Jaundice risk factors
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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
- Neonates
- Drugs - Rifampin, Probenecid
- Crigler-Najjar syndrome types I and II[4]
- Gilbert syndrome
- Ethinyl estradiol
- Liver diseases - chronic hepatitis, advanced cirrhosis
- Portosystemic shunts
Less Common Risk Factors
- Dyserythropoiesis
- Some patients with Gilbert syndrome
- Drugs - Flavaspadic acid, Bunamiodyl
- Hyperthyroidism
- Heart failure
Conjugated hyperbilirubinemia
Risk factors for conjugated hyperbilirubinemia includes the following:
Common Risk Factors
- Viral hepatitis[5][6]
- Alcohol[7]
- Non-alcoholic fatty liver disease
- Chronic hepatitis
- Primary biliary cirrhosis[7]
- 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
- Choledocholithiasis
- Intrinsic and extrinsic tumors (eg, cholangiocarcinoma)
- Primary sclerosing cholangitis
- Acute and chronic pancreatitis
Less Common Risk Factors
Less common risk factors are as follows: [8]
- Total parenteral nutrition
- Postoperative cholestasis
- Following organ transplantation
- Hepatic crisis in sickle-cell disease
- AIDS
- Certain parasitic infections (eg, Ascaris lumbricoides, liver flukes)
- Strictures after invasive procedures
- Dubin-Johnson syndrome
- Rotor syndrome
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.
- ↑ Thuener J (2017). "Hepatitis A and B Infections". Prim Care. 44 (4): 621–629. doi:10.1016/j.pop.2017.07.005. PMID 29132524.
- ↑ 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.
- ↑ 7.0 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.
- ↑ 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.