Rawashdeh MD MSc FRCP FRCPCH Professor of Pediatrics amp Gastroenterology Jaundice Definition Yellow staining of the skin and sclera by abnormally high blood levels of the bile pigment ID: 934333
Download Presentation The PPT/PDF document "A Child with Jaundice M" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
A Child with Jaundice
M
Rawashdeh
, MD,
MSc
, FRCP, FRCPCH
Professor of Pediatrics
&
Gastroenterology
Slide2Jaundice: Definition
Yellow staining of the skin and sclera by abnormally high blood levels of the bile pigment
bilirubin
. Normal?What? If abnormal
Slide3When is it physiologic?
Indirect
hyperbilirubinemia
Starts after 48 hoursEnds before 14 daysDoes not exceed 15 mg/dLHealthy newborn
Slide4Slide5Any problem with?
Indirect
hyperbilirubinemia
Direct
hyperbilirubinemia
And why?
Slide6Direct
hyperbilirubinemia
When the conjugated fraction rise to as high as 20% of the total
bilirubin
Always
check a total and direct, so that you can be sure you are excluding conjugated
hyperbilirubinemia
, which has totally different etiologies and treatments
.
Conjugated
hyperbilirubinemia
is always pathologic
Slide7Neonatal Cholestasis: History and physical findings
Slide8Summary of the differential diagnoses..1
Biliary
system structural issues
ExtrahepaticObstruction (EHBA)Dilatation (Choledochal cyst)Intrahepatic
Obstruction (
Alagielle
syndrome)
Dilatation (
Caroli
disease)
Slide9Summary of the differential diagnoses..2
Liver issues
Infections
Hepatitis B, CTORCHIdiopathic hepatitisGeneticPrimary familial intrahepatic
cholestasis
(PFIC)
Slide10Slide11Neonatal Cholestasis?
Wilson’s Disease
Glycogen Storage Disease
Slide12Systemic
Cystic Fibrosis
Sepsis
UTIDrugs
Slide13Endocrine
Hypothyroid
Hypopitutarism
Slide14Slide15Early Diagnosis?
Biliary
atresiaSepsisHypothyroidMetabolic diseaseGalactosemia
Slide16Slide17Slide18