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A 66-year-old female has been referred by her GP for evaluation of…
A 66-year-old female has been referred by her GP for evaluation of jaundice of about 6 weeks duration.
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intrahepatic
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Dubin-johnson syndrome
rare, autosomal recessive, benign disorder that causes an isolated increase of conjugated bilirubin in the serum
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Impaired biliary excretion of bilirubin glucuronides is due to a mutation in the canalicular multiple drug-resistance protein 2 (MRP2). A darkly pigmented liver is due to polymerized epinephrine metabolites, not bilirubin.[3]
Rotor's syndome
rare, relatively benign autosomal recessive[2] bilirubin disorder. It is a distinct, yet similar disorder to Dubin–Johnson syndrome[1] — both diseases cause an increase in conjugated bilirubin.
liver cells are not pigmented. The main symptom is a non-itching jaundice. There is a rise in bilirubin in the patient's serum, mainly of the conjugated type.
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Acute - which is frequently caused by infection, may seek medical care because of fever, chills, abdominal pain, and flu-like symptoms.
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PE
bruising, spider angiomas, gynecomastia, testicular atrophy, and palmar erythema. An abdominal examination to assess liver size and tenderness is important. The presence or absence of ascites also should be noted.
Investigations
Serum testing
CBC, LFT for infectious hepatitis.
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