Discussion:

Elevated level of total bilirubin in a patients blood serum sample indicates that
the particular individual might be suffered from some diseases or organ disorder. There
are several possible causes which will lead to abnormal high level of bilirubin in the
serum. A patient who is having haemolytic anemias will raise the bilirubin level due to
the increased haemolysis of red blood cells, which in turn increase the amount of
hemoglobin. The excessive amount of hemoglobin present in the blood will eventually
process into bilirubin which contributed to the abnormal level of bilirubin. In the case of
internal haemorrhage of a specific organ, same scenario will occur within the patient.
Besides, liver damage caused by cirrhosis and viral hepatitis can decrease the elimination
of bilirubin. Both cirrhosis, scarring of the liver tissues and viral hepatitis will affect the
normal metabolism of bilirubin. As a result, high level of bilirubin retains in the
bloodstream and eventually causes jaundice. Furthermore, in Gilberts syndrome and
Crigler-Najjar syndrome, both of them lack of UDP glucuronyltransferase within the
bilirubin metabolism process. Because of this deficiency, the bilirubin in the blood serum
will elevate unexpectedly. Lastly, the obstruction of the bile ducts due to the presence of
the gallstone and cholangitis which both are consistent with the elevation of the bilirubin
level. Due to the blockage of the bile ducts, less amount of bilirubin is eliminated and
consequently leading to the unusual level of bilirubin in the blood serum.
On the other hand, low level of bilirubin detected in the blood serum is caused by
some of the medication an individual consume such as vitamin C, phenobarbital, and
theophylline. In fact, low levels of bilirubin are not generally a concern for the medical
practitioner and it will not be monitored closely.
Reference:
Causes of Elevated Bilirubin Levels. (n.d). Retrieve May 15, 2011 from
http://www.livestrong.com/article/172084-causes-of-elevated-bilirubin-levels/
WebMD. (1995). Bilirubin. Retrieve May 13, 2010 from
http://www.webmd.com/digestive-disorders/bilirubin-15434?page=3
Marshall, W.J. and Bangert, S.K. (2008). Clinical chemistry (6
th
ed.). London: Mosby.