II. Lab: Normal

  1. <0.2 mg/dl

III. Causes: Increased Conjugated Bilirubin in Adults

  1. Intrahepatic Causes
    1. Viral Hepatitis (Hepatitis A, Hepatitis B, Hepatitis C)
    2. Alcoholic Liver Disease (e.g. Alcoholic Hepatitis, Alcoholic Cirrhosis)
    3. Nonalcoholic Steatohepatitis (NASH)
    4. Wilson Disease
    5. Hemochromatosis
    6. Ischemic Hepatitis
    7. Hepatocellular Carcinoma
    8. Drug induced cholestasis
    9. Prolonged Total Parenteral Nutrition
    10. Sarcoidosis
    11. Pregnancy
    12. Primary Biliary Cirrhosis
    13. Primary Sclerosing Cholangitis
    14. Sepsis
  2. Extrahepatic Causes (esp. Biliary Tract Obstruction)
    1. Choledocolithiasis
    2. Biliary stricture
    3. Biliary atresia
    4. Cholelithiasis
    5. Cholangitis
    6. Chronic Pancreatitis
    7. Cryptosporidium infection (Immunocompromised patient)
    8. HIV Infection
    9. Cytomegalovirus infection
    10. Cholangiocarcinoma
    11. Pancreatic Cancer
    12. Lymphoma
    13. Post-operative changes (Whipple Procedure, Billroth Procedure)

IV. Causes: Increased Conjugated Bilirubin in Neonatal Patients

  1. Sepsis
  2. Intrauterine Viral Infections
  3. Neonatal hepatitis
  4. Intrahepatic and extrahepatic biliary atresia
  5. Biliary tract obstruction
    1. Choledochal cyst
    2. Abdominal mass
    3. Annular Pancreas
  6. Trisomy 18
  7. Galactosemia
  8. Tyrosinemia
  9. Hereditary
    1. Dubin-Johnson Syndrome
    2. Rotor's syndrome
  10. Hypermethioninemia
  11. Alpha-1 antitrypsin deficiency
  12. Cystic Fibrosis
  13. Following Hemolytic Disease of the Newborn syndrome
    1. Inspissated bile
  14. Hypopituitarism
  15. Hypothyroidism

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Ontology: Jaundice, Obstructive (C0022354)

Definition (MSH) Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS.
Definition (NCI) A finding indicating increased bilirubin levels in the blood and urine, due to intrahepatic or extrahepatic obstruction of the biliary system.
Concepts Disease or Syndrome (T047)
MSH D041781
SnomedCT 197452009, 266545005, 155832005, 59848001, 44018007
English JAUNDICE CHOLESTATIC, Obstructive jaundice NOS, Jaundice cholestatic, Jaundice, Obstructive [Disease/Finding], cholestatic icterus, cholestatic jaundice, Jaundice;obstructive, jaundice cholestatic, jaundice obstructive, obstructive jaundice, Cholestatic icterus, Jaundice, Obstructive, Obstructive jaundice NOS (disorder), Jaundice, Cholestatic, Jaundice, Mechanical, Mechanical Jaundice, Obstructive hyperbilirubinemia, Cholestatic jaundice syndrome, Obstructive jaundice, Cholestatic jaundice, Cholestatic jaundice syndrome (disorder), Obstructive hyperbilirubinaemia, Obstructive hyperbilirubinemia (disorder), jaundice; obstructive, jaundice; regurgitation, obstructive; jaundice, regurgitation; jaundice, Cholestatic jaundice syndrome, NOS, Cholestatic jaundice, NOS, Obstructive Jaundice, Cholestatic Jaundice
Portuguese ICTERICIA COLESTATICA, Icterícia obstrutiva, Icterícia colestática, Icterícia Colestática, Icterícia Mecânica, Icterícia Obstrutiva
Spanish ICTERICIA COLESTATICA, Ictericia obstructiva, Icterus colestático, ictericia obstructiva, SAI, ictericia obstructiva, SAI (trastorno), hiperbilirrubinemia obstructiva (trastorno), hiperbilirrubinemia obstructiva, ictericia colestásica, ictericia obstructiva, síndrome de ictericia colestásica (trastorno), síndrome de ictericia colestásica, Ictericia colestática, Ictericia Colestática, Ictericia Mecánica, Ictericia Obstructiva
Dutch cholestatische icterus, cholestatische geelzucht, obstructieve geelzucht, geelzucht; obstructief, geelzucht; regurgitatie, obstructief; geelzucht, regurgitatie; geelzucht, geelzucht cholestatisch, Geelzucht, cholestatische, Geelzucht, obstructieve, Icterus, obstructieve, Obstructieve icterus, Stuwingsicterus, mechanische
French Ictère obstructif, ICTERE CHOLOSTATIQUE, Ictère cholestatique, Ictère cholostatique, Ictère mécanique, Ictère rétentionnel
German cholestatischer Ikterus, cholestatische Gelbsucht, obstruktive Gelbsucht, GELBSUCHT CHOLESTATISCH, Gelbsucht cholestatisch, Ikterus, mechanischer, Ikterus, obstruktiver, Verschlußikterus
Swedish Obstruktionsikterus
Japanese タンジュウウッタイセイオウダン, ヘイソクセイオウダン, 黄疸-機械的, 胆汁うっ滞性黄疸, 機械的黄疸, 黄疸-胆汁うっ滞性, 閉塞性黄疸, うっ滞性黄疸, 黄疸-閉塞性
Czech žloutenka obstrukční, žloutenka cholestatická, Cholestatický ikterus, Mechanický ikterus, Obstrukční ikterus
Finnish Obstruktiivinen ikterus
Italian Ittero colestatico, Ittero meccanico, Ittero ostruttivo
Polish Żółtaczka mechaniczna
Hungarian Elzáródásos sárgaság, Cholestatikus icterus, Epepangásos sárgaság, Epepangásos icterus
Norwegian Mekanisk ikterus, Mekanisk icterus, Okklusjonsicterus, Staseicterus, Okklusjonsikterus, Staseikterus

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Definition (NCI_CDISC) A measurement of the conjugated or water-soluble bilirubin in a biological specimen.
Definition (NCI) The bilirubin is bound to glucuronide to form conjugated bilirubin (direct bilirubin). Direct Bilirubin measurement is accomplished by a colorimetric method. Direct Bilirubin in biological fluids reacts with sulfanilic acid at acidic pH to produce a red colored complex. The optical density of produced color has a direct relationship with Direct Bilirubin concentration in the solution.
Concepts Laboratory Procedure (T059)
SnomedCT 39748002
CPT 80076, 82248
English Direct Bilirubin Measurement, Bilirubin, direct measurement, Bilirubin, conjugated measurement, Bilirubin, conjugated measurement, serum, Measurement of direct bilirubin, Direct Bilirubin, BILDIR, Bilirubin, direct measurement (procedure)
Spanish medición de bilirrubina directa (procedimiento), medición directa de bilirrubina, medición conjugada de bilirrubina, medición de bilirrubina conjugada, medición directa de bilirrubina (procedimiento), medición de bilirrubina directa

Ontology: Conjugated hyperbilirubinemia (C0268307)

Concepts Disease or Syndrome (T047)
SnomedCT 9326001
English conjugated hyperbilirubinemia, Hyperbilirubinemia, conjugated, Conjugated hyperbilirubinaemia, Conjugated hyperbilirubinemia, Conjugated hyperbilirubinemia (disorder), Conjugated hyperbilirubinemia, NOS
Spanish hiperbilirrubinemia conjugada (trastorno), hiperbilirrubinemia conjugada, hiperbilirrubinemia directa