Newborn- Direct Hyperbilirubinemia

Ryan Flaherty, DO, Samantha DeMarsh, DO, and Elizabeth Grogan, MD

Today we’ll be covering Direct Hyperbilirubinemia, going along with this month’s theme, Newborn Medicine. If you haven’t listened to our podcast before, each week we have a case-based discussion about a medical topic to help you study for the pediatric medicine board exam. Episodes are released every weekend, and the case is then reviewed and reinforced on social media throughout the week.

 

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Today’s Case:

 

A four week old infant is brought into your primary care office.  She was born at 39w6d via uncomplicated home delivery and missed her newborn appointment.  Mom received appropriate prenatal care, and the pregnancy was uncomplicated.  The child’s birth weight was appropriate for age.  She has been breast feeding well and has continued to gain weight along the 30th percentile.  She has had no fevers or other signs of illness. On exam the child is markedly jaundiced with prominent icteric sclera.  You note that she has a firm, palpable liver edge.  She has no dysmorphic features or murmurs on exam.  She has a stool in the office which is a pasty white color.  You check a total serum bilirubin which is notable for direct hyperbilirubinemia.  You also obtain an abdominal ultrasound, which is notable for a triangular fibrous mass at the porta hepatis.  What is the most likely diagnosis?  

 

Choledochal cyst 

Physiologic jaundice

Alagille syndrome

Biliary atresia

Galactosemia

 

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This podcast is intended for healthcare professionals. The information presented is for general educational purposes only and should NOT be used as professional medical advice or for the diagnosis or treatment of medical conditions.

 

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