What are the signs and symptoms of unconjugated hyperbilirubinemia?

Updated: May 21, 2019
  • Author: Hisham Nazer, MBBCh, FRCP, DTM&H; Chief Editor: BS Anand, MD  more...
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Signs/symptoms of unconjugated hyperbilirubinemia include the following:

  • Ineffective erythropoiesis (early labeled bilirubin [ELB] production) - Characterized by the onset of asymptomatic jaundice

  • Crigler-Najjar (CN) syndrome type 1 - Jaundice develops in the first few days of life and rapidly progresses by the second week; patients may present with evidence of kernicterus, the clinical manifestations of which are hypotonia, deafness, oculomotor palsy, lethargy and, ultimately, death

  • Crigler-Najjar syndrome type 2 - Usually, no clinical symptoms are reported with this disease entity

  • Gilbert syndrome - May manifest only as jaundice on clinical examination; at least 30% of patients with Gilbert syndrome are asymptomatic, although nonspecific symptoms, such as abdominal cramps, fatigue, and malaise, are common

  • Physiologic neonatal jaundice - Clinically obvious in 50% of neonates during the first 5 days of life

  • Nonphysiologic neonatal jaundice - Maternal serum jaundice, also known as Lucey-Driscoll syndrome, is an autosomal recessive metabolic disorder affecting the enzymes involved in bilirubin metabolism; it causes a transient familial neonatal unconjugated hyperbilirubinemia, and jaundice occurs during the first 4 days of life

See Presentation for more detail.

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