Patient's question:
My child, a girl, is 12 years old. During the school enrollment physical examination, it was found that the transaminase level was within the normal range, but the total bilirubin, direct bilirubin, and indirect bilirubin were elevated. Subsequently, an ultrasound examination revealed no abnormalities in the liver or bile ducts, and the tests for hepatitis A, B, and C surface antigens were negative.Doctor's answer:
12-year-old female, elevated bilirubin, normal transaminases. Recommendations: Ultrasound, no issues with hepatitis A, B, or C. Other causes of elevated bilirubin include drug-induced liver injury, such as taking cold medicine or fever-reducing drugs like nimesulide, which may cause liver damage and elevated bilirubin. Diarrhea and excessive fatigue can also lead to abnormal liver function. If the elevated bilirubin is primarily due to increased indirect bilirubin, consider the possibility of hemolytic jaundice. Additionally, congenital disorders of bilirubin metabolism should be ruled out.Based on your medical history, the child was found to have jaundice during a school physical examination and had no prior symptoms. If the bilirubin elevation is mild, you can consider taking Yinzhihuang oral liquid. The medications you mentioned in your records are less effective for jaundice compared to Yinzhihuang. Follow the steps I mentioned to self-exclude possibilities before seeking further medical evaluation at the hospital.