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Pediatrics Miscellaneous 780e3912

Unconjugated hyperbilirubinemia is seen in all EXCEPT

A
Gilberts syndrome
B
Dubin Johnson syndrome
C
Crigler Najjar syndrome
D
Neonatal physiological jaundice
High-Yield Explanation
(B) Dubin Johnson syndrome # Common causes of Raised Bilirubin and Urobilinogen:> Raised conjugated bilirubin (bilirubinuria): Hepatocellular disease and post-hepatic or cholestatic disease (intrahepatic and extrahepatic), including drug toxicity as well as pancreatic causes of obstructive jaundice. Inherited defects in excretion - Eg, Dubin-Johnson syndrome, Rotor's syndrome.> Raised unconjugated bilirubin (no bilirubinuria): Gilbert's syndrome Haemolysis Post viral hepatitis Mild chronic hepatitis Crigler-Najjar syndrome# Physiologic Jaundice (non-pathologic unconjugated hyperbilirubinemia):> Term Infants: 50-60 % of all newborns are jaundiced in the first week of life. Total serum bilirubin peaks at age 3-5 d (later in Asian infants). Mean peak total serum bilirubin is 6 mg/dL (higher in Asian infants).> Preterm Infants: Incidence of visible jaundice is much higher than in term infants. Peak is later (5-7d). Because of increased risk of bilirubin encephalopathy (see below), "physiologic" jaundice is more difficult to define and jaundice should be followed closely.

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