Conjugated hyperbilirubinemia

1. Neonatal cholestasis

1.1. increased levels of conjugated bilirubin in neonatal period resulting from diminished bile formation and/or excretion

1.2. if infant is jaundiced @ 2 weeks or > , serum total & direct bilirubin should be evaluated!

1.3. Cholestasis

1.3.1. direct bili>1.0 mg/dl if total bili<5.0mg/dl

1.3.2. OR >20% of T bili >5.0 mg/dl

1.3.3. Important: remember it is elevated DIRECT bilirubin

1.4. Etiologies

1.4.1. Extrahepatic Obstruction

1.4.1.1. biliary atresia

1.4.1.1.1. clinical features:

1.4.1.1.2. Diagnosis of B.A.

1.4.1.1.3. Surgical management; Kasai Procedure

1.4.1.2. viral, toxins, genetic, immunologic

1.4.2. Infection

1.4.3. TPN in NICU pts

1.4.4. Metabolic/Genetic disorders

1.4.5. Endocrince

1.4.6. Toxic exposures

1.4.7. Intrahepatic causes

1.4.8. others