Sorted By Test Name - Mayo Medical Laboratories

BFBL
34621
the color of bilirubin and hemoglobin.
Useful For: Evaluation of Rh disease, ie, hemolytic disease of the fetus Monitoring disease progression
to assess need for fetal transfusion
Interpretation: The reference range for bilirubin in amniotic fluid is related to the gestational age of
the fetus. Refer to either the Queenan Curve (gestational age 27 weeks) listed under Delta OD of Bilirubin in Amniotic Fluid in Special Instructions.
Reference Values:
Interpretation of fetal risk is dependent upon gestational age.
Refer to either the Queenan Curve (gestational age 27
weeks) listed under Delta OD of Bilirubin in Amniotic Fluid in Special Instructions.
Clinical References: 1. Scott F, Chan FY: Assessment of the clinical usefulness of the 'Queenan'
chart versus the 'Liley' chart in predicting severity of rhesus iso-immunization. Prenat Diagn
1998;18:1143-1148 2. Liley AW: Liquor amnii analysis in the management of the pregnancy complicated
by rhesus sensitization. Am J Obstet Gynecol 1961;82:1359-1370
Bilirubin, Body Fluid
Clinical Information: Assessing whether a body fluid specimen is exudative or transudative in nature
is the initial step in determining the etiology of the fluid. Transudative fluids result from hemodynamic
aberrations or oncotic changes and are associated with ultrafiltration of serum across pleural membranes.
Transudates most commonly occur in association with clinically apparent conditions such as heart failure
and cirrhosis. Exudative fluids tend to develop as a consequence of inflammation or malignant disorders
such as tuberculosis, pneumonia, or cancer, in which capillary permeability is increased, allowing
large-molecular-weight compounds to be released into the accumulating fluid. If the fluid is transudate,
further diagnostic procedures are often not necessary, however the presence of an exudative fluid often
triggers additional testing that may be invasive in nature. Determination of body fluid bilirubin
concentration can aid in the distinction between a transudative and an exudative fluid. Bilirubin values
tend to be higher in exudates than in transudates, although there is some overlap between groups.
However, a ratio of body fluids to serum bilirubin has been reported to identify exudative body fluids with
sensitivity, specifically, positive predictive accuracy, and absolute accuracy equivalent to that obtained
using Light's criteria for an exudative pleural fluid (pleural/serum protein ratio >0.5, pleural/serum lactate
dehydrogenase ratio >0.6, and serum lactate dehydrogenase >200 U/L).
Useful For: May aid in the distinction between a transudative and an exudative body fluid, when used
in conjunction with other testing including serum bilirubin analysis, body fluid; serum protein ratio, body
fluids; serum lactate dehydrogenase ratio, and serum lactate dehydrogenase
Interpretation: Elevated body fluid bilirubin is suggestive of an exudative fluid. This testing should be
performed in conjunction with other testing including serum bilirubin analysis, body fluid:serum protein
ratio, body fluids:serum lactate dehydrogenase ratio, and serum lactate dehydrogenase.
Reference Values:
Not applicable
The reference range has not been established for bilirubin in body fluids. The test result should be
integrated into the clinical context for interpretation.
Clinical References: 1. Elis A, Meisel S, Tishler T, et al: Ascitic fluid to serum bilirubin
concentration ratio for the classification of transudates or exudates. Am J Gastroenterol 1998
Mar;93(3):401-403 2. Runyon BA: Ascitic fluid bilirubin concentration as a key to choleperitoneum. J
Clin Gastroenterol 1987 Oct;9(5):543-545 3. Darwin P, Goldberg E, Uradomo L: Jackson Pratt drain
fluid-to-serum bilirubin concentration ratio for the diagnosis of bile leaks. Gastrointest Endosc 2010
Jan;71(1):99-104 Epub 2009, Nov 27 4. Burgess LJ: Biochemical analysis of pleural, peritoneal and
pericardial effusions. Clin Chim Acta 2004 May;343(1-2):61-84 5. Clinical and Laboratory Standards
Institute: Analysis of Body Fluids in Clinical Chemistry; Approved Guideline. Clinical and Laboratory
Standards Institute, Wayne, PA, 2007, CLSI document C49-A (ISBN 1-56238-638-7)
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