I was observing my old 2012 reports where my total bilirubin was 2.1,sgot 45, sgpt 55, in scan it was hepatic coarse echo texture, now in 2016 my total bilirubin is 1.9,almost many reports have the bilirubin level more ,what should be done next, I have pain in left shoulder bone and backbone lower while lying down, recent usg shows normal report except total bilirubin .

Dr. Lalit Kumar TripathyGeneral Physician40yrs exp

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1. Since your usg is normal and sgot, sgpt is within normal limit increased serum bilirubin could be due to unconjugated (indirect) bilirubin. 2. Increase in unconjugated bilirubin could be due to hemolytic anemia because of increased red cell destruction as in sickle cell anemia/t, halassemia, auto immune dis order, g6pd deficiency etc. 3. Do a complete hemogram, peripheral smear examination and consult physician/ hematologist with report for advice and treatment. 

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