Symptoms of<unk>  can be observed superficially, thus visual methods are used to identify the condition. However, underlying causes of<unk>  must be diagnosed through laboratory testing. Visual assessment In both newborns and adults, yellowing of the skin is a marker for<unk> . As most cases of<unk>  are observed in newborns, healthcare workers use visual methods to identify the presence of this condition. A clinical<unk>  scale, an adapted version of the Kramer's scale, is used to quantify the severity of<unk>  through the spread of skin discoloration from zone 1, the head, to zone 5, the palms and soles of the neonate's body. Cephalocaudal progression of<unk>  to zone 4 and 5 of the Kramer's scale shows a significant positive correlation with serum bilirubin concentration of at least 11.0 mg per 100 ml, indicating the need for treatment.<unk>  Eye Colour Index (JECI) Conjunctival icterus can be quantified by the<unk>  Eye Colour Index (JECI) through digital photography of the sclera, where a JECI of 0 indicates a white colour, and a JECI of 0.1 indicates an intense yellow colour, which is a sign of<unk> . Screening laboratory tests Multiple tests can be used to diagnose<unk> , but results of different parameters must be compared to determine its etiology. +Laboratory tests for<unk>  Method Parameter Results Urinalysis Urobilinogen Increased Bilirubin Absent Colour of urine Normal Stool analysis Colour of faeces Darker than normal Complete blood count Hemoglobin Decreased Schistocytes Present Reticulocytes Increased Serum testing Total serum bilirubin Increased Conjugated bilirubin Normal Unconjugated bilirubin Increased Liver biopsy Alkaline phosphatase Normal Aspartate transaminase (AST) Normal Alanine transaminase (ALT) Normal When a patient shows signs of<unk>  such as the yellowing of the skin and sclera, a urine test is performed to check the levels of urobilinogen present. The presence of urobilinogen and its increased levels indicate that there are more than normal amounts of bilirubin in the intestine, showing that<unk>  observed is not due to the blockage of bile flow, and is of pre-hepatic or hepatic causes. Normal colour of the patient's urine indicates the absence of unconjugated bilirubin. Results from the urine test should be confirmed by a complete blood count (CBC) and serum testing for total serum bilirubin and fractionated bilirubin. Increased reticulocytes and the presence of schistocytes in the blood smear of the patient observed during CBC indicates hemolysis. If the patient has<unk> , serum testing will show that conjugated bilirubin will only account for less than 15% of the total serum bilirubin due to the increase of unconjugated bilirubin. Analysis of liver biopsies will show the levels of alkaline phosphatase, aspartate transaminase, and alanine transaminase in the patient, which has a negative correlation with liver function. Normal levels of these enzymes indicate that there is no significant hepatocellular damage. When an infant is suspected to have<unk> , abnormal morphologies of erythrocytes can be analyzed to find out the causes of hemolysis. A Coomb's test should be performed, and end-tidal carbon monoxide concentration should be monitored to understand the rate of hemolysis in the infant's body. If chronic<unk>  is diagnosed in a newborn, development of anemia and bilirubin cholelithiasis should be monitored as well. Haptoglobin testing If other symptoms of anemia is present, the amount of serum haptoglobin in the patient can be measured to test for hemolysis. During hemolysis, hemoglobin in blood dissociates and forms complexes with haptoglobins in the plasma, which are then catabolized. Low levels of haptoglobin resulting from the test shows that there are large amounts of free hemoglobin in the blood to be bound, acting as an indicator of hemolysis.
Hemolytic jaundice
Steatohepatitis
Hepatic encephalopathy
Albinism
Bilirubinuria
Methanol toxicity
Choroideremia
Congestive hepatopathy