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Abdominal pain could indicate biliary tract obstruction and cirrhosis. [4] Urinalysis serves as a first-line diagnostic tool. Conjugated bilirubin, being water-soluble, is excreted through urine. Hence, dark urine tested bilirubin positive signifies conjugated hyperbilirubinemia. [3] A peripheral blood smear showing signs of haemolysis.
People with GS predominantly have elevated unconjugated bilirubin, while conjugated bilirubin is usually within the normal range or is less than 20% of the total. Levels of bilirubin in GS patients are reported to be from 20 μM to 90 μM (1.2 to 5.3 mg/dl) [ 38 ] compared to the normal amount of < 20 μM.
[64] [58] Symptoms that may indicate liver dysfunction include nausea, vomiting, abdominal pain, fatigue, anorexia, "flu-like" symptoms, dark urine, and jaundice. [64] As of 2022, at least 10 case reports of bicalutamide-associated hepatotoxicity or liver failure, two of which were fatal, have been published in the literature.
Lower left abdominal pain can have many causes, ranging from minor to serious, says Andrew Boxer, M.D., gastroenterologist of Gastroenterology Associates of New Jersey. Common causes include:
C-reactive protein is usually elevated although not commonly measured in the United States. [1] Bilirubin levels are often mildly elevated (1–4 mg/dL). [14] If bilirubin levels are more significantly elevated, alternate or additional diagnoses should be considered such as gallstone blocking the common bile duct (common bile duct stone). [1]
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [3] [6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. [7]
Zieve's syndrome is an acute metabolic condition that can occur during withdrawal from prolonged heavy alcohol use. It is defined by hemolytic anemia (with spur cells and acanthocytes), hyperlipoproteinemia (excessive blood lipoprotein), jaundice (elevation of unconjugated bilirubin), and abdominal pain. [1]
Though 40-50% of patients are asymptomatic, commonly reported symptoms include abdominal pain in the right upper quadrant, pruritus, jaundice, fatigue, and fever. [39] [40] The most common signs are hepatomegaly and splenomegaly. [39] Prolonged cholestasis in PSC may cause fat-soluble vitamin deficiency leading to osteoporosis [39]