Elevated serum bilirubin levels occur in advanced stages of primary biliary cholangitis (PBC)1-3


Elevated bilirubin is a marker of advanced PBC and an early indicator of cirrhosis and portal hypertension2-4

  • Usually, initial bilirubin levels remain normal for several years5
  • A serum bilirubin level higher than 1 mg/dL (17 μmol/L) is a predictive factor for developing cirrhosis2,3
  • A total serum bilirubin level exceeding 2 mg/dL (34 μmol/L) is associated with a late stage of the disease5

Are your patients’ bilirubin levels remaining low?

References:  1. European Association for the Study of the Liver. EASL clinical practice guidelines: management of cholestatic liver diseases. J Hepatol. 2009;51(2):237-267. doi:10.1016/j.jhep.2009.04.009.  2. Corpechot C, Poujol-Robert A, Wendum D, et al. Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCA-treated patients with primary biliary cirrhosis. Liver Int. 2004;24(3):187-193.  3. Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ. Primary biliary cirrhosis. Hepatology. 2009;50(1):291-308. doi:10.1002/hep.22906. (AASLD guidelines)  4. Poupon R, Chazouillères O, Balkau B, Poupon RE. Clinical and biochemical expression of the histopathological lesions of primary biliary cirrhosis. UDCA-PBC Group. J Hepatol. 1999;30(3):408-412.  5. Shapiro JM, Smith H, Schaffner F. Serum bilirubin: a prognostic factor in primary biliary cirrhosis. Gut. 1979;20(2):137-140. doi:10.1136/gut.20.2.137.