Specimen Name Result Units Range
Plasma Albumin 41 g/L (34-48)
Total Protein 68 g/L (60-80)
Total Bilirubin 180 μmol/L (6-24)
GGT 560 U/L (< 60)
ALP 525 U/L (30-110)
ALT 180 U/L (< 55)
AST 200 U/L (< 45)

62yo male with weight-loss & upper abdominal pain.
Extra-hepatic Obstructive Jaundice

 

Hyperbilirubinaemia

  • Predominantly Unconjugated
    1. Overproduction
      • haemolysis
      • reabsorption of haematoma
      • ineffective erythropoeisis
    2. Decreased hepatic uptake
      • sepsis
      • prolonged fasting
      • RV failure
      • drugs - rifampicin, probenecid
    3. Decreased conjugation
  • Predominantly Conjugated
    1. Biliary obstruction
      • biliary cirrhosis - primary | secondary
      • sclerosing cholangitis
      • extrahepatic obstruction - stone, tumour, stricture
    2. Impaired hepatic excretion
      • sepsis
      • post-operative state
      • hepatocellular disease
        • hepatitis - viral, ischaemic, drug-induced
        • cirrhosis
      • drug-induced cholestasis - OCP, methyltestosterone
      • inherited disorders:
        • Dubin-Johnson
        • Rotor syndrome
        • benign familial cholestasis
      • cholestasis of pregnancy