Increased Bile Acids

Following are differential diagnoses for patients presented with increased bile acids: 

• Abnormal portal blood flow  

  • Microvascular dysplasia 

  • Portosystemic shunts 

  • Other congenital vascular anomalies 

• Cholestatic disease 

  • Extrahepatic biliary obstruction (hyperbilirubinemia often present) 

  • Fibrosis 

  • Hepatic lipidosis 

  • Inflammation or infection (hepatitis/cholangiohepatitis) 

  • Neoplasia 

  • Toxin or drug hepatopathy 

• Hepatocellular dysfunction or failure 

  • Fibrosis   

  • Hepatic lipidosis 

  • Inflammation or infection (hepatitis/cholangiohepatitis) 

  • Neoplasia 

  • Toxin or drug hepatopathy 

• Interference 

  • Bile acids should not be measured in patients with hyperbilirubinemia    

  • Lipemia falsely increases bile acid values 

  • Hemolysis falsely decreases bile acid values