Jaundice laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

• Laboratory findings consistent with the diagnosis of jaundice include:
  • An elevated concentration of serum total bilirubin. the upper limit of normal is >1 mg/dL or >1.3 mg/d in some laboratories. Jaundice usually becomes clinically apparent when the serum total bilirubin concentration is greater than 2 to 3 mg/dL , but threshold for clinically apparent jaundice may vary among patients.  
• Hyperbilirubinemia can be further categorized as conjugated or unconjugated:
  • Conjugated hyperbilirubinemia:
    •  Serum conjugated bilirubin concentration >0.4 mg/dL (6.8 micromol/L).
    • Direct bilirubin >1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL (85 micromol/L), or more than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL(85 micromol/L).
  • Unconjugated hyperbilirubinemia:
    •  Conjugated bilirubin is <1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL, or less than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).  
• Total and unconjugated Bilirubin
  • Bilirubin is the major breakdown product of hemoglobin that is released from dying or damaged erythrocytes
  • The normal Bilirubin range is 0.3-1.0 mg/dL
• Aspartate transaminase(AST) (or) SGOT
• Alanine transaminase(ALT) (or) SGPT
• Albumin
• Alkaline phosphatase
• HIV serologies
• Hepatitis serologies
• Antinuclear antibody (ANA)
• Antimitochondrial antibodies
• Haptoglobin
• Reticulocyte count
• Leukocytosis
• Lactic dehydrogenase (LDH)

Inalcoholic hepatitis the aspartate aminotransferase:alanine aminotransferase ratio is > 2 (AST:ALT)