Jaundice risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Risk Factors
Risk factors for jaundice are classified under conjugated and unconjugated hyperbilirubinemia:[1]
Unconjugated hyperbilirubinemia
Risk factors for unconjugated hyperbilirubenemia includes:[2][3]
- Portosystemic shunts
- Drugs - Rifampin, Probenecid
- Crigler-Najjar syndrome types I and II[4]
- Gilbert syndrome
- Ethinyl estradiol
- Liver diseases - chronic hepatitis, advanced cirrhosis
Less Common
- Dyserythropoiesis
- Some patients with Gilbert syndrome
- Drugs - Flavaspadic acid, Bunamiodyl
- Neonates
- Hyperthyroidism
- Heart failure
Conjugated hyperbilirubinemia
Risk factors for conjugated hyperbilirubinemia include:
Common Causes
- Intrahepatic cholestasis:
- Viral hepatitis
- Alcoholic hepatitis
- Non-alcoholic fatty liver disease
- Chronic hepatitis
- Primary biliary cirrhosis
- Drugs and toxins (eg, alkylated steroids, chlorpromazine, herbal medications [eg, Jamaican bush tea], arsenic)
- Sepsis and hypoperfusion states
- Infiltrative diseases (eg, amyloidosis, lymphoma, sarcoidosis, tuberculosis)
- Pregnancy
- Cirrhosis
- Extrahepatic cholestasis (biliary obstruction):
- Choledocholithiasis
- Intrinsic and extrinsic tumors (eg, cholangiocarcinoma)
- Primary sclerosing cholangitis
- Acute and chronic pancreatitis
Less Common Causes
- Intrahepatic cholestasis:
- Total parenteral nutrition
- Postoperative cholestasis
- Following organ transplantation
- Hepatic crisis in sickle-cell disease
- Extrahepatic cholestasis (biliary obstruction):
- AIDS cholangiopathy
- Certain parasitic infections (eg, Ascaris lumbricoides, liver flukes)
- Strictures after invasive procedures
- Defect of canalicular organic anion transport:
- Defect of sinusoidal re uptake of conjugated bilirubin:
References
- ↑ VanWagner LB, Green RM (2015). "Evaluating elevated bilirubin levels in asymptomatic adults". JAMA. 313 (5): 516–7. doi:10.1001/jama.2014.12835. PMC 4424929. PMID 25647209.
- ↑ Arora V, Kulkarni RK, Cherian S, Pillai R, Shivali M (2009). "Hyperbilirubinemia in normal healthy donors". Asian J Transfus Sci. 3 (2): 70–2. doi:10.4103/0973-6247.53875. PMC 2920475. PMID 20808649.
- ↑ ARIAS IM (1962). "Chronic unconjugated hyperbilirubinemia without overt signs of hemolysis in adolescents and adults". J Clin Invest. 41: 2233–45. doi:10.1172/JCI104682. PMC 291158. PMID 14013759.
- ↑ Drenth JP, Peters WH, Jansen JB (2002). "[From gene to disease; unconjugated hyperbilirubinemia: Gilbert's syndrome and Crigler-Najjar types I and II]". Ned Tijdschr Geneeskd. 146 (32): 1488–90. PMID 12198827.