Summary
Definition
History and exam
Key diagnostic factors
- icterícia
- urina com coloração escura
Other diagnostic factors
- fadiga
- dor abdominal
Risk factors
- deficiência de glicose-6-fosfato desidrogenase
- talassemia beta
Diagnostic investigations
1st investigations to order
- bilirrubina total sérica
- bilirrubina conjugada sérica
- bilirrubina urinária
- aminotransferases séricas, fosfatase alcalina e gama-GT (glutamil transferase)
- hemoglobina
- contagem absoluta de reticulócitos
- esfregaço sanguíneo
- haptoglobina plasmática
Investigations to consider
- ácidos biliares séricos (totais)
- coproporfirinas urinárias
- biópsia hepática
- ultrassonografia do fígado e da árvore biliar
- colecistograma oral
- colecintigrafia com 99mTc-HIDA (ácido hidroxi-iminodiacético)
- teste genético molecular
- exame de retenção de sulfobromoftaleína (BSP) plasmática
Treatment algorithm
todos os pacientes
Contributors
Authors
Tracy A.F. Coelho, MBBS, DCH, MRCPCH, PhD
Consultant Paediatric Gastroenterologist
University Hospital Southampton
Southampton
UK
Disclosures
TAFC declares that he has no competing interests.
Anil Dhawan, MBBS, MD, FRCPCH
Professor of Paediatric Hepatology
King's College Hospital
London
UK
Disclosures
AD declares that he has no competing interests.
Peer reviewers
John T. Jenkins, MB, CHB, FRCP
Consultant Surgeon
St. Mark's Hospital
London
UK
Disclosures
JTJ declares that he has no competing interests.
William A. Petri, Jr., MD, PhD, FACP
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.
Nancy Reau, MD
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.
James Neuberger, BM, BCh
Consultant Physician
Liver Unit
Queen Elizabeth Hospital
Birmingham
UK
Disclosures
JN declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Rotor AB, Manahan L, Florentin A. Familial non-hemolytic jaundice with direct Van Den Bergh reaction. Acta Med Phil. 1948;5:37-49.
Vest MF, Kaufmann HJ, Fritz E. Chronic non-haemolytic jaundice with conjugated bilirubin in the serum and normal histology: a case study. Arch Dis Child. 1960;36:600-4.Full text Abstract
Kwo PY, Cohen SM, Lim JK. ACG clinical guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol. 2017 Jan;112(1):18-35.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Síndrome de Dubin-Johnson
- Síndrome de Gilbert
- Síndrome de Crigler-Najjar (tipos I e II)
More DifferentialsGuidelines
- ACG clinical guideline: evaluation of abnormal liver chemistries
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer