Differential diagnosis of jaundice beyond the neonatal period Abstract Jaundice is a common pediatric symptom which develops through deposition of bilirubin in skin, mucus membranes and sclera. The differential diagnosis comprises a wide range of pathologic and non-pathologic conditions. As a first step of the work-up it is paramount to distinguish between unconjugated and conjugated bilirubin. Lakritz gelbsucht bei baby. Gelbsucht bei Neugeborenen Aufgrund ABO. Manchmal, wenn Mutter. Wenn der Ikterus bei einem Erwachsenen. Unconjugated hyperbilirubinemia is the main symptom of hemolysis. Therefore the diagnostic work-up needs to be focused on blood analyses comprising hemoglobin electrophoresis, blood smears and antibody detection. Unconjugated hyperbilirubinemia without elevated hemolysis parameters indicates errors in bilirubin conjugation. Conjugated hyperbilirubinemia is almost always due to a condition with an underlying liver disease. The measurement of cholestase parameters is necessary to distinguish between intrahepatic and posthepatic origins of tissue damage. Intrahepatic causes comprise viral or autoimmune hepatitis as well as metabolic diseases, such as Wilson’s disease. Posthepatic jaundice is usually the sign of complete or partial obstructive cholestasis. It is of great importance to rapidly recognize conditions which require further treatment instantly.
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February 2018
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