Differential Diagnosis for Hyperbilirubinemia in Adults
Single Most Likely Diagnosis
- Viral Hepatitis: This is often the most common cause of hyperbilirubinemia in adults, particularly due to hepatitis A, B, and C viruses, which can cause liver inflammation leading to elevated bilirubin levels.
Other Likely Diagnoses
- Alcoholic Liver Disease: Chronic alcohol consumption can lead to liver damage, including alcoholic hepatitis and cirrhosis, which can result in hyperbilirubinemia.
- Drug-Induced Liver Injury: Various medications and drugs can cause liver injury, leading to elevated bilirubin levels.
- Gallstones: Obstruction of the bile ducts by gallstones can cause conjugated hyperbilirubinemia.
- Hemolytic Anemia: Conditions that lead to increased red blood cell destruction, such as autoimmune hemolytic anemia, can result in elevated levels of indirect (unconjugated) bilirubin.
Do Not Miss Diagnoses
- Budd-Chiari Syndrome: A rare condition caused by thrombosis of the hepatic veins, which can lead to liver failure and is potentially life-threatening if not promptly diagnosed and treated.
- Wilson's Disease: A genetic disorder that leads to copper accumulation in the liver, causing liver damage and potentially life-threatening if not recognized and managed appropriately.
- Acute Liver Failure: Conditions such as acetaminophen overdose, ischemic hepatitis, or severe viral hepatitis can lead to rapid deterioration of liver function, requiring urgent medical attention.
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: A benign condition similar to Dubin-Johnson syndrome but without liver discoloration, causing a mild increase in conjugated bilirubin.
- Crigler-Najjar Syndrome: A rare congenital disorder affecting the enzyme responsible for converting unconjugated bilirubin to conjugated bilirubin, leading to very high levels of unconjugated bilirubin.
- Primary Biliary Cholangitis (PBC): An autoimmune disease of the liver characterized by a progressive destruction of the bile ducts within the liver, leading to cholestasis and potentially cirrhosis.
- Primary Sclerosing Cholangitis (PSC): A chronic liver disease characterized by inflammation and scarring of the bile ducts, which can lead to liver failure.