Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • jaundice
  • dark-coloured urine

Other diagnostic factors

  • fatigue
  • abdominal pain

Risk factors

  • G6PD-deficiency
  • beta-thalassaemia

Diagnostic investigations

1st investigations to order

  • serum total bilirubin
  • serum conjugated bilirubin
  • urinary bilirubin
  • serum aminotransferases, alkaline phosphatase, and gamma-GT
  • haemoglobin
  • absolute reticulocyte count
  • blood smear
  • plasma haptoglobin
Full details

Investigations to consider

  • serum bile acids (total)
  • urinary coproporphyrins
  • liver biopsy
  • ultrasound of the liver and biliary tree
  • oral cholecystogram
  • cholescintigraphy with 99mTc-HIDA
  • sulphobromophthalein (BSP) plasma retention test
Full details

Treatment algorithm

ONGOING

Contributors

Authors VIEW ALL

Tracy A.F. Coelho

Specialist Registrar

Royal Alexandra Children's Hospital

Brighton

UK

Disclosures

TAFC declares that he has no competing interests.

Anil Dhawan

Professor of Paediatric Hepatology

King's College Hospital

London

UK

Disclosures

AD declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Surgeon

St. Mark's Hospital

London

UK

Disclosures

JTJ declares that he has no competing interests.

Chief and Professor of Medicine

Division of Infectious Diseases and International Health

University of Virginia Health System

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Assistant Professor of Medicine

University of Chicago

Center for Liver Disease

Chicago

IL

Disclosures

NR has received reimbursement for speaking for Gilead, maker of Viread and Hepsera, and BMS, maker of Baraclude.

Consultant Physician

Liver Unit

Queen Elizabeth Hospital

Birmingham

UK

Disclosures

JN declares that he has no competing interests.

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