mjl1717
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What diseases are in the differential of a slightly elevated total bilirubin but normal alk phos, normal ALT and normal AST.
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| Doc2378
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All right...lemme take a shot at it (please correct me if I am wrong! )...if only 'slightly' elevated I'd suspect Gilbert's $ but other causes that can cause an increase as well are...
1. All causes of unconjugated hyperbilirubinemias secondary to increased RBC hemolysis
2. In the liver:
Crigglar Najjar, Gilbert's $ (mainly unconjugated)
Dubin Johnson, Rotor $ (mainly conjugated)
Basically we can rule out Hepatitis (ALT, AST elevated with ALT > AST); Alcoholic Hepatitis (ALT, AST elevated with AST > ALT); and Obstruction (elevated GGT and Alk Phos)
Well???
Edited by Doc2378 on 12/29/05 - 12:36 PM
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| mjl1717
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This an associate of mine: 40 year old female who complains of an abnormal odor emanating from her pores not her vagina.(seriously)
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| sturge_weber
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well why dubin johnson, doc2378
rest all i agree withu, basically i think any cause of hemolysis that occurs outside the liver, would be a choice here
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| msyamp
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why not dubin johnson. it doesnt have high liver enzymes. it only has high biliruin conjugated
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| Doc2378
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Hmm...good point guys... ...I wonder if the transaminases get elevated with all that black pigment in there in Dubin Johnson?? Not sure...
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| skyhigh
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liver enzymes are not elevated in dubin johnson, only bilirubin is. agree with msyamp
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| msyamp
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yes. the liver enzymes do not raise . i dont know about rare possibilities
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| sturge_weber
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then can we add rotor to the list too. its conjugated without the pigment?????
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| Doc2378
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Tht's the way I remember it...anybody else?
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| msyamp
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 yes even that.
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