Bilirubin Elevation Caused by Naproxen Overdose: A Case Report Highlighting Laboratory Interference

16 October 2023 : Case report USA

Unusual clinical course, Unexpected drug reaction

Olivia Heutlinger^1DEF*, Tobin Mathew^1DEF, Dylann Fujimoto

^1DEF, Vishnu Bharani^1E, Rebecca Yamarik^2DE, Samuel Baz^2E

DOI: 10.12659/AJCR.941267

Am J Case Rep 2023; 24:e941267

Background Case Report Discussion Conclusions References:

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Table 2. Differential diagnosis of indirect hyperbilirubinemia [18].

Mechanism of hyperbilirubinemia	Examples
Intravascular hemolysis	Glucose-6-phosphate dehydrogenase (G6PD) deficiency
	Sickle cell anemia
	Thalassemia
	Hereditary spherocytosis
Extravascular hemolysis	Hematoma breakdown
Extravascular hemolysis	Splenic sequestration crisis
Acquired hemolysis	Autoimmune hemolytic anemia
	Hemolytic-uremic syndrome
	Thrombotic thrombocytopenic purpura
	Infection (malaria, babesiosis)
Drug-induced	Phenytoin
	Probenecid
	Ketoconazole
	Protease inhibitors
	Dapsone
	Quinidine
	Antibiotics (rifampicin, cephalosporins, penicillins, nitrofurantoin)
Genetic disorders	Gilbert syndrome
	Crigler-Najjar syndromes
	Lucy-Driscoll syndrome
Impaired hepatic bilirubin uptake	Congestive heart failure
	Portosystemic shunts
	Chronic liver disease
Miscellaneous	Wilson disease
Miscellaneous	Thyrotoxicosis
^* Typically symptomatic.

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