Bilirubin

Sample type:

Plasma or serum (plasma EDTA is preferred specimen type)

Uses:

• Diagnose hepatitis, cirrhosis, or other liver diseases.

• Find blockages in structures carrying bile from your liver.

• Monitor an existing liver disorder.

• Diagnose disorders related to red blood cell production problems.

• Test a patient who has history of drinking large amounts of alcohol.

• Test a patient who has a suspected drug toxicity.

Precautions:

• Avoid prolonged exposure of the sample to light.

• Plasma: Centrifuge after collection.

• Serum: Allow blood to clot for 30 minutes in a vertical.

• position and centrifuge within 2 hours.

Interfering factor:

• Drugs that may cause increased blood levels of total bilirubin include

(allopurinol, anabolic steroids, antibiotics, antimalarials, ascorbic acid, azathioprine, chlorpropamide (Diabinese), cholinergics, codeine, dextran, diuretics, epinephrine, meperidine, methotrexate, methyldopa, monoamine oxidase inhibitors, morphine, nicotinic acid (large doses)m oral contraceptives, phenothiazines, quinidine, rifampin, salicylates, steroids, sulfonamides, theophylline, and vitamin A)

• Drugs that may cause decreased blood levels of total bilirubin include

( barbiturates, caffeine, penicillin, and salicylates (high dose)

Pre analytical errors:

exposure of the sample to light

If a patient takes any medications that may influence Bilirubin secretion.

corrective of action:

The sample must be rejected and another sample be obtained.

post analytical errors:

reports were sent to the incorrect patient.

corrective action:

communication with patient, apologising for the error, and providing him with the correct report.

Reference range:

Total bilirubin: 0.3–1.0 mg/dL

Direct bilirubin: 0.1–0.3 mg/Dl

Indirect bilirubin: 0.2–0.7 mg/dL