A 20-year-old woman admits herself to the emergency room with a yellow discoloration of the whites of her eyes. She says that she does not drink and that she has not experienced any changes in her stool. Her liver enzyme profile and direct serum bilirubin levels are normal, while total bilirubin is elevated. What is the most likely cause for her jaundice?

Question

Quizplus · Accepted Answer

The elevated total bilirubin with normal direct bilirubin and liver enzymes suggests an increase in unconjugated bilirubin, which is typically due to hemolysis. Rupture of large numbers of red blood cells can result in jaundice in the absence of any liver disease. The capacity of the liver to clear released heme metabolites such as bilirubin is temporarily exceeded. Since the liver will not perform its normal function to conjugate bilirubin before excretion in bile and urine, unconjugated bilirubin backs up in serum. This is the reason for the increase in total bilirubin, while conjugated bilirubin, also called direct bilirubin, is not affected

A 20-Year-Old Woman Admits Herself to the Emergency Room with a Yellow