What is the role of fractionated bilirubin levels in the diagnosis of conjugated hyperbilirubinemia?

Updated: Jul 31, 2019
  • Author: Richard A Weisiger, MD, PhD; Chief Editor: BS Anand, MD  more...
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Answer

Obtain fractionated bilirubin levels. [13] Devgun et al indicate a direct bilirubin concentration of 10 μmol/L or higher should be used to consider the presence of conjugated hyperbilirubinemia, provided that total bilirubin concentration is also above the reference interval. [16] The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition consider a direct/conjugated bilirubin level above 1.0 mg/dL (17 μmol/L) as abnormal in the presence of an elevated total bilirubin. [13] In newborns, rule out infection for levels of conjugated bilirubin of 0.5 mg/dL and above, up to 2 mg/dL, and monitor the infant; for those with conjugated bilirubin levels of 2 mg/dL and higher, a more thorough evaluation of the hepatobiliary system is warranted. [17]


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