• Rotor syndrome • Hypopituitarism • Hypothyroidism • Cystic fibrosis • Idiopathic neonatal cholestasis or neonatal hepatitis syndrome • Progressive intrahepatic cholestasis types and (PFIC1, PFIC2) • Alagille syndrome • Benign recurrent intrahepatic cholestasis (BRIC) Obstruction • Biliary atresia • Choledochal cyst • Cholelithiasis • Choledocholithiasis • Cholecystitis • Cholangitis • Primary sclerosing cholangitis • Pancreatic disease • Gallbladder hydrops • Kawasaki disease • Streptococcal infection • Staphylococcal infection • Tumors of the liver and biliary tree HISTORY AND PHYSICAL EXAMINATION The provider interviewing the patient and family with hyperbilirubinemia can often differentiate the cause and severity of the underlying issue with a thorough medical history and physical examination ( Fig 44.1 ) The following questions can help elucidate key points in differentiating the cause of conjugated hyperbilirubinemia: Is this the first episode of jaundice? (to distinguish between an acute event and a chronic process) Are the stools acholic? Is there abdominal pain? If so, does the pain increase with certain foods? (to determine whether biliary obstruction is present) Is fever, fatigue, emesis, or diarrhea present? (to investigate viral causes, including EBV, hepatitis A, and hepatitis B) Is itching present? (sign of bile acids in the skin)