Conjugated Hyperbilirubinemia: Screening and Treatment in Older Infants and Children. (2007)

Jaundice refers to yellow discoloration of the skin, sclera, mucous membranes, and body fluids. It is a common problem that can be the presenting sign for many disorders. The challenge for the physician is to identify patients who need additional evaluation. The differential diagnosis for jaundice is age-specific; this review addresses the causative conditions in infants beyond the newborn period, older children, and adolescents.

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Jaundice in Older Children and Adolescents. (2001)

  1. Describe the basic physiology of bilirubin metabolism, the two standard laboratory methods for its fractionation, and the classification of jaundice.
  2. Characterize the features of Gilbert disease.
  3. Identify the leading infectious cause of acute jaundice in older children and adolescents.
  4. Delineate the clinical and biochemical features of Wilson disease and autoimmune hepatitis.
  5. Compare and contrast liver function tests and tests of liver function.
  6. Describe the “worrisome” clinical and laboratory signs of hepatic synthetic dysfunction in jaundiced patients that should prompt an immediate referral to a center whHere liver transplantation is available.

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Diagnostic approach to the patient with jaundice. (2011)

Jaundice is caused by many disease processes ranging from benign to life threatening. History and physical examination remain important tools in evaluating the etiology of jaundice. The conjugation state of bilirubin, along with other laboratory tests judiciously ordered, can guide the provider toward category of illness. Hyperbilirubinemia may be categorized as to its etiology: unconjugated/prehepatic, intrahepatic, or extrahepatic/obstructive. Referral should be considered when likelihood of malignancy, chronic autoimmune condition, or need for intervention exists.

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Book Chapter: Diagnostic Approach to Jaundice from Feldman: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed. (2010)

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