What are the most common diseases that cause conjugated hyperbilirubinemia?

Updated: Jul 31, 2019
  • Author: Richard A Weisiger, MD, PhD; Chief Editor: BS Anand, MD  more...
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A categoric listing of the most common diseases that produce conjugated hyperbilirubinemia is presented in the table below.

Table. Differential Diagnosis of Conjugated Hyperbilirubinemia (Open Table in a new window)

I. Acute or Chronic Hepatocellular Dysfunction

II. Diseases That Prevent Flow of Bile into the Intestine

A. Infection

A. Damage to Intrahepatic Bile Ducts or Portal Tracts

Viral hepatitis A-E

Cytomegalovirus (CMV) hepatitis

Epstein-Barr virus hepatitis


Primary biliary cirrhosis

Graft versus host disease

Veno-occlusive disease

Sclerosing cholangitis

B. Inflammation Without Infection

B. Damage to or Obstruction of Larger Bile Ducts

Toxic liver injury

Drug toxicity (eg, acetaminophen)

Halothane hepatitis

Alcoholic hepatitis

Iron overload (hemochromatosis)

Copper overload (Wilson disease)

Autoimmune hepatitis


Sclerosing cholangitis

AIDS cholangiopathy

Hepatic arterial chemotherapy

Postsurgical strictures

Bile duct cancers

Developmental disorders of the bile ducts (eg, Caroli disease)

Extrinsic compression of the bile duct


Acute pancreatitis

C. Metabolic Dysfunction

C. Diffuse Infiltrative Diseases

Ischemia ("shock liver")

Acute fatty liver of pregnancy

Alpha-1 antitrypsin deficiency


Reye syndrome

Total parenteral nutrition

Granulomatous diseases


Disseminated mycobacterial infections


Wegener granulomatosis


Diffuse malignancy

D. Inborn Errors of Metabolism

D. Diseases That Interfere with Biliary Secretion of Bilirubin

Dubin-Johnson syndrome

Rotor syndrome

Benign recurrent cholestasis

Drug-induced cholestasis, as with the following:

- Chlorpromazine

- Erythromycin

- Estrogens

- Anabolic steroids

- Many others

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