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Test Name:
Bilirubin, Total
- SBMF No:
23204 - Performance Lab Name:
Automated Lab - Test Mnemonic:
BILI-TOT - ABN:
Not required - CPT Code:
82247 - LOINC Code:
1975-2 - Also Known As:
Total Bilirubin - Also See:
23203 – Bilirubin, Direct - Spec Type:
Serum - Spec Container:
Gold top (SST) or red top (serum) tube - Alt Spec Type:
Plasma - Alt Spec Container:
Green top (lithium heparin) tube - Pref Vol:
1.0 mL - Min Vol:
0.5 mL - Fasting:
No - Spec Collect:
Routine venipuncture
Label sample tube
Protect from light - Spec Process:
Serum sample tubes, clot 30 minutes
Promptly centrifuge 15 minutes
Immediately transfer serum or plasma to light-protected (amber) plastic tube
Properly centrifuged gel barrier tube sample does not require transfer of serum to separate tube - Spec Store Transport:
Refrigerated; protected from light - Spec Stability:
1 week refrigerated (2-8°C) and protected from light
6 months frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles - Methodology:
Colorimetric/Photometric - Use:
Liver and biliary tests are useful in the differential diagnosis of jaundice from bilirubin overproduction (hemolysis), decreased uptake (Gilbert's), decreased conjugation (heptatocellular disease, neonatal immaturity, Crigler-Najjar, drug inhibition), decreased excretion into bile (hepatocellular disease, familial, drug-induced, pregnancy, obstructive bile duct disease) - Clinical Significance:
In obstructive jaundice, there is an increase in the total bilirubin, but the increase is primarily in the bilirubin glucuronide. In hemolytic jaundice and in neonatal jaundice, there is an increase primarily in the indirect (the difference between total and direct) bilirubin. In newborns, the jaundice may be caused by Rh, ABO or other blood group incompatibilities, by hepatic immaturity or by hereditary defects in bilirubin conjugation. Both direct and indirect bilirubin are increased in hepatitis. The relative proportion of the direct fraction increases with progression of the disease until eventually the liver loses its ability to carry out the conjugation reaction. - Reference Range:
- Bilirubin, Total
- 0-3 days of age: 0.5-6.0 mg/dL
3 days-1 week of age: 0.5-10.0 mg/dL
1 week-2 weeks of age: 0.5-9.0 mg/dL
2 weeks-3 weeks of age: 0.5-5.0 mg/dL
3 weeks-4 weeks of age: 0.5-3.0 mg/dL
Greater than 4 weeks-Adult: 0.0-1.0 mg/dL - Critical High Value:
16.1 mg/dL - Day Run:
Sun-Sat (daily) - Time Run:
As received - Time Reported:
4 hours - Test Type:
CHEMISTRY
