Neonatal jaundice diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Bilirubin plasma level is the gold standard test for the diagnosis of jaundice. Usually the concentration of bilirubin in the blood must exceed 2–3 mg/dL for the coloration to be easily visible.
Diagnostic Study of Choice
Study of choice:
- Bilirubin plasma level is the gold standard test for the diagnosis of jaundice.
- Usually the concentration of bilirubin in the blood must exceed 2–3 mg/dL for the coloration to be easily visible.
- Laboratory findings consistent with the diagnosis of jaundice include:[1]
- An elevated concentration of serum total bilirubin. The upper limit of normal is >1 mg/dL or >1.3 mg/d in some laboratories.
- Jaundice usually becomes clinically apparent when the serum total bilirubin concentration is greater than 2 to 3 mg/dL, but threshold for clinically apparent jaundice may vary among patients.
- Hyperbilirubinemia can be further categorized as conjugated or unconjugated:
- Conjugated hyperbilirubinemia:
- Serum conjugated bilirubin concentration >0.4 mg/dL (6.8 micromol/L).
- Direct bilirubin >1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL (85 micromol/L), or more than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).
- Unconjugated hyperbilirubinemia:
- Conjugated bilirubin is <1 mg/dL (17 micromol/L) if the total bilirubin is <5 mg/dL, or less than 20 percent of the total bilirubin if the total bilirubin is >5 mg/dL (85 micromol/L).
- Conjugated hyperbilirubinemia: