What Infections Are Most Likely to Cause Bilirubin Level Increases?
More Programs and Publications Featuring Dr. Kyle Riding
In this program:
What are the specific infection types that are most likely to cause notable bilirubin level increases? Medical laboratory scientist Dr. Kyle Riding explains two infection categories that can impact bilirubin levels and different types of infections that are common culprits of bilirubin rising.
Transcript
Deandre White:
Dr. Riding, are there specific types of infections that are more likely to cause significant increases in bilirubin levels?
Dr. Kyle Riding:
Yes, so there are some infections that can lead to increased bilirubin levels. Basically, we can break this down into two categories of infections. The first are any infections that can lead to a hemolytic process or red cells rupturing, so things like malaria and Babesia and sepsis, and certain forms, certain strains of E. coli if they get into your blood, can do that, all right? So any type of infection that can lead to red cell rupturing can lead to increased bilirubin levels. Now, I will tell you, the providers are not going to diagnose the infection off of the bilirubin levels, so it's just an additional finding that helps them in that diagnostic process. The other category of infections that can lead to increased bilirubin levels are going to be those infections that impact the liver. So we're going to talk about viruses, hepatitis viruses, hep A, hep B, hep C virus, and the alphabet continues on the hepatitis viruses. Additionally, things like infectious mononucleosis, which does impact the liver. So our lovely little Epstein-Barr or kissing virus, can cause increases in bilirubin. But again, that's because they're impacting the machinery in our liver, and that is messing up its ability to conjugate and excrete the bilirubin.
Deandre White:
Now, speaking of infections, I'm sure you know what my follow-up question will be, but what about COVID-19's effect on bilirubin levels?
Dr. Kyle Riding:
So there was some evidence in severe cases where we were seeing that systemic inflammatory syndrome in patients with really bad COVID. Usually, these were the patients that were ending up in the ICUs, or possibly still, it's not like it's gone off the face of the earth or anything, unfortunately. But it's usually going to be that level of systemic inflammatory burden that starts damaging the liver, where we will see any impact to the bilirubin. There's a lot of other laboratory testing that the providers are going to use for risk assessment in our patients with COVID, or who were worried about it, transitioning into severe COVID-19 disease. So bilirubin is not the top of the list, but it can increase in bad cases of COVID.
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