Cholestatic jaundice is associated with all of the following, except:

Clinical features comprise those due to cholestasis itself, those due to secondary infection (cholangitis) and those of the underlying condition. Obstruction of the bile duct drainage due to blockage of the extrahepatic biliary tree is characteristically associated with pale stools and dark urine.     Pruritus may be a dominant feature and can be accompanied by skin excoriations. Peripheral stigmata of chronic liver disease are absent. If the gallbladder is palpable, the jaundice is unlikely to be caused by biliary obstruction due to gallstones, probably because a chronically inflamed, stone-containing gallbladder cannot readily dilate. This is Courvoisier’s Law, and suggests that jaundice is due to a malignant biliary obstruction (e.g. pancreatic cancer). Cholangitis is characterised by ‘Charcot’s triad’ of jaundice, right upper quadrant pain and fever. Cholestatic jaundice is characterised by a relatively greater elevation of ALP and GGT than the aminotransferases.     Key Concept: Cholestatic jaundice is associated with predominantly conjugated hyperbilirubinemia. There is minimal biochemical changes in parenchymal liver damage.