi.org] Intrahepatic Cholestasis Up to 60% of patients will have elevated transaminases and 20% of patients will have increased direct bilirubin levels. [smfm.org] […] of direct bilirubin relative to total bilirubin concentration. [ncbi.nlm.nih.gov] An increase in the frequency of MSAF was also associated with higher serum levels at diagnosis of alanine transaminase, alkaline phosphatase and direct bilirubin. [ncbi.nlm.nih.gov] Fatty Liver Intern Med. 2006;45(16):953-6. Epub 2006 Sep 15. Abstract A 42-year-old male with visceral obesity and a fatty liver presented with hepatopathy accompanied by jaundice and was diagnosed to have early syphilis based on the results of standard serologic tests and clinical findings. Both the subjective and objective[…] [ncbi.nlm.nih.gov] Gallbladder Carcinoma Biochimie. 2018 Mar;146:56-67. doi: 10.1016/j.biochi.2017.10.027. Epub 2017 Nov 17. Author information 1 Department of General Surgery, Affiliated Hospital, Logistics University of People's Armed Police Force, Tianjin 300162, China. 2 Department of Hepatopancreatobiliary and Splenic Medicine, Affiliated Hospital, Logistics[…] [ncbi.nlm.nih.gov] Extrahepatic Cholestasis An increase in urinary bilirubin is nearly always indicative of a corresponding increase in the serum direct fraction attributable to intrahepatic or extrahepatic cholestasis [medical-dictionary.thefreedictionary.com] Rotor Syndrome This is similar to Dubin-Johnson syndrome and both leads to increase conjugated (direct) bilirubin. [labpedia.net] Laboratory findings showed increased serum bilirubin with direct bilirubin predominance. The urinary excretion of total coproporphyrin was slightly elevated. [kjp.or.kr] Liver function tests are shown below: ALT 26 U/L AST 29 U/L Alkaline Phosphatase 138 U/L Bilirubin, Total 8 mg/dL Bilirubin, Direct 7.5 mg/dL A urine analysis shows a normal [usmleforum.com]
