Unconjugated hvperbilirubenemia is seen in all except
Gilbert's syndrome
Dubin Johnson's syndrome
Criggle Najar syndrome
Neonatal physiological jaundice
(B) Dubin Johnson's syndrome# Common causes of raised bilirubin and urobilinogen> Raised conjugated bilirubin (bilirubinuria)> Hepatocellular disease and post-hepatic or cholestatic disease (intrahepatic and extrahepatic), including drug toxicity as well as pancreatic causes of obstructive jaundice.> Inherited defects in excretion - eg, Dubin-Johnson syndrome, Rotor's syndrome.> Raised unconjugated bilirubin (no bilirubinuria) Gilbert's syndrome Haemolysis Post viral hepatitis Mild chronic hepatitis Crigler-Najjar syndrome> PHYSIOLOGIC JAUNDICE (non-pathologic unconjugated hyperbilirubinemia):1. Term Infants: 50-60 % of all newborns are jaundiced in the first week of life. Total serum bilirubin peaks at age 3-5 d (later in Asian infants). Mean peak total serum bilirubin is 6 mg/dL (higher in Asian infants).2. Preterm Infants: Incidence of visible jaundice is much higher than in term infants. Peak is later (5-7d). Because of ? risk of bilibubin encephalopathy (see below), "physiologic" jaundice is more difficult to define and jaundice should be followed closely.
Miscellaneous