Jaundice classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Fatima Shaukat, MD [2]

## Overview[edit | edit source]

Jaundice is classified in two categories including unconjugated hyperbilirubinemia and conjugated hyperbilirubinema. Unconjugated hypebilirubinemia can be caused by either increased production, reduced reuptake or defects in conjugation of bilirubin. While conjugated hyperbilirubinemia is further classified into obstruction of biliary tract, interahepatic cholestasis, injury to hepatocellular parenchyma, and defects of hepatocellular canalicular excretion or re-uptake in sinusoids.

## Classification[edit | edit source]

Jaundice is classified into two subtypes:[1][2][3][4]

* Conjugated hyperbilirubinemia
* Unconjugated hyperbilirubinemia

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| Jaundice classification|

| Predominately conjugated hyperbilirubenemia|

| Mixed conjugated and unconjugated hyperbilirubinemia|

| Predominately unconjugated hyperbilirubinemia|

Obstruction of biliary tract|

| Intra-hepatic cholestasis|

| Injury to hepatocellular parenchyma|

| Defects of hepatocellular
canalicular excretion or re-uptake
in sinusoids|

| Increased production|

| Reduced uptake|

| Defects in conjugation|

| Acquired|

| Inherited|

| • Cholangiocarcinoma
• Pancreatic cancer
• Gallbladder cancer
• Ampullary cancer
• Choledocholithiasis
• Choledocholithiasis
•Postoperative biliary strictures
•Primary sclerosing cholangitis
• Chronic pancreatitis
• AIDS cholangiopathy
• Parasitic disease ascariasis|

| • Primary biliary cholangitis
•Primary sclerosing cholangitis
• Viral hepatitis (ocassionally)
• Progressive familial intrahepatic cholestasis
• Intrahepatic Cholestasis of Pregnancy
•Corticosteroids|

| Infiltrative liver disorders like
• Hemochromatosis
•Amyloidosis|

| • Dubin-Johnson syndrome
• Rotor syndrome|

| • Wilson's disease
•Viral hepatitis
•Alcoholic hepatitis
• Drug toxicity
• Autoimmune hepatitis|

• Hemolysis
• Hereditary spherocytosis
• G6PD deficiency
• Thalassemia
• Paroxysmal nocturnal hemoglobinuria
• Immune hemolysis
• Extravasation
• Shunt hyperbilirubinemia|

| • Portosystemic shunts
• Drugs
• Gilbert syndrome (some cases)|

• Neonatal
• Maternal milk
• Lucy-Driscoll
•Hyperthyroidism
• Chronic persitent hepatitis
• Advanced cirrhosis|

| • Crigler-Najjar syndrome l
• Crigler-Najjar syndrome II
• Gilbert syndrome

## References[edit | edit source]

1. ↑ VanWagner LB, Green RM (2015). "Evaluating elevated bilirubin levels in asymptomatic adults". JAMA. 313 (5): 516–7. doi:10.1001/jama.2014.12835. PMC 4424929. PMID 25647209.
2. ↑ Gadia CLB, Manirakiza A, Tekpa G, Konamna X, Vickos U, Nakoune E (2017). "Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: a retrospective assessment, 2008-2010". BMC Infect Dis. 17 (1): 735. doi:10.1186/s12879-017-2840-8. PMC 5707826. PMID 29187150.CS1 maint: Multiple names: authors list (link)
3. ↑ Kremer M (1940). "The Classification of Jaundice: With details of some of the causes of this condition". Postgrad Med J. 16 (171): 11–7. PMC 2476810. PMID 21313179.
4. ↑ Kasper, Dennis (2015). Harrison's principles of internal medicine. New York: McGraw Hill Education. ISBN 978-0-07-180215-4.

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