Problematic Issues of Differential Diagnosis of Jaundice in Children. Case Studies (Clinical Lecture)
Depending on the level, at which bilirubin metabolism disorders occur, the following types of jaundice are identified: hemolytic, hepatocellular, obstructive. Hemolytic jaundice is characterized by increased levels of indirect bilirubin in the blood at a normal activity of liver cell enzymes, in parallel there is a reduction in hemoglobin, red blood cells levels and high reticulocytosis in the blood. A typical laboratory sign of hepatocellular jaundice is elevated level of total bilirubin due to the direct one and increased activity of hepatocellular enzymes. Obstructive jaundice occurs in violation of the bile outflow from the gallbladder and bile ducts into the lumen of the small intestine.
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