Sandbox:Jaundice: Difference between revisions

Latest revision as of 21:11, 5 January 2018

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

Differential diagnosis of jaundice

Abbreviations: RUQ= Right upper quadrant of the abdomen, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CT= Computed tomography

Classification of jaundice based on etiology		Disease	History and clinical manifestations				Diagnosis
			History and clinical manifestations				Lab Findings						Other blood tests	Other diagnostic
			Family history	Fever	RUQ Pain	Pruritis	AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology	Other blood tests	Other diagnostic
Jaundice	Hepatocellular Jaundice	Hemochromatosis	+	-	-/+	-	↑	↑	↑/N	↑/N	N	-	Ferritin ↑	Liver biopsy
		Wilson's disease	+	-	-/+	-	↑	↑	N	↑/N	N	-	Serum cerulloplasmin ↑	Liver biopsy
		Viral hepatitis	-	-/+	-	-	↑	↑	N	↑/N	N	+	Specific viral antibody for each type	-
		Alcoholic hepatitis	-	-/+	-/+	-	↑↑	↑	N	↑/N	N	-	-	-
		Drug induced hepatitis	-	-/+	-	-	↑	↑	N	↑/N	N	-	-	-
		Autoimmune hepatitis	-/+	-	-	-/+	↑	↑	N	↑/N	N	-	Anti-LKM antibody	Liver biopsy
		Cirrhosis	-/+	-/+	-/+	-	↑	↑	↑/N	↑/N	↑/N	-/+	Low platelet	Small liver on ultrasound
	Cholestatic Jaundice	Common bile duct stone	-/+	-	+	+	N	N	↑	N	↑	-	Dilated ducts on ultrasound	CT/ERCP
		Hepatitis A cholestatic type	-	-/+	+	+	N	N	↑	N	↑	+	HAV- AB	Abdominal ultrasound
		EBV / CMV hepatitis	-	-/+	+	+	N	N	↑	N	↑	+	Positive serology	-
		Primary biliary cirrhosis	-/+	-	-/+	+	N/↑	N/↑	↑	N	↑	-	AMA positive	Liver biopsy
		Primary sclerosing cholangitis	-/+	-	-/+	+	N/↑	N/↑	↑	N	↑	-	Beading on MRCP	Liver biopsy
		Pancreatic carcinoma	+	-	-/+	-	N/↑	N/↑	↑	N	↑	-	Mass on ultrasound	CT scan for diagnosis
	Isolated Jaundice	Crigler-Najjar type 2	+	-	-	-	N	N	N	↑	↑	-	Genetic testing
		Gilbert	+	-	-	-	N	N	N	↑	↑	-	Genetic testing
		Rotor syndrome	+	-	-	-	N	N	N	N	↑	-	Genetic testing	Liver biopsy
		Dubin-Johnson syndrome	+	-	-	-	N	N	N	N	↑	-	Genetic testing	Liver biopsy
		Hereditory spherocytosis	+	-	-/+	-	N	N	N	↑	N	-	Genetic testing	Osmotic fragility
		G6PD deficiency	+	-	-	-	N	N	N	↑	N	-	Genetic testing
		Thalassemia	+	-	-	-	N	N	N	↑	N	-	Genetic testing
		Sickle cell disease	+	-	-	-	N	N	N	↑	N	-	Genetic testing
		Paroxismal nocturnal hemoglobinoria	-	-	-	-	N	N	N	↑	N	-	Flocytometery
		Immune hemolysis	-	-/+	-	-	N	N	N	↑	N	-	Autoantibodies
		Hematoma	-	-/+	-	-	N	N	N	↑	N	-	Anemia	Truma or surgery in history

The differential diagnosis for jaundice and pruritis are:

				Lab Findings						Other blood tests	Other diagnostic
Disease	History and clinical manifestations			Diagnosis
				AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology
	Type of jaundice	Pruritis	Family history	AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology
Common bile duct stone	Cholestatic Jaundice	+	-/+	N	N	↑	N	↑	-	Dilated ducts on sono	CT/ERCP
Hepatitis A cholestatic type		+	-	N	N	↑	N	↑	+	HAV- AB	Abdominal ultrasound
EBV / CMV hepatitis		+	-	N	N	↑	N	↑	+	Positive serology	PCR or ELISA
Primary biliary cirrhosis		+	-/+	N/↑	N/↑	↑	N	↑	-	AMA positive	Liver biopsy
Primary sclerosing cholangitis		+	-/+	N/↑	N/↑	↑	N	↑	-	Beading on MRCP	Liver biopsy
Autoimmune hepatitis	Hepatocellular Jaundice	-/+	-/+	↑	↑	N	↑/N	N	-	Anti-LKM antibody	Liver biopsy

The differential diagnosis for jaundice, pruritis and RUQ pain are:

Disease	History and clinical manifestations					Diagnosis
						Lab Findings						Other blood tests	Other diagnostic
						AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology
	Type of jaundice	Pruritis	RUQ pain	Fever	Family history	AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology
Common bile duct stone	Cholestatic Jaundice	+	+	-	-/+	N	N	↑	N	↑	-	Dilated ducts on sono	CT/ERCP
Hepatitis A cholestatic type		+	+	-/+	-	N	N	↑	N	↑	+	HAV- AB	Abdominal ultrasound
EBV / CMV hepatitis		+	+	-/+	-	N	N	↑	N	↑	+	Positive serology	PCR or ELISA
Primary biliary cirrhosis		+	-/+	-	-/+	N/↑	N/↑	↑	N	↑	-	AMA positive	Liver biopsy
Primary sclerosing cholangitis		+	-/+	-	-/+	N/↑	N/↑	↑	N	↑	-	Beading on MRCP	Liver biopsy

The differential diagnosis for jaundice, pruritis and RUQ pain are:

Classification of jaundice based on etiology		Disease	History and clinical manifestations				Diagnosis
			History and clinical manifestations				Lab Findings						Other blood tests	Other diagnostic
			Family history	Fever	RUQ Pain	Pruritis	AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology	Other blood tests	Other diagnostic
Jaundice	Cholestatic Jaundice	Common bile duct stone	-/+	-	+	+	N	N	↑	N	↑	-	Dilated ducts on ultrasond	CT/ERCP
		Hepatitis A cholestatic type	-	-/+	+	+	N	N	↑	N	↑	+	HAV- AB	Abdominal ultrasound
		EBV / CMV hepatitis	-	-/+	+	+	N	N	↑	N	↑	+	Positive serology
		Primary biliary cirrhosis	-/+	-	-/+	+	N/↑	N/↑	↑	N	↑	-	AMA positive	Liver biopsy
		Primary sclerosing cholangitis	-/+	-	-/+	+	N/↑	N/↑	↑	N	↑	-	Beading on MRCP	Liver biopsy

The differential diagnosis for jaundice, fever and RUQ pain are:

Classification of jaundice based on etiology		Disease	History and clinical manifestations				Diagnosis
			History and clinical manifestations				Lab Findings						Other blood tests	Other diagnostic
			Family history	Fever	RUQ Pain	Pruritis	AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology	Other blood tests	Other diagnostic
Jaundice	Hepatocellular Jaundice	Alcoholic hepatitis	-	-/+	-/+	-	↑↑	↑	N	↑/N	N	-	-	-
	Hepatocellular Jaundice	Cirrhosis	-/+	-/+	-/+	-	↑	↑	↑/N	↑/N	↑/N	-/+	Low platate	Small liver on ultrasond
	Cholestatic Jaundice	Hepatitis A cholestatic type	-	-/+	+	+	N	N	↑	N	↑	+	HAV- AB	Abdominal ultrasound
	Cholestatic Jaundice	EBV / CMV hepatitis	-	-/+	+	+	N	N	↑	N	↑	+	Positive serology	PCR or ELISA

The differential diagnosis for jaundice and fever are:

Classification of jaundice based on etiology		Disease	History and clinical manifestations				Diagnosis
			History and clinical manifestations				Lab Findings						Other blood tests	Other diagnostic
			Family history	Fever	RUQ Pain	Pruritis	AST	ALT	ALK	BLR Indirect	BLR Direct	Viral serology	Other blood tests	Other diagnostic
Jaundice	Hepatocellular Jaundice	Viral hepatitis	-	-/+	-	-	↑	↑	N	↑/N	N	+	Specific viral antibody for each type	-
		Alcoholic hepatitis	-	-/+	-/+	-	↑↑	↑	N	↑/N	N	-	-	-
		Drug induced hepatitis	-	-/+	-	-	↑	↑	N	↑/N	N	-	-	-
		Cirrhosis	-/+	-/+	-/+	-	↑	↑	↑/N	↑/N	↑/N	-/+	Low platate	Small liver on ultrasond
	Cholestatic Jaundice	Hepatitis A cholestatic type	-	-/+	+	+	N	N	↑	N	↑	+	HAV- AB	Abdominal ultrasound
	Cholestatic Jaundice	EBV / CMV hepatitis	-	-/+	+	+	N	N	↑	N	↑	+	Positive serology	PCR or ELISA
	Isolated Jaundice	Immune hemolysis	-	-/+	-	-	N	N	N	↑	N	-	Autoantibodies
	Isolated Jaundice	Hematoma	-	-/+	-	-	N	N	N	↑	N	-	Anemia	Truma or surgery in history

@@ Line 1: / Line 1: @@
-==Differential diagnosis==
+{{CMG}}; {{AE}} {{MJ}}
+==Differential diagnosis of jaundice==
 <span style="font-size:85%">'''Abbreviations:'''
 '''[[RUQ]]'''= Right upper quadrant of the abdomen, '''LFT'''= Liver function test, SIRS= [[Systemic inflammatory response syndrome]], '''[[ERCP]]'''= [[Endoscopic retrograde cholangiopancreatography]], '''N'''= Normal, '''AMA'''= Anti mitochondrial antibodies, '''[[LDH]]'''= [[Lactate dehydrogenase]], '''GI'''= Gastrointestinal, '''CT'''= [[Computed tomography]]</span><br>
@@ Line 12: / Line 14: @@
 ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
 |-
-! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" | Lab Findings
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
 ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other blood tests
-! rowspan="2" |Other diagnostic
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other diagnostic
 |-
 ! rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Family history
@@ Line 27: / Line 29: @@
 ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Viral serology
 |-
-! rowspan="21" align="center" style="background:#4479BA; color: #FFFFFF;" |Jaundice
+! rowspan="25" align="center" style="background:#4479BA; color: #FFFFFF;" |Jaundice
-! colspan="1" rowspan="6" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Hepatocellular Jaundice
+! colspan="1" rowspan="7" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Hepatocellular Jaundice
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hemochromatosis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
@@ Line 39: / Line 41: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Ferritin ↑
-|Liver biopsy
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Wilson's disease
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Wilson's disease
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
@@ Line 53: / Line 55: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Serum cerulloplasmin ↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Viral hepatitis
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Viral hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
@@ Line 67: / Line 69: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Specific viral antibody for each type
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Alcoholic hepatitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Alcoholic hepatitis
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Drug induced hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" ||-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Drug induced hepatitis
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Autoimmune hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="left" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Anti-LKM antibody
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cirrhosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Low platelet
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Small liver on ultrasound
+|-
+! rowspan="6" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Cholestatic Jaundice
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Common bile duct stone
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Dilated ducts on ultrasound
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |CT/ERCP
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |HAV- AB
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abdominal ultrasound
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV hepatitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive serology
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+|-
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary biliary cirrhosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |AMA positive
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary sclerosing cholangitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Beading on MRCP
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Pancreatic carcinoma
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mass on ultrasound
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |CT scan for diagnosis
+|-
+! rowspan="11" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Isolated Jaundice
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Crigler-Najjar type 2
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Gilbert
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Rotor syndrome
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Dubin-Johnson syndrome
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hereditory spherocytosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Osmotic fragility
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |G6PD deficiency
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Thalassemia
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Sickle cell disease
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Genetic testing
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Paroxismal nocturnal hemoglobinoria
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Flocytometery
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Immune hemolysis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Autoantibodies
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hematoma
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Anemia
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Truma or surgery in history
+|-
+|}
+|}
+'''The differential diagnosis for jaundice and pruritis are:'''
+{| align="center"
+|-
+|
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+| rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
+! colspan="3" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |History and clinical manifestations
+! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
+|-
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Other blood tests
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Other diagnostic
+|-
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |AST
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |ALT
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |ALK
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Indirect
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Direct
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Viral serology
+|-
+| align="center" style="background:#4479BA; color: #FFFFFF;" |Type of jaundice
+| align="center" style="background:#4479BA; color: #FFFFFF;" |Pruritis
+| align="center" style="background:#4479BA; color: #FFFFFF;" |Family history
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Common bile duct stone
+! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" | '''Cholestatic Jaundice'''
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Dilated ducts on sono
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |CT/ERCP
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |HAV- AB
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abdominal ultrasound
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV hepatitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive serology
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |PCR or ELISA
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary biliary cirrhosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |AMA positive
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary sclerosing cholangitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Beading on MRCP
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
 |-
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Autoimmune hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-/+
+| rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |'''Hepatocellular Jaundice'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-/+
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
@@ Line 109: / Line 458: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Anti-LKM antibody
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
 |-
+|}
+|}
+'''The differential diagnosis for jaundice, pruritis and RUQ pain are:'''
+{| align="center"
+|-
+|
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
+! colspan="5" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |History and clinical manifestations
+! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
+|-
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Other blood tests
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Other diagnostic
+|-
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |AST
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |ALT
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |ALK
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Indirect
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Direct
+! colspan="1" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Viral serology
+|-
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Type of jaundice
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Pruritis
+! align="center" style="background:#4479BA; color: #FFFFFF;" |RUQ pain
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Family history
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Common bile duct stone
+! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Cholestatic Jaundice
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Dilated ducts on sono
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |CT/ERCP
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |HAV- AB
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abdominal ultrasound
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV hepatitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive serology
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |PCR or ELISA
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary biliary cirrhosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |AMA positive
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary sclerosing cholangitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Beading on MRCP
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+|}
+|}
+'''The differential diagnosis for jaundice, pruritis and RUQ pain are:'''
+{| align="center"
+|-
+|
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Classification of jaundice based on etiology
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
+! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |History and clinical manifestations
+! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
+|-
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other blood tests
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other diagnostic
+|-
+! rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Family history
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" |RUQ Pain
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Pruritis
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |AST
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |ALT
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |ALK
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Indirect
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Direct
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Viral serology
+|-
+! rowspan="6" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Jaundice
 ! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" | Cholestatic Jaundice
 | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Common bile duct stone
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Dilated ducts on ultrasond
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |CT/ERCP
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |HAV- AB
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abdominal ultrasound
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV hepatitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive serology
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary biliary cirrhosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |AMA positive
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary sclerosing cholangitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Beading on MRCP
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Liver biopsy
+|-
+|}
+|}
+'''The differential diagnosis for jaundice, fever and RUQ pain are:'''
+{| align="center"
+|-
+|
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Classification of jaundice based on etiology
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
+! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |History and clinical manifestations
+! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
+|-
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other blood tests
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other diagnostic
+|-
+! rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Family history
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
+! align="center" style="background:#4479BA; color: #FFFFFF;" |RUQ Pain
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Pruritis
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |AST
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |ALT
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |ALK
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Indirect
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Direct
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Viral serology
+|-
+! rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Jaundice
+! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatocellular Jaundice
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Alcoholic hepatitis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+|-
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cirrhosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Low platate
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Small liver on ultrasond
+|-
+! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cholestatic Jaundice
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |HAV- AB
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abdominal ultrasound
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive serology
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |PCR or ELISA
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary biliary cirrhosis
+|}
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+|}
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+'''The differential diagnosis for jaundice and fever are:'''
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+{| align="center"
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Primary sclerosing cholangitis
+|
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Classification of jaundice based on etiology
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |History and clinical manifestations
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
 |-
-! rowspan="10" |Isolated Jaundice
+! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Lab Findings
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |Crigler-Najjar
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other blood tests
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other diagnostic
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
 |-
-!'''Gilbert'''
+! rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Family history
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Fever
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" |RUQ Pain
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! align="center" style="background:#4479BA; color: #FFFFFF;" |Pruritis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |AST
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |ALT
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |ALK
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Indirect
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |BLR Direct
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" |Viral serology
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
 |-
-!Rotor syndrome
+! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Jaundice
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatocellular Jaundice
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Viral hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Specific viral antibody for each type
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 |-
-!Dubin-Johnson syndrome
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Alcoholic hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 |-
-!Hereditory spherocytosis
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Drug induced hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
 |-
-!G6PD deficiency
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cirrhosis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Low platate
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Small liver on ultrasond
 |-
-!Thalassemia
+! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Cholestatic Jaundice
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hepatitis A cholestatic type
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |HAV- AB
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Abdominal ultrasound
 |-
-!Sickle cell disease
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |EBV / CMV hepatitis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Positive serology
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |PCR or ELISA
 |-
-!Paroxismal nocturnal hemoglobinoria
+! rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Isolated Jaundice
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Immune hemolysis
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" align="center" |Autoantibodies
 |-
-!Immune hemolysis
+| colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Hematoma
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -/+
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" | -
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Anemia
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Truma or surgery in history
 |-
 |}
 |}

Sandbox:Jaundice: Difference between revisions

Latest revision as of 21:11, 5 January 2018

Differential diagnosis of jaundice

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