Bilirubin, what are the normal values
Bilirubin is the main breakdown product of haemoglobin. It is divided into direct or conjugated bilirubin (water-soluble and can be excreted by bile) and indirect or unconjugated (only partially soluble)
Normal values for bilirubin
Normal values for total bilirubin range between 0.2 and 1.1 mg/dL.
Post-hepatic direct (or conjugated) bilirubin should not exceed 0.3 mg/dL; pre-hepatic indirect (unconjugated) bilirubin should remain within 0.8 mg/dL.
When total bilirubin values exceed 2-2.5 mg/dL, jaundice appears, characterised by yellow discolouration of the skin and sclerae.
The absence of bilirubin in the urine suggests that jaundice is due to an increase in unconjugated bilirubin
An increase in total bilirubin may be due to cholestasis, hepatocellular damage, increased haemolysis, Gilbert syndrome.
Elevated direct bilirubin values are caused by an obstruction of bile flow (due to hepatic cholestasis, cholestasis gravidarum, pancreatic carcinoma, parasitic diseases).
A decrease in bilirubin – either total or direct – may indicate aplastic anaemia, sideropenic anaemia or barbiturate abuse.
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