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==Overview==
Common risk factors in the development of jaundice are classified under conjugated and unconjugated hyperbilirubinemia. The most common risk factors for unconjugated hyperbilirubinemia includes [[neonatal]] period, [[drugs]] like [[rifampin]] and [[probenecid]], syndromes like [[Gilbert's syndrome|Gilbert]] and [[Crigler-Najjar syndrome type 1|Crigler-Najjar syndrome types I]] and [[Crigler-Najjar syndrome|II]], [[steroids]] and [[chronic liver diseases]]. The most common risk factors for conjugated hyperbilirubinemia includes [[viral hepatitis]], [[alcohol]], [[non-alcoholic fatty liver disease]], [[chronic hepatitis]], [[primary biliary cirrhosis]], [[drugs]], and [[toxins]] (eg, alkylated steroids, [[chlorpromazine]], herbal medications, [[arsenic]]), [[sepsis]] and [[hypoperfusion]] states, infiltrative diseases (eg, [[amyloidosis]], [[lymphoma]], [[sarcoidosis]], and [[tuberculosis]]), [[pregnancy]], [[cirrhosis]], [[choledocholithiasis]], [[Biliary tract neoplasm|intrinsic and extrinsic tumors of biliary tracts]], [[primary sclerosing cholangitis]], [[Acute pancreatitis|acute]] and [[chronic pancreatitis]].
 
==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 the following:<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>
 
==== Common Risk Factors ====
 
*[[Neonates]]
*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]]
*Portosystemic shunts
 
==== Less Common Risk Factors====
 
*[[Dyserythropoiesis]]
*Some patients with [[Gilbert's syndrome|Gilbert syndrome]]
*[[Drugs]] - Flavaspadic acid, Bunamiodyl
*[[Hyperthyroidism]]
*[[Heart failure]]
 
=== '''Conjugated hyperbilirubinemia''' ===
Risk factors for conjugated hyperbilirubinemia includes the following:
 
==== Common Risk Factors ====
 
*[[Viral hepatitis]]<ref name="pmid29132524">{{cite journal| author=Thuener J| title=Hepatitis A and B Infections. | journal=Prim Care | year= 2017 | volume= 44 | issue= 4 | pages= 621-629 | pmid=29132524 | doi=10.1016/j.pop.2017.07.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29132524  }} </ref><ref name="pmid29187150">{{cite journal| author=Gadia CLB, Manirakiza A, Tekpa G, Konamna X, Vickos U, Nakoune E| title=Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: a retrospective assessment, 2008-2010. | journal=BMC Infect Dis | year= 2017 | volume= 17 | issue= 1 | pages= 735 | pmid=29187150 | doi=10.1186/s12879-017-2840-8 | pmc=5707826 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29187150 }} </ref>
*[[Alcohol]]<ref name="LuceyMathurin2009">{{cite journal|last1=Lucey|first1=Michael R.|last2=Mathurin|first2=Philippe|last3=Morgan|first3=Timothy R.|title=Alcoholic Hepatitis|journal=New England Journal of Medicine|volume=360|issue=26|year=2009|pages=2758–2769|issn=0028-4793|doi=10.1056/NEJMra0805786}}</ref>
*[[Non-alcoholic fatty liver disease]]
*[[Chronic hepatitis]]
*[[Primary biliary cirrhosis]]<ref name="LuceyMathurin2009">{{cite journal|last1=Lucey|first1=Michael R.|last2=Mathurin|first2=Philippe|last3=Morgan|first3=Timothy R.|title=Alcoholic Hepatitis|journal=New England Journal of Medicine|volume=360|issue=26|year=2009|pages=2758–2769|issn=0028-4793|doi=10.1056/NEJMra0805786}}</ref>
*[[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]]
*[[Choledocholithiasis]]
*Intrinsic and extrinsic tumors (eg, [[cholangiocarcinoma]])
*[[Primary sclerosing cholangitis]]
*[[Acute pancreatitis|Acute]] and [[chronic pancreatitis]]
 
==== Less Common Risk Factors  ====
Less common risk factors are as follows: <ref>VanWagner LB, Green RM (2015). "Evaluating elevated bilirubin levels in asymptomatic adults.". JAMA. 313 (5): 516–7. PMC 4424929 Freely accessible. PMID 25647209. doi:10.1001/jama.2014.12835.</ref>
*[[Total parenteral nutrition]]
*Postoperative [[cholestasis]]
*Following [[Organ transplant|organ transplantation]]
*Hepatic crisis in [[Sickle-cell disease|sickle-cell disease]]
*[[HIV AIDS|AIDS]]
*Certain [[parasitic infections]] (eg, [[Ascaris lumbricoides]], [[Opisthorchis felineus|liver flukes]])
*[[Strictures]] after invasive procedures
*[[Dubin-Johnson syndrome]]
*[[Rotor syndrome]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 22:27, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fatima Shaukat, MD [2]

Overview

Common risk factors in the development of jaundice are classified under conjugated and unconjugated hyperbilirubinemia. The most common risk factors for unconjugated hyperbilirubinemia includes neonatal period, drugs like rifampin and probenecid, syndromes like Gilbert and Crigler-Najjar syndrome types I and II, steroids and chronic liver diseases. The most common risk factors for conjugated hyperbilirubinemia includes viral hepatitis, alcohol, non-alcoholic fatty liver disease, chronic hepatitis, primary biliary cirrhosis, drugs, and toxins (eg, alkylated steroids, chlorpromazine, herbal medications, arsenic), sepsis and hypoperfusion states, infiltrative diseases (eg, amyloidosis, lymphoma, sarcoidosis, and tuberculosis), pregnancy, cirrhosis, choledocholithiasis, intrinsic and extrinsic tumors of biliary tracts, primary sclerosing cholangitis, acute and chronic pancreatitis.

Risk Factors

Risk factors for jaundice are classified under conjugated and unconjugated hyperbilirubinemia:[1]

Unconjugated hyperbilirubinemia

Risk factors for unconjugated hyperbilirubenemia includes the following:[2][3]

Common Risk Factors

Less Common Risk Factors

Conjugated hyperbilirubinemia

Risk factors for conjugated hyperbilirubinemia includes the following:

Common Risk Factors

Less Common Risk Factors 

Less common risk factors are as follows: [8]

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Thuener J (2017). "Hepatitis A and B Infections". Prim Care. 44 (4): 621–629. doi:10.1016/j.pop.2017.07.005. PMID 29132524.
  6. Gadia CLB, Manirakiza A, Tekpa G, Konamna X, Vickos U, Nakoune E (2017). "Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: a retrospective assessment, 2008-2010". BMC Infect Dis. 17 (1): 735. doi:10.1186/s12879-017-2840-8. PMC 5707826. PMID 29187150.
  7. 7.0 7.1 Lucey, Michael R.; Mathurin, Philippe; Morgan, Timothy R. (2009). "Alcoholic Hepatitis". New England Journal of Medicine. 360 (26): 2758–2769. doi:10.1056/NEJMra0805786. ISSN 0028-4793.
  8. VanWagner LB, Green RM (2015). "Evaluating elevated bilirubin levels in asymptomatic adults.". JAMA. 313 (5): 516–7. PMC 4424929 Freely accessible. PMID 25647209. doi:10.1001/jama.2014.12835.

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