Differential Diagnosis for Elevated Direct Bilirubin
- Single Most Likely Diagnosis
- Cholestasis due to gallstones: This is a common cause of elevated direct bilirubin, as gallstones can obstruct the bile ducts, preventing bilirubin from being excreted into the intestine.
- Other Likely Diagnoses
- Viral hepatitis: Infections such as hepatitis A, B, or C can cause inflammation of the liver, leading to elevated direct bilirubin levels.
- Drug-induced liver injury: Certain medications can cause liver damage, resulting in elevated direct bilirubin.
- Primary biliary cirrhosis: A chronic liver disease characterized by progressive destruction of the bile ducts, leading to elevated direct bilirubin.
- Do Not Miss Diagnoses
- Pancreatic cancer: A tumor in the pancreas can obstruct the bile ducts, causing elevated direct bilirubin. Although less common, missing this diagnosis can be deadly.
- Sclerosing cholangitis: A chronic liver disease characterized by inflammation and scarring of the bile ducts, which can lead to elevated direct bilirubin.
- Rare Diagnoses
- Budd-Chiari syndrome: A rare condition characterized by obstruction of the hepatic veins, leading to elevated direct bilirubin.
- Alagille syndrome: A rare genetic disorder that affects the liver, heart, and other organs, causing elevated direct bilirubin.
- Zellweger spectrum disorders: A group of rare genetic disorders that affect the liver and other organs, leading to elevated direct bilirubin.