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Symptoms and Signs – Differential Diagnosis of Jaundice
Pre-hepatic
Haemolysis (See Anaemia, haemolytic), ineffective erythropoiesis,
Reduced glucuronidation (Gilbert's syndrome, Crigler-Najjar syndrome)
Hepatocellular
Alcoholic hepatitis
Autoimmune hepatitis
Cirrhosis, hepatic metastases, hepatic abscess
Drugs (paracetamol, anti-TB drugs, statins, sodium valproate, halothane), toxins, herbal medications
Dubin-Johnson syndrome, Rotor syndrome
Septicaemia
Viral: A, B, C; (other infections: CMV, EBV, toxoplasmosis, leptospirosis, Q fever)
Wilson's disease, haemochromatosis, cr1-antitrypsin deficiency, Budd-Chiari syndrome
Obstructive
Benign stricture (following invasive procedures)
Carcinoma of head of pancreas/ampulla of Vater/bile duct
Drugs: (antibiotics, OCPs, chlorpromazine, sulphonylureas, gold)
Gallstones (in the common bile duct)
Lymphadenopathy at the porta hepatic
Parasites, e.g. schistosomiasis/fasciola, pancreatitis, AIDS cholangiopathy
Primary sclerosing cholangitis, primary biliary cirrhosis
Pre-hepatic
Haemolysis (See Anaemia, haemolytic), ineffective erythropoiesis,
Reduced glucuronidation (Gilbert's syndrome, Crigler-Najjar syndrome)
Hepatocellular
Alcoholic hepatitis
Autoimmune hepatitis
Cirrhosis, hepatic metastases, hepatic abscess
Drugs (paracetamol, anti-TB drugs, statins, sodium valproate, halothane), toxins, herbal medications
Dubin-Johnson syndrome, Rotor syndrome
Septicaemia
Viral: A, B, C; (other infections: CMV, EBV, toxoplasmosis, leptospirosis, Q fever)
Wilson's disease, haemochromatosis, cr1-antitrypsin deficiency, Budd-Chiari syndrome
Obstructive
Benign stricture (following invasive procedures)
Carcinoma of head of pancreas/ampulla of Vater/bile duct
Drugs: (antibiotics, OCPs, chlorpromazine, sulphonylureas, gold)
Gallstones (in the common bile duct)
Lymphadenopathy at the porta hepatic
Parasites, e.g. schistosomiasis/fasciola, pancreatitis, AIDS cholangiopathy
Primary sclerosing cholangitis, primary biliary cirrhosis
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