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27 Possible Causes for Direct Bilirubin Increased, Green Jaundice, Scleral Icterus

  • Cholestasis

    Perera DR, Greene ML, Fenster F: Cholestasis associated with extrabiliary Hodgkin's disease. Gastroenterology 1974;67:680–685.[clevelandclinicmeded.com] Up to 60% of patients will have elevated transaminases and 20% of patients will have increased direct bilirubin levels.[smfm.org] Her physical exam was remarkable for jaundice and scleral icterus without any stigmata of liver disease.[ncbi.nlm.nih.gov]

  • Portal Cirrhosis

    Kayser-Fleischer ring—brown-green ring of copper deposit around the cornea, pathognomonic for Wilson’s disease Nail changes: Muehrcke’s nails—paired horizontal white bands[aafp.org] icterus Yellow discoloration of skin, cornea, and mucous membranes Increasing serum bilirubin due to compromised hepatocyte excretory function Spider angiomata Central arteriole[pathophys.org] Scleral icterus can usually be detected if the serum bilirubin level is greater than 3.0 mg/dL.[hepatitisc.uw.edu]

  • Hemochromatosis

    […] or odd colored skin (ashen gray green or reddish) • Abdominal pain (upper right quadrant—in area of the liver) • Joint pain • Rapid weight loss • Gall bladder, pancreas or[irondisorders.org] […] girl fails to start a menstrual cycle at the proper age, has very erratic periods or stops having a period once she begins, • With MALES: hypgonadism (small testicles) • Jaundice[irondisorders.org]

  • Liver Failure

    Kayser-Fleischer ring—brown-green ring of copper deposit around the cornea, pathognomonic for Wilson’s disease Nail changes: Muehrcke’s nails—paired horizontal white bands[aafp.org] These findings translated to tests of upscaled adsorbents in a dynamic model for liver failure: upscaled Hepalbin adsorbent removes bile acids, direct bilirubin and indirect[ncbi.nlm.nih.gov] – measures all of the bilirubin in the blood; levels are increased with many liver diseases Direct bilirubin – measures a form of bilirubin that is conjugated (combined with[labtestsonline.org]

  • Extrahepatic Cholestasis

    Keywords: bile duct stone ; bile duct stricture ; bilirubin ; cholestasis ; jaundice ; liver function test References 1. Green RM, Flamm S.[degruyter.com] An increase in urinary bilirubin is nearly always indicative of a corresponding increase in the serum direct fraction attributable to intrahepatic or extrahepatic cholestasis[medical-dictionary.thefreedictionary.com] Definition Jaundice : yellowish discoloration of the skin, sclerae, and mucous membranes due to the deposition of bilirubin Scleral icterus : discoloration of the sclerae,[amboss.com]

  • Intrahepatic Cholestasis

    Perera DR, Greene ML, Fenster F: Cholestasis associated with extrabiliary Hodgkin's disease. Gastroenterology 1974;67:680–685.[clevelandclinicmeded.com] Up to 60% of patients will have elevated transaminases and 20% of patients will have increased direct bilirubin levels.[smfm.org] Scleral icterus and jaundice were observed at 27 weeks.[ncbi.nlm.nih.gov]

  • Toxic Hepatitis

    Jaundice as a misadventure of a green tea (camellia sinensis) lover: a case report. Acta Gastroenterol Belg 2008; 71: 409-12.[livertox.nih.gov] A 47-year-old woman was admitted to our clinic with weakness, fatigue, pruritus, and scleral icterus that had developed 10 days prior to presentation.[ncbi.nlm.nih.gov] Patient 1 On July 16, 1992, a 42-year-old man visited his family physician for evaluation of scleral icterus and diffuse jaundice.[cdc.gov]

  • Rotor Syndrome

    Deficiency of OATP1B1 and OATP1B3 also explains the poor uptake by the liver of unconjugated bilirubin and anionic dyes such as bromosulfophthalein, indocyanin green, rose[ncbi.nlm.nih.gov] This is similar to Dubin-Johnson syndrome and both leads to increase conjugated (direct) bilirubin.[labpedia.net] Unlike true jaundice, carotenemia does not result in scleral icterus or elevation of the bilirubin level. 8 PREHEPATIC CAUSES Unconjugated hyperbilirubinemia results from[aafp.org]

  • Primary Sclerosing Cholangitis

    Perera DR, Greene ML, Fenster F: Cholestasis associated with extrabiliary Hodgkin's disease. Gastroenterology 1974;67:680–685.[clevelandclinicmeded.com] Reddy AN, Grosberg SJ, Wapnick S: Intermittent cholestatic jaundice and nonmetastatic prostatic carcinoma. Arch Intern Med 1977;137:1616–1618.[clevelandclinicmeded.com]

  • Drug-induced Cholestatic Hepatitis

    Perera DR, Greene ML, Fenster F: Cholestasis associated with extrabiliary Hodgkin's disease. Gastroenterology 1974;67:680–685.[clevelandclinicmeded.com] His pertinent physical exam findings were scleral icterus and jaundice all over the body and evidence of scratch marks and excoriations from itching but no abdominal distention[karger.com] Physical examination was unremarkable other than mild scleral icterus. No hepatosplenomegaly or other stigmata of chronic liver disease was apparent.[gastroenterologyandhepatology.net]

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