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Differential Diagnosis for a 17-year-old with Yellow Sclera

Single Most Likely Diagnosis

  • Viral Hepatitis: This is a common cause of jaundice (yellowing of the skin and sclera) in adolescents, often resulting from hepatitis A, B, or C infection. The justification for this being the most likely diagnosis is the age of the patient and the presentation of jaundice, which is a hallmark symptom of hepatitis.

Other Likely Diagnoses

  • Gilbert Syndrome: A benign condition that affects the liver's ability to process bilirubin, leading to intermittent jaundice. It's more common in males and often becomes apparent during adolescence.
  • Choledochal Cysts: Congenital anomalies of the bile duct that can cause obstructive jaundice. While less common, they are a significant consideration in adolescents presenting with jaundice.
  • Hemolytic Anemias: Conditions like sickle cell disease or autoimmune hemolytic anemia can lead to increased bilirubin production due to red blood cell breakdown, resulting in jaundice.

Do Not Miss Diagnoses

  • Pancreatic Cancer: Although extremely rare in adolescents, any cause of obstructive jaundice needs to be thoroughly investigated, including the possibility of pancreatic cancer.
  • Budd-Chiari Syndrome: A condition characterized by thrombosis of the hepatic veins, leading to liver dysfunction and jaundice. It's crucial to diagnose due to its potential for severe complications.
  • Wilson's Disease: An inherited disorder that causes copper accumulation in the liver, leading to liver damage and potentially jaundice. Early diagnosis is critical for effective management.

Rare Diagnoses

  • Dubin-Johnson Syndrome: A rare genetic disorder affecting the liver's ability to transport bilirubin, leading to chronic jaundice.
  • Crigler-Najjar Syndrome: A rare congenital condition characterized by a severe deficiency of the enzyme responsible for converting bilirubin into a water-soluble form, resulting in severe jaundice.
  • Primary Sclerosing Cholangitis (PSC): A chronic liver disease that leads to scarring and narrowing of the bile ducts, potentially causing jaundice. It's rare in adolescents but can be associated with inflammatory bowel disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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