Differential Diagnosis for High Bilirubin
Single Most Likely Diagnosis
- Viral Hepatitis: This is often the most common cause of elevated bilirubin levels, especially in adults, due to its prevalence and the liver's central role in bilirubin processing. Viral hepatitis can cause inflammation of the liver, leading to impaired bilirubin conjugation and excretion.
Other Likely Diagnoses
- Alcoholic Liver Disease: Chronic alcohol consumption can lead to liver damage, including alcoholic hepatitis and cirrhosis, which can result in elevated bilirubin levels due to decreased liver function.
- Gallstones: Obstruction of the bile ducts by gallstones can prevent bilirubin from being excreted into the intestine, leading to its buildup in the blood.
- Drug-Induced Liver Injury: Certain medications can cause liver damage, affecting its ability to process bilirubin.
- Hemolytic Anemia: Conditions that lead to the breakdown of red blood cells can increase the amount of bilirubin produced, overwhelming the liver's ability to conjugate and excrete it.
Do Not Miss Diagnoses
- Biliary Atresia (in infants): A condition where the bile ducts are absent or blocked, leading to severe jaundice. Early diagnosis is crucial for treatment.
- Pancreatic Cancer: Obstruction of the bile duct by a pancreatic tumor can cause jaundice. Although less common, missing this diagnosis can have severe consequences.
- Sepsis: In severe infections, liver function can be impaired, leading to elevated bilirubin levels. Sepsis is a medical emergency.
Rare Diagnoses
- Dubin-Johnson Syndrome: A rare genetic disorder characterized by chronic jaundice due to an inability to secrete conjugated bilirubin into the bile.
- Crigler-Najjar Syndrome: A rare condition where there is a deficiency of the enzyme responsible for converting unconjugated bilirubin to its conjugated form, leading to very high levels of unconjugated bilirubin.
- Primary Biliary Cholangitis: An autoimmune disease of the liver that leads to progressive destruction of the bile ducts, resulting in elevated bilirubin levels.
- Primary Sclerosing Cholangitis: A disease that leads to scarring and narrowing of the bile ducts, which can cause obstructive jaundice.