Direct bilirubin: Direct bilirubin or conjugated hyperbilirubinemia, which is always pathologic. Usually due to biliary obstruction, hepatocellular pathology, or metabolic disorder. Hepatitis, and in particular, idiopathic neonatal hepatitis, is a common cause of conjugated hyperbilirubinemia. Prolonged parenteral alimentation is another common cause of conjugated hyperbilirubinemia that can persist several months beyond the cessation of parenteral nutrition.
Metabolic disorders of the liver that can also result in conjugated hyperbilirubinemia include alpha 1-antitrypsin deficiency, galactosemia, tyrosinemia, fructosemia, glycogen storage diseases, lipid storage diseases, cerebrohepatorenal syndrome, trisomy 18, cystic fibrosis, hemochromatosis, and idiopathic hypopituitarism.
Obtain CBC, blood culture, albumin, LFT’s PT/PTT, hepatitis serologies, urinalysis, urine culture, and urine-reducing substances. Biliary atresia and neonatal hepatitis are the most common etiologies and patients with biliary atresia have better outcomes the earlier they are diagnosed.
Author(s) Details:
Elsharif Ahmed Bazie,
Elimam Elmahdi University, Sudan.
Mona Isam El-Din Osman,
Sudan International University, Sudan.