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What do increased bilirubin levels indicate?

Dr Anil Handoo
Consultant, Department of Haematology,
B L Kapoor Memorial Hospital,
New Delhi

Q: Q. I am a 30 years old male. Lately, I underwent a blood test and it revealed the following abnormalities: Absolute eosinophil count-- 650 cell/cumm; Total WBC count—10, 400; ESR-- 19 mm/hr; Normocytic normochromic peripheral smear RBC, with mild eosinophilia. It has been five days now that my right testicle has enlarged and the doctor considered it to be a hydrocoele. My total bilirubin level is around 1.5- 2 mg/dl and it varies but the doctors consider it to be normal. Please give me an account of the probable reason for such abnormalities and kindly mention a few advisable steps.

A:Gilbert’s syndrome is the most common hereditary cause of increased bilirubin and is found in up to 5% of the population. A major characteristic is jaundice, caused by elevated levels of unconjugated bilirubin in the bloodstream. This explains your increased bilirubin.Coming to your problem of increased TLC with absolute eosinophilia and hydrocele, the possibility of underlying filariasis, would need evaluation and subsequent treatment with Hetrazan.I would, therefore, suggest that you get in touch with a surgeon for assessment of hydrocoele, and at the same time get investigations done for filariasis.