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Further investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Investigations worth considering in the further unravelling of jaundice include, depending on site:

Pre-hepatic jaundice:

  • direct Coomb's test - positive in haemolytic anaemia
  • blood film - abnormal red cells suggest haemolysis
  • reduced haptoglobins in haemolysis
  • bone marrow examination

Hepatic jaundice:

  • viral markers - for hepatitis A, B, C, E; cytomegalovirus
  • Monospot test for Epstein-Barr virus
  • immunological test - antimitochondrial, anti-smooth muscle, and antinuclear antibodies for chronic active hepatitis or primary biliary cirrhosis
  • serum ferritin - increased in alcoholic liver disease, haemochromatosis
  • alpha feto protein - raised in hepatocellular carcinoma
  • caeruloplasmin - reduced in Wilson's disease
  • needle liver biopsy - reserved for the patient who presents diagnostic difficulty

Extra-hepatic jaundice - also, see cholestasis:

  • percutaneous transhepatic cholangiography
  • endoscopic retrograde cholangio-pancreatography
  • needle liver biopsy
  • CT scan abdomen - especially for lesions of head of pancreas

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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