Which conditions should be considered in the differential diagnosis of suspected conjugated hyperbilirubinemia?

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

Consider the following conditions in the differential diagnosis of patients with suspected conjugated hyperbilirubinemia:

  • Cytomegalovirus (CMV) hepatitis

  • Drug toxicity, especially the following: acetaminophen, allopurinol, anabolic steroids, chlorpromazine, estrogens, halothane, isoniazid, methyldopa, phenytoin, protease inhibitors, quinidine, rifampicin, statins, and sulfa drugs

  • Exposure to environmental hepatotoxins (eg, beryllium, "nutraceuticals" [eg, herbal tea], organic solvents)

  • Acute fatty liver of pregnancy

  • Inherited disorders of bilirubin conjugation (eg, Rotor syndrome)

  • Liver congestion

  • Liver ischemia (shock liver)

  • Rejection of transplanted liver

  • Reye syndrome

  • Total parenteral nutrition (TPN) toxicity [9]

  • Veno-occlusive disease associated with chemotherapy


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