Show Menu

Causes of Elevated Billirubin Cheat Sheet by

Causes of Elevated Billirubin
results     medical     lab     causes     elevated     billirubin

Causes of Elevated Bilirubin

Elevated unconj­ugated biliru­bin
Gilbert’s syndrome
Crigle­r-N­ajjar syndrome
Hemolysis (intra­vas­cular and extrav­asc­ular)
Ineffe­ctive erythr­opo­iesis
Resorption of large hematomas
Neonatal jaundice
Hypert­hyr­oidism
Medica­tions
Post-blood transf­usion
Elevated conjugated hyperb­ili­rub­ine­mia
Bile duct obstru­ction
     Choled­och­oli­thiasis
     Malignant obstru­ction
     Bile duct flukes
Bile duct stricture
AIDS cholan­gio­pathy
Viral hepatitis
Toxic hepatitis
Medica­tions or drug-i­nduced liver injury
Acute alcoholic hepatitis
Ischemic hepatitis
Cirrhosis
Primary biliary cirrhosis
PSC
Infilt­rative diseases of the liver
     Sarcoid
     Granul­omatous hepatitis
     Tuberc­ulosis
     Metastatic cancer
     Lymphoma
Hepato­cel­lular carcinoma
Wilson disease (espec­ially fulminant Wilson’s disease)
Autoimmune hepatitis
Ischemic hepatitis
Congestive hepato­pathy
Sepsis
TPN
Intrah­epatic choles­tasis of pregnancy
Benign post-o­per­ative jaundice
ICU or multif­act­orial jaundice
Benign recurrent choles­tasis
Vanishing bile duct syndrome
Ductopenia
 

Continued

Dubin-­Johnson syndrome
Rotor syndrome
Sickle cell liver crisis
Hemoph­ago­cytic lympho­his­tio­cytosis
PSC, primary sclerosing cholan­gitis; TPN, total parenteral nutrition.

Algorithm Elevated (predo­minant unconj­ugated)

Elevated total bilirubin (predo­minant unconj­uga­ted)
1. History and physical exam
Assess liver transa­minases and serum alkaline phosph­atase
2. Review medica­tions
Evaluate for hemolysis
Evaluate for Gilbert's syndrome
3. If persistent elevation is otherwise unexpl­ained, may consider
diagnostic testing for Gilbert's syndrome (UGT1A1 genotype)
and evaluate for uncommon etiologies in Table 6
4. If persistent elevation is otherwise unexpl­ained, is
sympto­matic, is worsening over time, and/or associated with
abnormal transa­minases
--> consider liver biopsyy

Algorithm Elevated (predo­minant conjug­ated)

Elevated total bilirubin (predo­minant conjug­ated)
1. History & physical exam
Assess liver transa­minases and serum alkaline phosph­atase
2. Review medica­tions
Evaluate for clinically overt etiolo­gies: sepsis, TPN, cirrhosis, & biliary obstru­ction
Perform right upper quadrant ultrasound
3. If ductal dilatation --> ERCP or MRCP
If no ductal dilatation --> check AMA, ANA, and SMA
4. If persistent elevation is otherwise unexpl­ained, is
sympto­matic, is worsening over time, and/or associated with
abnormal transa­minases
--> consider liver biopsy

Download the Causes of Elevated Billirubin Cheat Sheet

1 Page
//media.cheatography.com/storage/thumb/davidpol_causes-of-elevated-billirubin.750.jpg

PDF (recommended)

Alternative Downloads

Share This Cheat Sheet!

 

Comments

No comments yet. Add yours below!

Add a Comment

Your Comment

Please enter your name.

    Please enter your email address

      Please enter your Comment.

          Related Cheat Sheets

          Causes of Elevated Alkaline Phosphatase Cheat Sheet

          More Cheat Sheets by Davidpol

          Naming Conventions: ICD-10 Coding Systems Cheat Sheet
          Reducing Psychotropic Polypharmacy Cheat Sheet