NEONATAL JAUNDICE: Approach To Direct Hyperbilirubinemia

Neonatal Jaundice Check bilirubin (If >2 weeks, check total AND direct) <20% Direct Indirect (Unconjugated) Hyperbilirubinemia → See: Neonatal Jaundice: Approach to Indirect Hyperbilirubinemia >20% Direct Direct (Conjugated) Hyperbilirubinemia Direct hyperbilirubinemia is NEVER normal and requires further workup Hepatic Causes Infectious: TORCH, hepatitis virus, bacterial sepsis, UTI Genetic: Cystic fibrosis, Alagille syndrome Metabolic: Inborn errors of metabolism, alpha-1-antitrypsin deficiency Endocrine: Hypothyroid, hypopituitarism Iatrogenic: TPN, other drugs Neoplastic: Hepatoblastoma Post-Hepatic Causes Biliary atresia Other obstructive: Choledochal cyst, mass, intestinal obstruction