Differential Diagnosis for Yellowing of the Eyes

The yellowing of the eyes, also known as jaundice or icterus, can be caused by a variety of conditions. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Viral Hepatitis: This is often the first consideration due to its prevalence and the fact that hepatitis A, B, and C can all cause jaundice. The liver inflammation leads to an increase in bilirubin levels, which causes the yellowing of the skin and eyes.

• Other Likely Diagnoses

  • Alcoholic Liver Disease: Chronic alcohol consumption can lead to liver damage, including cirrhosis and alcoholic hepatitis, both of which can cause jaundice.
  • Gallstones: Obstruction of the bile ducts by gallstones can prevent bilirubin from leaving the liver, leading to its buildup and jaundice.
  • Pancreatic Cancer: A tumor in the pancreas can block the bile duct, causing jaundice. This condition is more common in older adults.
  • Hemolytic Anemia: Conditions that lead to the breakdown of red blood cells can increase bilirubin levels, as the body breaks down the hemoglobin from these cells.

• Do Not Miss Diagnoses

  • Budd-Chiari Syndrome: A rare condition caused by occlusion of the hepatic veins, which can lead to liver failure and is potentially life-threatening if not promptly treated.
  • Wilson's Disease: A genetic disorder that leads to copper accumulation in the liver, causing liver damage and potentially jaundice. Early diagnosis is crucial for effective treatment.
  • Acute Liver Failure: Conditions such as drug-induced liver injury or viral infections can lead to rapid deterioration of liver function, which 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.
  • Rotor Syndrome: Similar to Dubin-Johnson syndrome, it's a benign condition that causes jaundice due to a problem with the transport of bilirubin.
  • Crigler-Najjar Syndrome: A rare inherited disorder affecting the metabolism of bilirubin, leading to non-hemolytic jaundice.

Each of these conditions has a different underlying cause and requires a distinct approach to diagnosis and treatment. A thorough medical history, physical examination, and diagnostic tests such as liver function tests, imaging studies, and sometimes liver biopsy are essential for determining the cause of jaundice.