Bilirubin Direct
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Breakdown product of hemoglobin; elevated in liver disease or hemolysis, causing jaundice.
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🧪 Bilirubin – Direct (Conjugated Bilirubin) Test
Parameter | Details |
|---|---|
Test Name | Bilirubin - Direct (Conjugated Bilirubin) |
Sample Type | Serum (venous blood) |
Fasting Required | ❌ Not mandatory, but 8–10 hrs fasting may improve accuracy |
Normal Range | 0.0 – 0.3 mg/dL (may vary slightly by lab) |
Organs Involved | Liver, Bile Ducts, Gallbladder |
🧬 What Is Direct Bilirubin?
Direct bilirubin refers to the conjugated form of bilirubin — it is water-soluble and formed in the liver when unconjugated (indirect) bilirubin is processed by enzymes (mainly UDP-glucuronosyltransferase).
Once conjugated, it is excreted into the bile and travels to the intestine. Elevated levels in blood usually mean the liver is conjugating bilirubin, but it’s not excreting it properly.
🧪 Why Is This Test Done?
Purpose | Details |
|---|---|
🩺 Assess Liver Function | Helps determine the liver’s ability to process and excrete bilirubin |
🚧 Diagnose Biliary Obstruction | High direct bilirubin may indicate gallstones, tumors, or cholestasis |
👶 Monitor Neonatal Jaundice | Particularly if prolonged or conjugated hyperbilirubinemia is suspected |
⚠️ Identify Liver Disorders | Differentiates between hepatocellular vs. obstructive jaundice |
📊 Interpretation
Bilirubin Type | Elevated Means |
|---|---|
Direct (conjugated) | Liver conjugated it, but can’t excrete properly → likely obstructive or intrahepatic cholestasis |
Indirect (unconjugated) | Overproduction or impaired liver conjugation → likely hemolysis or Gilbert's syndrome |
⚠️ Conditions That Raise Direct Bilirubin
- Obstructive jaundice (gallstones, tumors, bile duct stricture)
- Hepatitis
- Primary Biliary Cholangitis
- Drug-induced liver injury
- Dubin-Johnson and Rotor syndromes
- Neonatal cholestasis
🧪 Recommended Additional Tests
Test | Purpose |
|---|---|
Bilirubin – Total & Indirect | Complete bilirubin fractionation |
Liver Function Test (LFT) | Includes ALT, AST, ALP, GGT, Albumin, PT/INR |
Ultrasound Abdomen | Detect bile duct blockage, gallstones, or tumors |
GGT & ALP | Elevated in bile flow obstruction |
Hepatitis Panel | If viral hepatitis is suspected |
📋 Summary Table
Test Name | Bilirubin - Direct (Conjugated) |
|---|---|
Sample | Serum |
Fasting Required | Optional (recommended for consistency) |
Normal Range | 0.0 – 0.3 mg/dL |
Indicates | Liver’s excretion function, biliary tract issues |
Elevated In | Cholestasis, hepatitis, liver tumors, bile duct obstruction |
How our test process works!
