Question:medium
Cause of conjugated hyperbilirubinemia is?
Cause of conjugated hyperbilirubinemia is?
Show Hint
Gilbert, Crigler-Najjar and breast milk jaundice are all unconjugated.
Updated On: Jun 24, 2026
- Rotor syndrome
- Breast milk jaundice
- Crigler-Najjar syndrome
- Gilbert syndrome
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Split the choices by where the metabolic block lies. If bilirubin cannot be conjugated, the result is unconjugated jaundice; if it is conjugated but cannot exit the hepatocyte into bile, the result is conjugated (direct) jaundice.
Step 2: Gilbert and Crigler-Najjar both knock down glucuronyl transferase activity, so the pigment never gets conjugated and accumulates in its unconjugated form. Breast milk jaundice acts the same way functionally, raising unconjugated bilirubin. All three give an indirect pattern and are excluded.
Step 3: Rotor syndrome differs fundamentally. Here conjugation is normal but hepatic storage and canalicular excretion of the already conjugated pigment is faulty, so direct bilirubin spills back into blood.
Step 4: A direct/conjugated rise is therefore the hallmark of Rotor syndrome among these options, alongside Dubin-Johnson syndrome.
\[\boxed{\text{Rotor syndrome}}\]
Step 2: Gilbert and Crigler-Najjar both knock down glucuronyl transferase activity, so the pigment never gets conjugated and accumulates in its unconjugated form. Breast milk jaundice acts the same way functionally, raising unconjugated bilirubin. All three give an indirect pattern and are excluded.
Step 3: Rotor syndrome differs fundamentally. Here conjugation is normal but hepatic storage and canalicular excretion of the already conjugated pigment is faulty, so direct bilirubin spills back into blood.
Step 4: A direct/conjugated rise is therefore the hallmark of Rotor syndrome among these options, alongside Dubin-Johnson syndrome.
\[\boxed{\text{Rotor syndrome}}\]
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