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==Risk Factors== | ==Risk Factors== | ||
Risk factors for jaundice are classified under conjugated and unconjugated hyperbilirubinemia:<ref name="pmid256472092">{{cite journal| author=VanWagner LB, Green RM| title=Evaluating elevated bilirubin levels in asymptomatic adults. | journal=JAMA | year= 2015 | volume= 313 | issue= 5 | pages= 516-7 | pmid=25647209 | doi=10.1001/jama.2014.12835 | pmc=4424929 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25647209 }}</ref> | |||
=== '''Unconjugated hyperbilirubinemia''' === | |||
Risk factors for unconjugated hyperbilirubenemia includes:<ref name="pmid20808649">{{cite journal| author=Arora V, Kulkarni RK, Cherian S, Pillai R, Shivali M| title=Hyperbilirubinemia in normal healthy donors. | journal=Asian J Transfus Sci | year= 2009 | volume= 3 | issue= 2 | pages= 70-2 | pmid=20808649 | doi=10.4103/0973-6247.53875 | pmc=2920475 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20808649 }}</ref><ref name="pmid14013759">{{cite journal| author=ARIAS IM| title=Chronic unconjugated hyperbilirubinemia without overt signs of hemolysis in adolescents and adults. | journal=J Clin Invest | year= 1962 | volume= 41 | issue= | pages= 2233-45 | pmid=14013759 | doi=10.1172/JCI104682 | pmc=291158 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14013759 }}</ref> | |||
*Portosystemic shunts | |||
*Drugs - [[Rifampin]], [[Probenecid]] | |||
*[[Crigler-Najjar syndrome type 1|Crigler-Najjar syndrome types I and II]]<ref name="pmid12198827">{{cite journal| author=Drenth JP, Peters WH, Jansen JB| title=[From gene to disease; unconjugated hyperbilirubinemia: Gilbert's syndrome and Crigler-Najjar types I and II]. | journal=Ned Tijdschr Geneeskd | year= 2002 | volume= 146 | issue= 32 | pages= 1488-90 | pmid=12198827 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12198827 }}</ref> | |||
*[[Gilbert's syndrome|Gilbert syndrome]] | |||
*[[Ethinylestradiol|Ethinyl estradiol]] | |||
*Liver diseases - [[chronic hepatitis]], advanced [[cirrhosis]] | |||
==== Less Common ==== | |||
*[[Dyserythropoiesis]] | |||
*Some patients with [[Gilbert's syndrome|Gilbert syndrome]] | |||
*[[Drugs]] - Flavaspadic acid, Bunamiodyl | |||
*[[Neonates]] | |||
*[[Hyperthyroidism]] | |||
*[[Heart failure]] | |||
=== '''Conjugated hyperbilirubinemia''' === | |||
Risk factors for conjugated hyperbilirubinemia include: | |||
==== Common Causes ==== | |||
*[[Intrahepatic cholestasis]]: | |||
**[[Viral hepatitis]] | |||
**[[Alcoholic hepatitis]] | |||
**[[Non-alcoholic fatty liver disease]] | |||
**[[Chronic hepatitis]] | |||
**[[Primary biliary cirrhosis]] | |||
**[[Drugs]] and [[Toxin|toxins]] (eg, alkylated [[Steroid|steroids]], [[chlorpromazine]], herbal medications [eg, Jamaican bush tea], [[arsenic]]) | |||
**[[Sepsis]] and hypoperfusion states | |||
**Infiltrative diseases (eg, [[amyloidosis]], [[lymphoma]], [[sarcoidosis]], [[tuberculosis]]) | |||
**[[Pregnancy]] | |||
**[[Cirrhosis]] | |||
*[[Extrahepatic cholestasis]] ([[biliary obstruction]]): | |||
**[[Choledocholithiasis]] | |||
**Intrinsic and extrinsic tumors (eg, [[cholangiocarcinoma]]) | |||
**[[Primary sclerosing cholangitis]] | |||
**[[Acute pancreatitis|Acute]] and [[chronic pancreatitis]] | |||
==== Less Common Causes ==== | |||
*[[Intrahepatic cholestasis|Intrahepatic cholestasis:]] | |||
**[[Total parenteral nutrition]] | |||
**Postoperative [[cholestasis]] | |||
**Following [[Organ transplant|organ transplantation]] | |||
**Hepatic crisis in [[Sickle-cell disease|sickle-cell disease]] | |||
*[[Extrahepatic cholestasis]] ([[biliary obstruction]]): | |||
**[[HIV AIDS|AIDS]] cholangiopathy | |||
**Certain [[parasitic infections]] (eg, [[Ascaris lumbricoides]], [[Opisthorchis felineus|liver flukes]]) | |||
**[[Strictures]] after invasive procedures | |||
*Defect of canalicular organic anion transport: | |||
**[[Dubin-Johnson syndrome]] | |||
*Defect of sinusoidal re uptake of [[conjugated bilirubin]]: | |||
**[[Rotor syndrome]] | |||
==References== | ==References== | ||
Revision as of 16:37, 6 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Risk Factors
Risk factors for jaundice are classified under conjugated and unconjugated hyperbilirubinemia:[1]
Unconjugated hyperbilirubinemia
Risk factors for unconjugated hyperbilirubenemia includes:[2][3]
- Portosystemic shunts
- Drugs - Rifampin, Probenecid
- Crigler-Najjar syndrome types I and II[4]
- Gilbert syndrome
- Ethinyl estradiol
- Liver diseases - chronic hepatitis, advanced cirrhosis
Less Common
- Dyserythropoiesis
- Some patients with Gilbert syndrome
- Drugs - Flavaspadic acid, Bunamiodyl
- Neonates
- Hyperthyroidism
- Heart failure
Conjugated hyperbilirubinemia
Risk factors for conjugated hyperbilirubinemia include:
Common Causes
- Intrahepatic cholestasis:
- Viral hepatitis
- Alcoholic hepatitis
- Non-alcoholic fatty liver disease
- Chronic hepatitis
- Primary biliary cirrhosis
- Drugs and toxins (eg, alkylated steroids, chlorpromazine, herbal medications [eg, Jamaican bush tea], arsenic)
- Sepsis and hypoperfusion states
- Infiltrative diseases (eg, amyloidosis, lymphoma, sarcoidosis, tuberculosis)
- Pregnancy
- Cirrhosis
- Extrahepatic cholestasis (biliary obstruction):
- Choledocholithiasis
- Intrinsic and extrinsic tumors (eg, cholangiocarcinoma)
- Primary sclerosing cholangitis
- Acute and chronic pancreatitis
Less Common Causes
- Intrahepatic cholestasis:
- Total parenteral nutrition
- Postoperative cholestasis
- Following organ transplantation
- Hepatic crisis in sickle-cell disease
- Extrahepatic cholestasis (biliary obstruction):
- AIDS cholangiopathy
- Certain parasitic infections (eg, Ascaris lumbricoides, liver flukes)
- Strictures after invasive procedures
- Defect of canalicular organic anion transport:
- Defect of sinusoidal re uptake of conjugated bilirubin:
References
- ↑ VanWagner LB, Green RM (2015). "Evaluating elevated bilirubin levels in asymptomatic adults". JAMA. 313 (5): 516–7. doi:10.1001/jama.2014.12835. PMC 4424929. PMID 25647209.
- ↑ Arora V, Kulkarni RK, Cherian S, Pillai R, Shivali M (2009). "Hyperbilirubinemia in normal healthy donors". Asian J Transfus Sci. 3 (2): 70–2. doi:10.4103/0973-6247.53875. PMC 2920475. PMID 20808649.
- ↑ ARIAS IM (1962). "Chronic unconjugated hyperbilirubinemia without overt signs of hemolysis in adolescents and adults". J Clin Invest. 41: 2233–45. doi:10.1172/JCI104682. PMC 291158. PMID 14013759.
- ↑ Drenth JP, Peters WH, Jansen JB (2002). "[From gene to disease; unconjugated hyperbilirubinemia: Gilbert's syndrome and Crigler-Najjar types I and II]". Ned Tijdschr Geneeskd. 146 (32): 1488–90. PMID 12198827.