Note not only the presence of symptoms but also the timing

occur.

Hyperbilirubinemia may result from 4 primary mechanisms:

Overproduction of bilirubin, which results in an increase in unconjugated bilirubin

(ex. From massive hemolysis)

Impaired uptake, conjugation, or excretion of bilirubin

In physiologic neonatal jaundice, hepatic physiologic processes are incompletely

developed at birth

Regurgitation of unconjugated bilirubin from damaged hepatocytes or bile ducts

Obstruction of bile ducts as in cancer, or stones result in an increase primarily of

conjugated bilirubin

SIGNS AND SYMPTOMS

HISTORY

EPIDEMIOLOGY(this was not discussed)

Liver and biliary diseases are the leading cause of jaundice in most populations

Hemolysis sufficient to cause jaundice is the second major etiologic category

Prevalence of inherited hyperbilirubinemia

Crigler-Najar Type II - More common that Type I

Conjugated hyperbilirubinemia - Found in 2 rare inherited conditions: Dubin Johnson

syndrome and Rotor’s syndrome

Vanishing bile duct syndrom

from recording

From Harrisons