What are the signs and symptoms of conjugated hyperbilirubinemia?

Updated: Jul 31, 2019
  • Author: Richard A Weisiger, MD, PhD; Chief Editor: BS Anand, MD  more...
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Also note the following:

  • Colicky abdominal pain or fever suggests gallstone disease.
  • Weight loss or constitutional systems suggests malignancy or chronic infection.
  • Recent anesthesia with the use of halothane suggests halothane hepatitis.
  • A history of pruritus suggests cholestatic disease resulting from biliary obstruction or intrahepatic cholestasis.
  • A family history of jaundice suggests inborn errors of bilirubin metabolism.
  • In patients with severe intercurrent illnesses, consider sepsis, hepatic ischemia, and opportunistic infections.
  • Severe right heart failure or tricuspid insufficiency with hepatomegaly suggests hepatic congestion.
  • Patients on parenteral nutrition may experience cholestasis that sometimes improves with the addition of lipid infusions.
  • Patients with acquired immunodeficiency syndrome (AIDS) may experience biliary obstruction from opportunistic infections (eg, AIDS cholangiopathy).
  • Patients with chronic liver disease may experience transient elevation of their bilirubin levels following blood transfusion, which is due to the more rapid turnover of the infused cells.
  • In patients younger than 20-25 years, a history of a recent flulike syndrome treated with aspirin raises the possibility of Reye syndrome.
  • Pregnancy suggests benign recurrent cholestasis or, in late pregnancy, acute fatty liver of pregnancy.

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