Bilirobin

My son's bilirobin is 1.9 which is considered more than the normal range. Does this cause any side effects or health problems? By the way, he is 4 years old.
How can i know that his growth rate is normal ?

Manal

Which Bilirubin test was done? Was it Total Bilirubin or Direct Bilirubin?

Also when you mention 1.9 - which unit is the measure in? Is the Unit μmol/L or is it mg/dL?? (Seems like the unit was mg/dL)

The normal range is :-
Bilirubin, direct  <0.3 mg/dL
 
Bilirubin, total  0.2-1.3 mg/dL
 
-Narendra

For thals bilrubin is generally higher than the normal values. I'm a thal intermedia and my bilrubin is always in between 4.5 to 5.5.
Direct is around 0.5 - 0.7 and indirect is around 4 or 4.5.

I think this is because of excessive hemolysis of RBCs. Thals have jaundice eyes/pale skin and this is because of high bilrubin.

--Hallu

I think this is because of excessive hemolysis of RBCs. Thals have jaundice eyes/pale skin and this is because of high bilrubin.

I am not sure if excessive destruction of RBCs cause the bilirubin to rise?  And, the yellow eyes/pale skin is the effect of high bilirubin.
As far as i know, a high bilirubin is linked to a malfunctioning liver, and even Thals should not necessarily have high bilirubin if they are properly chelated.

Please do a full Liver Function Test (LFT) and also a liver MRI to be absolutely sure that there is no liver damage.
Aslo, if you have been transfused before, check for HCV.

Poirot

Poirot,
I'm a little concerned after reading your post as till now I was always told that my bilirubin is high because of excessive hemolysis and I should just ignore it.
The only Liver tests that I get done are : SGOT and SGPT, which are fine so far. What all tests comprise LFT? I'm not sure from where to get Liver MRI done as in US it can be done only at two places, one is in LA and other is Philidelphia and my doctor says that since i'm not on transfusions I don't need one.

After reading your post, i tried finding more info. I found some info regarding bilirubin at http://www.emedicine.com/ped/topic2229.htm.
It says: "Evidence of hemolysis is usually present, with elevated indirect bilirubin level, high lactate dehydrogenase (LDH) level, and low level of haptoglobin.".

May be there's a relation. I use to think that paleness is because of excessive bilirubin pigment.

Do other people in forum have normal level of bilirubin?

--Hallu.

After reading your post, i tried finding more info. I found some info regarding bilirubin at http://www.emedicine.com/ped/topic2229.htm.
It says: "Evidence of hemolysis is usually present, with elevated indirect bilirubin level, high lactate dehydrogenase (LDH) level, and low level of haptoglobin."

Hallu,

You are right that bilirubin is formed due to the breakdown of RBCs. However, this bilirubin is then cleared out of the body by the liver, where bilirubin gets bound to albumin, and the liver makes it water soluble. Bulk of it is then excreted out through the intestines, while a small residual portion may be excreted out through the kidney.

As far as I have read, increased haemolysis only leads to a mild increase in bilirubin. A more moderate increase (like over 2.0 for total) is more probably due to hepatitis. Again, an increase in direct bilirubin is more indicative of hepatitis. (Although, I have never really managed to figure out the diff between direct and indirect!)

Sorry to have alarmed you, but better to know and get treatment for it, than to be in the dark. Since, you say your SGOT and SGPT levels are normal, your liver is likely okay. Better to just test for Hep B and C to eliminate these as causes for the elevated bilirubin.

Hope that is useful.

Poirot

Thanks a lot for all your answers.

Manal

PS For Poirot: Why are using the picture of the train in this horrible accident?? Sorry for minding others business, but it curiosity!

High bilirubin and the jaundice involved are, as has been said, a product of the destruction of red blood cells. The level can go quite high in fact.

From http://health.enotes.com/nursing-encyclopedia/jaundice

In all causes of prehepatic jaundice, the predominant bilirubin is insoluble—that is, unconjugated. Hemolysis alone will rarely cause the total bilirubin level to rise above 7 mg/dL.

Also, as far as the dangers

High bilirubin levels themselves are not dangerous to patients other than neonates, so all symptoms of high bilirubin levels are reversible if the underlying condition is treatable.

If it is determined that the problem involves any risks,

Surgical removal of the spleen (splenectomy) may arrest hemolytic anemia....The gallbladder may need to be removed, or small stones removed from lower in the biliary tract.

PS For Poirot: Why are using the picture of the train in this horrible accident?? Sorry for minding others business, but it curiosity!

That train was not in an accident, it was bombed. It is one of the seven commuter trains in Mumbai that were bombed by Lashkar-e-Toiba terrorists on July 11 this year. The picture is in memory of the 187 people who died in the blasts, and as a reminder to ourselves of the dangers of rising fundamentalism. I have posted on this separately in the Mumbai bomb blasts thread (http://www.thalassemiapatientsandfriends.com/index.php?topic=284.0) in General chatter. Check that out if you are interested.

Poirot

Dear Poirot
Thank you for your replay. You have all the right, it was horrible. No country these days hasn't tasted terrorists acts. No excuse to kill all those innocent people. May God save us all from those extremists
Manal

Is there anything to use to get rid of the yellow colour in (especially) eyes?

I have read on a pkd website that one should use:
lemon tea or
dandelion coffee
lots of fluids
sunshine

Any suggestions/thoughts?

Bilirubin is the produced from the breakdown of RBCs. The things you mentioned may all have some potential for reducing the amount of bilirubin. As always, stay well hydrated and get sunshine when you can. The herbs may have some potential, so give them a try.

I become pale/yellowish as soon as i'm tired. Which happens daily of course.

Does that mean bilirubin levels vary during the day? Then how would one decide when to get tested? How would I know if its normal hemolysis or if there's some other problem?

Like I look normal now, then i do some work for 2 hours and I turn pale. I look pale even if my blood pressure drops or if its too hot.

Confused.

Hi Pretty,

Yes, it does look like normal hemolysis which is affected by the amount of physical activity. The hemolysis is related to oxidative stresses related to physical activity and thal minor red cells easily break down from oxidation and dehydration of the cells. Staying well hydrated during activity can help, as can making sure your intake of antioxidants is considered when you are more active. Fresh fruit can help with both hydration and providing antioxidants.

Hi there,

Is it normal for Thal minor Infants (5 weeks old) to look yellowish ? Pediatrician did the blood work and considered the following results to be normal for a 5 week old infant:
   Total Direct : 0.3
   Bili Total : 3.2

The infant had jaundice on day 2 and was given photo-therapy which brought the levels down in 24 hours. I'm thinking the residue yellow is because of that ?

I've heard about a Vit-D supplement also which can given directly to infants or mixed with expressed breast milk. Would that help removing the yellow in face and eyes ?

Thanks!