significance of bile acid determination in latent hyperbilirubinaemia

ABSTRACT

This work was conducted on 1540 apparently healthy personels and blood donors. Individuals with total serum bilirubin 1.4 mg/dl or more were subjected to haematological investigations to exclude haemolysis, biochemical investigations including conjugated and unconjugated bilirubin, serum transaminases [AST and ALT], alkaline, phosphatase [ALP], albumin and prothrombin time and post prandial serum bile acids as well as serological markers for viral hepatitis. Liver biopsy was performed in selected cases. Serum bilirubin was found to be elevated [1.9 mg/dl] in 56 cases [3.63%]. 39 of these cases were found to be positive for serological markers of viral hepatitis [11 HBV and 28 HCV] and 17 cases were seronegative. The latter group had no evidence of haemolysis with normal hepatic enzymes as well as normal serum bile acid level. In HBV positive cases, 4 of them had elevated hepatic enzymes and 7 had elevated serum bile acids while in HCV positive cases there were 6 cases with elevated hepatic enzymes and 23 cases had elevated serum bile acids. Abnormal histopathological changes in liver structure were reported in seropositive cases. Serum bile asid determination should join the common liver function tests, its level correlates with liver histopathological findings better than aminotransferases