Diagnosaurus
Jaundice (icterus)
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DDx
Hyperbilirubinemia
Unconjugated (indirect bilirubin)
- Increased production: hemolysis, hematoma, pulmonary infarction
- Impaired uptake and storage: posthepatitis hyperbilirubinemia, Gilbert's syndrome, Crigler-Najjar syndrome, drugs
Conjugated (direct bilirubin)
- Biliary obstruction: choledocholithiasis, pancreatic tumor, biliary stricture, primary sclerosing cholangitis, biliary duct carcinoma
- Hepatocellular damage or intrahepatic cholestasis: hepatitis (eg, alcoholic, viral), hepatic cirrhosis, biliary cirrhosis, drugs, sepsis, cholangitis, liver abscess, Budd-Chiari syndrome, infectious mononucleosis, spirochetal infection, infiltrative disease (tuberculosis, sarcoidosis, lymphoma), industrial toxins
- Hereditary bilirubin excretion defect: Dubin-Johnson syndrome, Rotor's syndrome
Other causes of yellow skin
- Carotenemia (excessive beta-carotene ingestion, especially in hypothyroidism)
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DDx
Hyperbilirubinemia
Unconjugated (indirect bilirubin)
- Increased production: hemolysis, hematoma, pulmonary infarction
- Impaired uptake and storage: posthepatitis hyperbilirubinemia, Gilbert's syndrome, Crigler-Najjar syndrome, drugs
Conjugated (direct bilirubin)
- Biliary obstruction: choledocholithiasis, pancreatic tumor, biliary stricture, primary sclerosing cholangitis, biliary duct carcinoma
- Hepatocellular damage or intrahepatic cholestasis: hepatitis (eg, alcoholic, viral), hepatic cirrhosis, biliary cirrhosis, drugs, sepsis, cholangitis, liver abscess, Budd-Chiari syndrome, infectious mononucleosis, spirochetal infection, infiltrative disease (tuberculosis, sarcoidosis, lymphoma), industrial toxins
- Hereditary bilirubin excretion defect: Dubin-Johnson syndrome, Rotor's syndrome
Other causes of yellow skin
- Carotenemia (excessive beta-carotene ingestion, especially in hypothyroidism)
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