Ask a doctor on the topic of General medicine

Demand urine

March 16, 2020 | 20,00 EUR | answered by Dr. med. Frauke Gehring

Hello again Mrs. Gehring,

I'm sorry to bring up the topic again, and of course I am trying to somehow come to terms with the idea that things could always happen (especially in unusual times like now)...however, the issue with bilirubin is still bothering me.

It does reassure me that the value was weakly positive back then (and nothing has happened since), and also that values like AP, LDH, GGT, and GOT are all within normal range, with only a minimal increase in GPT. Red blood cells and platelets, as well as all other blood values, are also okay.
Just for your information - back when there was a (+) sign, the bilirubin value in the serum was within normal range! This time it was not determined.

Now I am just a little surprised that while you cannot imagine anything malignant with me, you emphasize that it can occur at any age - although I would dismiss liver and bile duct tumors as a real rarity at my age based on research - and otherwise you always make it clear to me that my fears are completely absurd, which now unsettles me a bit...

Now my fear is also leaning towards primary biliary cirrhosis, should I quickly forget this fear with the above values?

Could my increased albumin excretion through the kidney be related to bilirubin, since it is bound there? I don't think I fully understand the connection...larger proteins come through in my case, because my kidney is slightly affected by lupus, so I thought about that.

Maybe you can reassure me again, the internet is causing me more anxiety in this regard...

Dr. med. Frauke Gehring

Good day,

You may understand that I am not able to respond as quickly given the crisis situation.

How could you have primary biliary cirrhosis if all liver values are normal and the serum bilirubin as well? Elevated bilirubin in urine with normal serum bilirubin is not a sign of illness. It is possible that your kidneys may occasionally pass a bit more bilirubin (we always have some in urine, which gives it a yellow color, but it is usually below the detection limit). Since you are also losing proteins, it fits quite well, but I cannot say for sure as I am not very familiar with this topic.

However, I think we have much more pressing concerns at the moment, so you should try not to worry about the meaningless ones.

Sincerely, Dr. Gehring