Jaundice in Child

Unconjugated hyperbilirubinaemia 

Conjugated hyperbilirubinaemia 

History 

Investigations

Unconjugated hyperbilirubinaemia 

1. Haemolysis 
   • Drugs 
   • Infections Hepititis A, HUS 
   • Congenital red cell membrane defects Spherocytosis 
   • Congenital red cell enzyme defects G6PD 
2. Hereditary enzyme deficiencies Gilberts, Criggler-Najjar 
3. Neonatal causes see separate guidelines 

Conjugated hyperbilirubinaemia 

• Hepatocellular disease - Hepatitis, Wilson’s, α1 Anti trypsin 
• Extrahepatic biliary obstruction - Gallstones, Biliary atresia, choledochal cyst 
• Intrahepatic biliary hypoplasia - Alagille syndrome 
• Enzyme deficiencies - Rotor, Dubin-Johnson 
• Systemic diseases - Sepsis, Right heart failure 
• Neonatal causes - See separate guidelines 

History 

• Family history 
• Preceding symptoms or illness 
• Is the substance of the stool pale? 

Investigations 

• FBC, retics, smear, coombs, coagulation screen 
• Liver function tests including total & conj bili, albumin, globulin, liver enzymes 
• Hepatitis virus serology 
• Urine dipstix ± MC & S 
• Abdominal ultrasound 
• Specific tests for rarer diseases if suspected