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Hepatic Jaundice Due to a Congenital Enzymatic Defect

CLINICAL DIAGNOSTIC MANUAL



Hepatic jaundice due to a congenital enzymatic defect is a condition where the accumulation of bilirubin in the body results from inherited enzymatic defects that affect the liver’s ability to metabolise and excrete bilirubin.


These defects can vary in severity and lead to different levels of hyperbilirubinemia. The two main conditions associated with these enzymatic defects are Gilbert’s syndrome and Crigler-Najjar syndrome.


Pathology

Symptoms and Clinical Signs

Suspected Diagnosis

Confirmatory Diagnosis

Gilbert’s syndrome

Mild and fluctuating jaundice, generally asymptomatic, may worsen with stress, exercise, or fasting

Family history, intermittent jaundice, physical examination

Serum bilirubin levels (elevated unconjugated bilirubin), genetic testing

Crigler-Najjar syndrome

Persistent jaundice from birth, severe jaundice, neurological symptoms in type I, mild to moderate jaundice in type II

Family history, persistent jaundice, physical examination

Serum bilirubin levels, enzymatic activity test, genetic testing


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