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Serum Direct-to-Total Bilirubin Ratio

Purpose: To use the ratios of liver function tests in the diagnosis of liver disease.

Description

The ratio of direct to total serum bilirubin can help in predicting the cause of jaundice. The total serum bilirubin must exceed 2.5 mg/dl to produce clinical jaundice.


 

direct bilirubin-to-total bilirubin ratio =

= ((serum direct bilirubin) / (serum total bilirubin))

 

Interpretation

 

Ratio

Differential Diagnosis

< 20%

constitutional hyperbilirubinemia (Gilbert's, Crigler-Najjar, etc.)

20-40%

hepatocellular disease more likely than extrahepatic obstruction

40-60%

may be either hepatocellular disease or extrahepatic obstruction

> 60%

extrahepatic obstruction more likely than hepatocellular disease

 

 


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Specialty

Objective

ICD-10