小结
定义
病史和体格检查
关键诊断因素
- 黄疸
- 深色尿
其他诊断因素
- 疲劳
- 腹痛
危险因素
- 葡萄糖-6-磷酸脱氢酶缺乏症
- β-地中海贫血
诊断性检查
首要检查
- 血清总胆红素
- 血清结合胆红素
- 尿胆红素
- 血清转氨酶、碱性磷酸酶和 γ-GT
- 血红蛋白
- 网织红细胞绝对计数
- 血涂片
- 血浆结合珠蛋白
需考虑的检查
- (总)血清胆汁酸
- 尿粪卟啉
- 肝脏活检
- 肝脏和胆管系统超声
- 口腔胆囊造影
- 用 99mTc-HIDA 进行胆道闪烁显像
- 分子遗传学检测
- 磺基磺溴酞钠 (BSP) 血浆保留试验
治疗流程
所有患者
撰稿人
作者
Tracy A.F. Coelho, MBBS, DCH, MRCPCH, PhD
Consultant Paediatric Gastroenterologist
University Hospital Southampton
Southampton
UK
利益声明
TAFC declares that he has no competing interests.
Anil Dhawan, MBBS, MD, FRCPCH
Professor of Paediatric Hepatology
King's College Hospital
London
UK
利益声明
AD declares that he has no competing interests.
同行评议者
John T. Jenkins, MB, CHB, FRCP
Consultant Surgeon
St. Mark's Hospital
London
UK
利益声明
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
利益声明
WAP declares that he has no competing interests.
Nancy Reau, MD
Assistant Professor of Medicine
University of Chicago
Center for Liver Disease
Chicago
IL
利益声明
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
利益声明
JN declares that he has no competing interests.
鉴别诊断
- Dubin-Johnson 综合征
- Gilbert 综合征
- Crigler-Najjar 综合征(I 型和 II 型)
更多 鉴别诊断指南
- ACG 临床指南:肝脏化学指标异常的评估
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