Viral Hepatitis: This is often the most common cause of elevated liver enzymes and bilirubin levels, including both direct and indirect fractions, due to inflammation of the liver which can impair its ability to process bilirubin.

Alcoholic Liver Disease: Chronic alcohol consumption can lead to liver inflammation and scarring, affecting the liver's function to metabolize bilirubin.
Drug-Induced Liver Injury: Certain medications can cause liver damage, leading to elevated bilirubin levels.
Autoimmune Hepatitis: An autoimmune condition where the body's immune system attacks liver cells, potentially causing elevated bilirubin.
Hemolytic Anemia: Conditions that lead to the breakdown of red blood cells can increase indirect bilirubin, and if severe, can also affect liver function and direct bilirubin levels.

Budd-Chiari Syndrome: A condition caused by thrombosis of the hepatic veins, which can lead to liver dysfunction and elevated bilirubin levels. It's crucial to diagnose early due to its high mortality rate if left untreated.
Wilson's Disease: A genetic disorder leading to copper accumulation in the liver, which can cause liver damage and elevated bilirubin. Early diagnosis is critical to prevent irreversible liver damage.
Acute Biliary Obstruction: Blockage of the bile ducts can cause direct bilirubin to rise rapidly. It's a medical emergency that requires prompt intervention.

Dubin-Johnson Syndrome: A rare genetic disorder characterized by an inability to secrete conjugated bilirubin into the bile, leading to a chronic elevation of direct bilirubin.
Rotor Syndrome: Similar to Dubin-Johnson Syndrome, it's a benign condition with elevated levels of both direct and indirect bilirubin due to a problem with the hepatic uptake or storage of bilirubin.
Crigler-Najjar Syndrome: A rare congenital disorder affecting the enzyme responsible for converting indirect bilirubin to direct bilirubin, leading to very high levels of indirect bilirubin.