Page 20 - Clinical Biochemistry

disease it becomes exaggerated because subsequently, the platelet count may become
diminished.

Total/Direct Bilirubin (TB/DB)
• The difference between the two values is termed the indirect bilirubin.
• Indirect bilirubin correlates with unconjugated bilirubin.
• The reference range of total bilirubin is 0.2-1.2 mg/dL. The reference range of direct
bilirubin is 0.1-0.4 mg/dL.

Liver Biopsy
• In a typical liver biopsy, a needle is inserted through the rib cage or abdominal wall and
into the liver to obtain a sample for examination.
• The procedure can also be performed by inserting a needle into the jugular vein in the neck
and passing a catheter through the veins down to the liver to obtain the sample.

Hepatitis
• Hepatitis is an inflammation of the liver characterized by the presence of inflammatory
cells in the tissue of the organ.
• The condition can be self-limiting (healing on its own) or can progress to fibrosis (scarring)
and cirrhosis.
• Hepatitis may occur with limited or no symptoms, but often leads to jaundice, anorexia
(poor appetite) and malaise.
• Hepatitis is acute when it lasts less than six months and chronic when it persists longer.
• A group of viruses known as hepatitis viruses cause most cases of hepatitis worldwide, but
it can also be due to toxins (alcohol, certain medications), other infections and autoimmune
diseases.

Clinical course of virus related liver disease

Figure 3: Progression of liver disease