Unconjugated hyperbilirubinemia is seen in: (A) Rotor syndrome, (B) Dubin-Johnson syndrome, (C) Gilbe syndrome, (D) Bile duct obstruction
Answer is C. Classification of jaundice A. Predominantly unconjugated hyperbilirubinemia 1. increased production of bilirubin Hemolytic anemias Resorption of blood from intestinal hemorrhages(eg: gi bleeding, hematomas) Ineffective erythropoiesis 2. Reduced hepatic intake Drug that interfere with the membrane carrier systems Diffuse liver disease ( hepatitis, cirrhosis) Some cases of Gilbe syndrome 3. Impaired bilirubin conjugation Physiological jaundice of the new born Crigler-Najjar syndrome types I and II Gilbe syndrome Diffuse liver disease ( hepatitis, cirrhosis) B. Predominantly conjugated hyperbilirubinemia 1. Decreased hepatocellular excretion Deficiency of canalicular membrane transpoers - Dubin- Johnson syndrome - Rotor syndrome Liver damage or toxicity 2. Impaired intra/extra hepatic bile flow Inflammatory destruction of bile ducts( eg: primary biliary cirrhosis) Gallstones Carcinoma of pancreas GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.429