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Is increasing Serum Bilirubin level dangerous?

Q: I am a 23 years old man diagnosed with jaundice with Serum Bilirubin 1.8 and SGPT (Serum glutamic pyruvic transaminase) 95 two months back. Since then, I am following a special diet (zero spices and zero oil diet). In two months’ time, I went for the test thrice and there is an increasing trend (2.2, 2.3, 2.5) in Serum Bilirubin whereas SGPT is decreasing (60, 48, 24). Apart from the urine colour and eye colour, I do not have any other symptoms of jaundice. Do I need to take bed rest?

A:The rise in Bilirubin level is not so significant. You need to be evaluated for deranged liver function tests. Is the increase in bilirubin predominantly conjugated or unconjugated? Unconjugated bilirubin may be high by birth in certain individuals, especially males and does not indicate any serious problem. What is your haemogram, G6PD level, reticulocyte count and haemoglobin electrophoresis if it is predominantly unconjugated? If it is conjugated fraction, which is higher, you need to be tested for viral markers including hepatitis B and C. Ultrasound of upper abdomen may also be done. 2. This level of LFT derangement does not need stringent diet control; consume the same meals as the rest of the family is eating. Avoid alcohol.


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