Clinical implications of conjugated vs. direct bilirubin testing: analytical limits and clinical consequences

The measurement of direct bilirubin (DBIL) is a well-established practice in clinical laboratories for the diagnosing and therapeutic management of a vast array of hepatic (liver) and hematologic (blood-related) disorders. However, the clinical distinction between conjugated and DBIL is often overlooked, despite its significant diagnostic and therapeutic implications. We discuss here the biochemical and methodological distinctions between conjugated and DBIL for accurate diagnosis and effective patient management.