Bilirubin increased

and Martina Feichter, medical editor and biologist

Dr. med. Andrea Reiter is a freelance writer for the medical editorial team.

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Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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Occasionally the level of bilirubin in the blood is increased. This can have harmless, but also dangerous causes. Bilirubin is a breakdown product of the red blood pigment from the red blood cells. If the concentration of bilirubin is very high, the skin turns yellow. Read when bilirubin is increasingly detectable in the blood and when what is known as hyperbilirubinemia becomes dangerous.

When is bilirubin increased?

Bilirubin is produced when the red blood pigment hemoglobin is released and broken down from old red blood cells that have been discarded by the body. Normally, the liver is responsible for converting bilirubin into water-soluble forms, which can then be excreted in the urine and stool.

With various diseases, however, increased levels of bilirubin can accumulate and lead to increased blood levels (hyperbilirubinemia). Excess bilirubin can then also increasingly appear in the urine (bilirubinuria) and also be deposited in the skin and mucous membranes (jaundice = jaundice). Possible causes of increased bilirubin are:

Meulengracht's disease

In this disease, the amount of the enzyme that converts bilirubin into a water-soluble compound is reduced. This results in slightly increased bilirubin levels in the blood.

Meulengracht's disease affects around two to twelve percent of the population, most of them men. The disease usually does not cause any symptoms. However, the mild hyperbilirubinemia can be exacerbated by factors such as fasting, stress, and fever.

Other causes of the bilirubin increase

But there are other reasons why bilirubin can be increased. Examples are inflammation of the liver (hepatitis), fatty liver or liver cirrhosis, congestion of the bile or increased disintegration of red blood cells due to illness or injury (hemolysis). The bilirubin levels can increase significantly in such cases.

Bilirubin increased: what to do?

In general, no treatment is necessary for Meulengracht's disease.

If other diseases are the reason that the bilirubin is increased, appropriate therapeutic measures must be taken. With the diseases mentioned, one has to lower the concentration of bilirubin. For example, if there is a bile congestion as a result of a trapped gallstone, the bilirubin can be reduced by dissolving the gallstone with medication and shattering it with shock waves.

Neonatal jaundice is a special form of hyperbilirubinemia. It is caused by an as yet immature enzyme system in the liver. In most cases it goes away on its own within a few days after the birth. Depending on how much the bilirubin is increased, a supportive UV light treatment can be carried out.

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