Introduction Hyperbilirubinaemia can be a serious problem and logical evaluation is necessary to identify the significant underlying disorders that may require urgent management.
Method We retrospectively reviewed the causes, investigations, treatment and outcome of jaundice (bilirubin >40 micromol/litre) in children between 8 weeks and 18 years of age over a 5 year period. These children were identified from a biochemistry database. Cases of neonatal jaundice were excluded. We also undertook a questionnaire survey of Consultant Paediatricians in Wales regarding their perception of the common causes of jaundice and investigations which they felt appropriate to aid in management.
Result Of the total 35 patients, only 18 had clinical jaundice and an additional 17 presenting with other medical conditions were found to have biochemical jaundice. While all these children had their liver functions tested, coagulation profile was performed in only 10 (28.5%). Infectious mononucleosis was the commonest cause of clinical jaundice (28%) followed by Gilbert syndrome (22%) and haemolytic anaemia (17%). None of the 35 patients had positive hepatitis A, B or C serology. While most Consultant Paediatricians felt that children with jaundice required full blood count, liver function tests and hepatitis serology, only a small number (10%) felt that coagulation profile was an essential part of the investigation. Hepatitis-A and Gilbert syndrome were perceived to be the commonest causes of jaundice by the respondents.
Conclusion The common causes of jaundice in children are due to benign conditions. Hepatitis A is a rare cause of jaundice contrary to the Paediatricians’ perceptions.