Differential Diagnosis for High Bilirubin in a Teenager
Single Most Likely Diagnosis
- Gilbert's Syndrome: A benign condition characterized by a mild increase in unconjugated bilirubin levels, often exacerbated by stress, fasting, or illness. It's the most common cause of elevated bilirubin in adolescents and young adults.
Other Likely Diagnoses
- Viral Hepatitis: Infections such as hepatitis A, B, or C can cause elevated bilirubin levels due to liver inflammation. The presentation may include jaundice, fatigue, and abdominal pain.
- Hemolytic Anemia: Conditions like autoimmune hemolytic anemia or hereditary spherocytosis can lead to increased bilirubin production due to red blood cell breakdown.
- Choledocholithiasis: Gallstones can obstruct the bile duct, causing a buildup of conjugated bilirubin and leading to jaundice.
Do Not Miss Diagnoses
- Wilson's Disease: A rare genetic disorder that leads to copper accumulation in the liver, causing liver damage and potentially life-threatening complications if left untreated.
- Alpha-1 Antitrypsin Deficiency: A genetic disorder that can cause liver disease and lung disease, often presenting with elevated liver enzymes and bilirubin levels.
- Budd-Chiari Syndrome: A rare condition characterized by hepatic vein thrombosis, which can cause liver dysfunction, ascites, and potentially life-threatening complications.
Rare Diagnoses
- Dubin-Johnson Syndrome: A rare genetic disorder that affects the transport of conjugated bilirubin, leading to chronic jaundice.
- Rotor Syndrome: A rare, benign condition similar to Dubin-Johnson syndrome, characterized by elevated conjugated bilirubin levels.
- Crigler-Najjar Syndrome: A rare genetic disorder that affects the metabolism of bilirubin, leading to severe unconjugated hyperbilirubinemia.
- Porphyrias: A group of rare genetic disorders that can cause elevated bilirubin levels, abdominal pain, and neurological symptoms.