Jaundice (icterus)

Jaundice (icterus) is a topic covered in the Diagnosaurus.

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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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