Q. My bilirubin level keeps on increasing with negative hepatitis test. What is my problem?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 31, 2020 and last reviewed on: Jun 11, 2020

Hello doctor,

I have jaundice. My biliurubin was 7.5 three weeks ago. I went to the doctor for jaundice. Weekly blood tests as of three weeks show bilirubin has been increasing. Hep test shows I do not have hepatitis. Ultrasound says no tumor bile duct coverage or stones. I took a CT scan and the results show there is no obstruction and pancreas is normal. In other words my body parts are normal.

In two weeks, I will see a gastroenterologist. What do you think I have? I will probably have more blood tests this Monday to check bilirubin levels. I am currently on Hydroxyzine HCl.

#

Hello,

Welcome to icliniq.com.

Well, your US (ultrasound) and CT (computed tomography) scan are normal which is kind of satisfying to me. Of course you suppose to have more blood tests to confirm the origin of this jaundice.

Hepatitis, although common, but they are not the only one to cause liver problem there are many other causes such as nonhepatotrophic virus infections as herpes virus, Ebstein Barr virus, cytomegalovirus. Non-viral causes are Wilson hemochromatosis, alpha-1 trypsin deficiency. The causes of predominantly raised bilirubin (jaundice) with normal CT scan suggest microscopic primary sclerosing cholangitis, primary biliary cholangitis benign and progressive familial intrahepatic cholestasis. The hepatologist will start from blood tests first and at times can be recommended liver biopsy if the blood test does not serve the purpose.

It is possible that you have one of the above or not any of the above. The reason is it is always important to have a clinical history then targeted blood tests and examinations before a hepatologist is able to give you one word specific diagnosis.


The Probable causes:

Deranged liver function tests.

Probable diagnosis:

Deranged liver function tests.

Treatment plan:

After establishing a diagnosis.

Regarding follow up:

Follow up if want to provide more information and discuss the right approach to each and everyone of above disorders.


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