A 2 week old male infant brought to the office by his 28-year old primiparous mother for the evaluation of jaundice that was noticed two days ago. The infant stool has a lighter color. He is exclusively breastfed. The pregnancy was uncomplicated, and prenatal screening tests for TORCH organisms were all negative. The infant was delivered vaginally with no complications. His temp. is 37.2 C, pulse is 140/min, respirations are 50/min, and capillary refill is <2sec. Examination reveals jaundiced skin and mucous membranes. Abdominal palpation reveals hepatomegaly. The initial investigations show the following:
Hb 18.0 g/dl
Hct 52%
Bilirubin total 5mg/dl
Bilirubin Direct 4mg/dl
Blood type O +ve ( The mother blood type B ــ )
Coomb's test Negative
What is the most likely diagnosis?
a) Breast milk jaundice
b) Biliary atresia.
c)Physiologic jaundice.
d) Gilbert syndrome.
e) Crigler- Najjar syndrome.
f) Erythroblastosis fetalis.
