When the bilirubin in the blood is high, it is manifested as yellowing of the sclera, skin, mucous membranes, and other body fluids, known as jaundice. If the total bilirubin value is between 17.1 and 34.2 μmol/L, the jaundice is not visible to the naked eye and is called occult jaundice. If the total bilirubin value is greater than 34.2 μmol/L, yellowing of the eyes, skin and urine is visible to the naked eye and is called overt jaundice. The higher the value of total bilirubin, the more severe the jaundice. Elevated total bilirubin can first lead to damage to the central nervous system, including the brain and nerves. Secondly, it can lead to cirrhosis of the liver and the development of cholestatic cirrhosis. It can also cause fat as well as affect kidney function and can even bring about renal insufficiency. When bilirubin is deposited to the skin it can cause itching. It can also affect immune function leading to immune deficiency. It can also affect the heart, leading to decreased cardiac function. If too many red blood cells are destroyed, too much indirect bilirubin is produced and this makes it impossible for the liver to fully convert it into direct bilirubin, which in turn leads to hemolytic jaundice. The inability to convert bilirubin into bile properly, lesions in the hepatocytes, swelling of the hepatocytes, compression of the bile ducts in the liver or obstruction of bile excretion can all cause an increase in bilirubin in the blood, which can lead to hepatocellular jaundice; the occurrence of tumors or stones in the extrahepatic biliary system, obstruction of the bile ducts, and failure to excrete bile smoothly, which can lead to obstructive jaundice. Jaundice in patients with hepatitis is mainly hepatocellular jaundice. Indirect bilirubin can pass through the cell membrane and has toxic effects on the cells, and cannot be excreted through the kidneys.