Differential Diagnosis for Waxing and Waning Jaundice

• Single most likely diagnosis
  • Viral Hepatitis: This is the most common cause of waxing and waning jaundice due to its fluctuating nature of liver inflammation and recovery.
• Other Likely diagnoses
  • Alcoholic Liver Disease: Repeated episodes of heavy drinking can lead to fluctuating liver function and jaundice.
  • Autoimmune Hepatitis: This condition can cause fluctuating liver enzymes and jaundice due to the immune system's periodic attacks on the liver.
  • Hemolytic Anemias (e.g., Gilbert's syndrome): These conditions can cause intermittent jaundice due to fluctuations in hemolysis and bilirubin production.
• Do Not Miss diagnoses
  • Pancreatic Cancer: Although less common, pancreatic cancer can cause intermittent jaundice due to obstruction of the bile duct, and missing this diagnosis can be fatal.
  • Cholangiocarcinoma: This rare cancer of the bile duct can cause intermittent jaundice and has a poor prognosis if not diagnosed early.
  • Primary Sclerosing Cholangitis: This condition can cause intermittent jaundice due to inflammation and scarring of the bile ducts, and missing this diagnosis can lead to severe complications.
• Rare diagnoses
  • Primary Biliary Cholangitis: An autoimmune disease that causes progressive destruction of the bile ducts, leading to intermittent jaundice.
  • Caroli's Disease: A rare congenital disorder that causes cystic dilatation of the bile ducts, leading to intermittent jaundice and recurrent cholangitis.
  • Byler's Disease: A rare genetic disorder that causes chronic and intermittent jaundice due to a defect in bile salt transport.