A blood test is the main way to detect malfunctions in the work of some organs and systems of the body. For example, abnormalities in the liver can be detected in violation of the quantitative indicators of such a blood component as bilirubin. With hepatitis, some other diseases and pathologies, this bile pigment will be produced either in larger or smaller quantities.
Blood counts - a signal of health or illness
Blood is a multicomponent biological fluid, which is a transport structure that ensures the delivery of the necessary components to each cell and removal for disposal of waste substances. Science has determined the norms for the content of all blood components in accordance with a person’s age, as well as certain deviations of each component, according to which a specialist can suggest a particular pathology or disease, and assign a patient an examination for an accurate diagnosis. For example, experts will immediately say that bilirubin for viral hepatitis will not be normal with blood donation.
The role of the bile component
Bile, produced by the liver and accumulating in the gall bladder, is a significant biological fluid that has a huge impact on the digestive and excretory processes in the human body. It consists of many important components, one of which is bilirubin - a pigment that gives this liquid a special yellow-green color. The formation of bilirubin is a complex metabolic process of the breakdown of proteins (hemoglobin, myoglobin and cytochrome), which is the norm for life support processes.
Blood hemoglobin undergoes a process of decay in special cells distributed in the spleen, lymph nodes, liver and bone marrow. Metabolites enter the bile and leave the body with it. The functionality of bilirubin has not yet been fully studied. Today it has been found that it serves as a cellular oxidizing agent that absorbs oxygen. This process leads to the reverse formation of biliverdin - the green pigment of bile and also an intermediate decomposition product of hemoglobin.
Carrying out a blood test, a specialist discovers in it a small presence of bilirubin in the form of two fractions - bound and free. It is their number and ratio that make it possible to diagnose certain diseases. What kind of bilirubin for hepatitis in the test results will be discussed later.
The amount of bilirubin in the blood
A blood test is an informative procedure that allows you to determine further ways of examination, if the results have any deviations from the norm. The level of bilirubin in hepatitis will never be normal, since this disease is associated with the work of the liver, therefore, with the level of bilirubin in the blood. Detailed information on the amount of bound, unbound and total bilirubin is listed in the table.
norm bilirubin μmol / l | 1 trimester pregnancy | 2 trimester pregnancy | 3 trimester pregnancy | newborns | 2-4 day of life | 5-10 day of life | 1 month of life | men | women |
| common | 5-21,2 | 5-21,2 | 5-21,2 | 23.9 | 54.3-90.1 | 52.2-69.1 | 9.2-14.5 | 3.4-17.1 | 3.2-17.0 |
| unrelated | 1-8.9 | 1-10,1 | 0-11.2 | 14,4 | 45.5-82.3 | 44.3-63.3 | 6.7-10.4 | 0.7-7.9 | 0.9-4.3 |
| connected | 3.9-21 | 4,5-22,8 | 4.9-23.9 | 8.72 | 7.87 | 7.72-8.71 | 1.2-4.5 | 6.4-16.8 | 6.4-16.8 |
As can be seen from the table, the maximum level of bilirubin is observed in the blood of children who were only born during the first 10 days of life. After a month, this indicator should normalize and correspond to the norm by gender.
Preparation for analysis for bilirubin
Hepatitis is an insidious viral disease, because it does not immediately make itself felt. The period between the moment of infection and clinically significant symptoms that can cause a person to see a doctor can be up to several weeks (with hepatitis C - up to 6 months). Because many are interested in what bilirubin can be with hepatitis. But for adequate results of the analysis, it is necessary to observe several rules before donating blood. They are as follows:
- refusal (if possible) from taking medications that can affect the functionality of the liver and gall bladder two weeks before the appointed date for blood donation;
- quitting alcohol and smoking three days before the appointed date for a blood test;
- refusal to eat fatty foods three days before the date of analysis;
- reduction of physical activity a day before visiting the laboratory;
- food intake - no later than 8 hours before blood donation for the determination of bile pigment.
The analysis is given on an empty stomach in the morning.
Indicators are normal
Many patients who are screened for diseases that affect the functioning of the liver and gall bladder, wonder if bilirubin can be normal with hepatitis.
Unbound bilirubin, or indirect, is formed during the breakdown of red blood cells, the average duration of which is about 120 days. This bilirubin is toxic, getting into the cells, it damages them, causing oxidation processes. It enters the liver already with albumin.
In the liver, toxic bilirubin reacts with glucuronic acid, this reaction ends with the formation of bound bilirubin (direct). It is this type of bile pigment that is filtered and excreted through the gallbladder along with feces. Total bilirubin consists of direct and indirect. It is the ratio of the bound and unbound component of bile, as well as its total amount found in the analysis of blood and urine, that can indicate certain problems in the body.
Pigment of bile in the urine
So, blood and urine tests for bilirubin passed, and their results are obtained. A healthy person should not have bilirubin in the urine. Therefore, if you suspect hepatitis or other diseases in which the functionality of the liver and gall bladder is impaired, a special analysis is necessary. High bilirubin in the blood with hepatitis also affects the analysis of urine, which should be the reason for the following conclusions:
- it is necessary to conduct additional diagnostics to detect infection with the hepatitis virus;
- liver function is impaired if the level of bile pigment in the urine exceeds 17 mmol / l (for an adult).
It should be remembered that a high level of bile pigment in the urine can be caused by conditions when the liver is disturbed, for example, with excessive alcohol consumption on the eve of the test. A urinalysis can show only indirect (toxic) bilirubin, because the liver does not cope with its duties and can not conduct metabolic processes. Experts know that direct bilirubin can also be increased, for example, with hemolytic anemia. A blood test will reveal its high level, but a urinalysis will not, because it is not excreted in the urine.
Blood test results
High bilirubin for hepatitis, found in the patient’s blood and urine, is one of the indicators of the existing disease. In a patient with hepatitis, the overall level of bilirubin, and direct and indirect bilirubin will be high. Total bilirubin may be above normal in the following cases:
- intrahepatic cholestasis;
- helminthiases and parasites in the body;
- hepatitis of various etiologies.
- pregnant jaundice;
- cholelithiasis;
- liver tumors;
- violation of the production of enzymes responsible for the formation of bilirubin;
- violation of the outflow of bile;
- primary biliary cirrhosis;
- accelerated decay of red blood cells;
The detection of such a deviation in the blood composition during a general analysis requires other diagnostic measures that will establish the cause of the pathology or disease. Everyone probably knows that with hepatitis, bilirubin rises. But it is not always this viral disease that causes a change in its indicators.
Hepatitis and bilirubin in the blood
How to suspect hepatitis in a patient? The doctor should, as a result of examination and research, get a whole range of symptoms and deviations in the tests. Most often, this viral infection begins with an acute phase. In the absence of adequate treatment or a certain type of virus that affects a person, the disease can become chronic. The most dangerous type C hepatitis. It often does not make itself felt by any striking symptoms, but it carries on its destructive work all the time, killing liver cells. Without a special analysis, hepatitis C can be suspected only when the disease goes into a deadly phase.
One of the symptoms that allows a specialist to suggest infection with a virus that destroys the liver is increased bilirubin. Hepatitis causes a violation of the functionality of the liver and the accumulation in the body of a liver enzyme that damages the cells. Yellowness of the skin is not always present, but darkening of the urine can be in the case when indirect bilirubin enters the urine.
Informativeness of an indicator
According to the amount of bilirubin found in blood plasma, a specialist can judge the severity of the ongoing disease:
- less than 90 micromol / l characterizes a mild degree of liver damage;
- from 90 to 170 micromoles per liter reports an average degree of damage;
- over 170 micromoles per liter - an indicator of severe liver damage.
The acute form of the disease in the absence of adequate treatment quickly turns into chronic hepatitis. Bilirubin in this case, more precisely, its amount in the blood, will witness the neglect of the disease.
A complex of blood tests for diagnosis
In addition to a high level of bilirubin, an analysis of antibodies to hepatitis virus is carried out to determine viral liver damage. Their absence serves as evidence that there is no virus of this disease in the patient's body. If an antigen is detected, the specialist will establish the fact of infection and then a series of studies will be carried out to establish the severity of the disease and the type of virus. A person who can assume the fact of infection, for example, through unprotected sexual intercourse, should remember that the incubation period of hepatitis C virus is 42 days.
A general blood test makes it possible to know about any violation in the state of health, it is thanks to him that subsequent tests are prescribed to the patient. Blood biochemistry examines such abnormalities as:
- an increase in the number of liver enzymes ALT and AST, which, due to the destruction of liver cells, penetrate the blood;
- an increase in the amount of bilirubin, especially the so-called indirect; high bilirubin for hepatitis is one of the main signs of a viral liver health problem;
- an increase in the level of gammaglobulins;
- decrease in the amount of albumin;
- increased lipid count.
Diagnosis involves histology. This set of measures for the detection of pathology allows the specialist to make an adequate diagnosis and prescribe a high-quality treatment in each specific situation.
Security measures
The processes of formation and breakdown of blood components are the most important in ensuring the health of all organs and systems. High bilirubin for hepatitis is just the result of a misnomer. It is only necessary to observe certain norms of intimate relations, since dangerous forms of viral hepatitis C and B are transmitted through the blood and through unprotected sexual intercourse. With any manipulations, such as tattooing, injections, acupuncture, all tools should be clean.