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Neonatal Jaundice
Secondary to Unconjugated Hyperbilirubinemia |
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Overproduction of bilirubin |
Psora/Sycosis |
thuj. sulph. nit-ac.
calc. lyc. nat-m. sil. ars. caust. ferr. |
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1. Increased rate of hemolysis (reticulocyte count
elevated) |
Syphilis |
apis. arg-nit. Lach.
crot-h. cad-m. kali-c. am-c. kali-chl. Phos. ac- sal.
pl-m. crot-h. latr-m. |
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a. Patients with a positive Coombs test |
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ABO blood group
incompatibility |
Psora |
Causa occasionalis |
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Rh incompatibility |
Psora |
Causa occasionalis |
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Other blood group sensitizations |
Psora |
Causa occasionalis |
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b. Patients with a negative Coombs test |
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Abnormal red cell shapes |
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Spherocytosis- the
best known inherited membrane abnormality leading to
a reduced red cell lifespan and sometimes severe
anaemia. Inheritance is usually autosomal dominant,
and there is often a positive family history. |
Psora/Syphilis |
ARS. Bry. calc.
card-m. Cham. chel. chin. chion. chol. cupr. dig.
eberth. gels. Hydr. jug-c. lach. Lept. lith-c. lob.
lyc. mag-p. MERC. myric. nat-s. nux-v. Phos. podo.
ptel. sang. sulph. tarax. thlas. verat.
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Elliptocytosis |
Psora/Syphilis |
Acetanilidum.
cortisonum. Kali-c. Sulfanilamidum. |
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Pyknocytosis |
Sycosis |
Adren. Coffea. latr-m. |
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Stomatocytosis |
Syphilis |
apis. arg-nit. Lach.
crot-h. cad-m. kali-c. am-c. kali-chl. Phos. ac- sal.
pl-m. crot-h. latr-m. |
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Red cell enzyme abnormalities |
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Glucose-6-phosphate dehydrogenase deficiency |
Psora |
chin. iod. ars. calc. con. ferr. ign. lach. nat-m.
nit-ac. |
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Pyruvate kinase
deficiency |
Psora |
loxo-lae. malar.
loxo-recl. calc-ar. ferr-ar. cedr. ferr-i. chinin-ar.
ars-i. agn. |
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Hexokinase deficiency |
Psora |
agar. agn. ars-i. ars. brom. calc-ar. calc. carb-v.
cedr. chin. |
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Other metabolic defects |
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c. Patients with bacterial or viral sepsis |
Psora/ Syphilis/Sycosis |
bapt. lach. arn. phos.
chin. ars-i. ars. carb-v. crot-h. agar. |
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2. Nonhemolytic causes of increased bilirubin load (reticulocyte
count normal) |
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a. Extravascular hemorrhage |
Psora/Syphilis |
chin. ferr. ars. calc. carb-v. lach. nat-m. nux-v.
phos. sulph. |
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Cephalhematoma |
Psora/ Syphilis/Sycosis |
bar-c. cocc. crot-h. nux-v. hydr-ac. bell. glon. ip.
acon. arn. |
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Extensive bruising |
Psora/Syphilis |
arn. chin. carb-v. |
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Central nervous system hemorrhage |
Psora/Syphilis |
bar-c. cocc. crot-h. nux-v. hydr-ac. bell. glon. ip.
acon. arn. |
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b. Polycythemia |
Psora/Sycosis |
cean. cob-n. cortico.
lach. phos. x-ray |
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c. Exaggerated enterohepatic circulation of
bilirubin- due to decreased life span of RBCs, the
production of bilirubin is increased. |
Psora/Sycosis |
apis. arg-nit. Lach.
crot-h. cad-m. kali-c. am-c. kali-chl. Phos. ac- sal.
pl-m. crot-h. latr-m. |
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Gastrointestinal tract obstruction- may cause
obstructive jaundics. |
Psora/Syphilis |
astac. chin. fel-t.
nux-v. |
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Functional ileus-
is present when either a dynamic dysfunction or even
a paralysis of the intestinal muscles prevent the
passage of food through the intestines. Auscultation
reveals a silent abdomen with missing bowel sounds,
which is why this diagnostic finding is called "Grabesstille". |
Psora/Syphilis |
alum. apoc. bry. con. esin-sal. lyc. mag-m. nux-v.
OP. Phos. PLB. plb-act. pyrog. Rhus-t. samb. Sec.
tab. thuj. visc.
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Decreased rate of conjugation (Unconjugated
bilirubin elevated, reticulocyte count normal) |
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Physiologic jaundice- due to the breakdown of red
blood cells (which release bilirubin into the blood)
and to the immaturity of the newborn's liver (which
cannot effectively metabolize the bilirubin and
prepare it for excretion into the urine). |
Psora |
Bell. bry. chin. Lyc. Merc-cor. Merc-sol. Naphth.
Nat-phos. Phos. Sec-cor. Sulph- ac. |
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Crigler-Najjar
syndrome- a rare disorder of bilirubin metabolism
caused by a deficiency of hepatic UDP glucuronyl
transferase, and characterized by high serum levels
of unconjugated bilirubin that appear in the first
days after birth and continue through life. |
Psora |
Maintaining cause. |
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Type I glucuronyl transferase deficiency, autosomal-recessive |
Psora |
Maintaining cause. |
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Type II glucuronyl transferase deficiency, autosomal-dominant |
Psora |
Maintaining cause. |
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Gilbert syndrome- an autosomal recessive condition,
characterized by intermittent jaundice in the
absence of hemolysis or underlying liver disease.
The hyperbilirubinemia is mild (less than 6 mg/dL).
Considerable daily and seasonal variations are
observed. It may be precipitated by dehydration,
fasting, menstrual periods, or stress, such as an
intercurrent illness or vigorous exercise. |
Psora |
sep. calc. nux-v. sulph. chin. phos. puls. ars. lach.
plb. |
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Hypothyroidism |
Psora/Syphilis |
iod. con. lyc. merc.
nat-m. nux-v. sep. calc-sil. calc. alum. |
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Neonatal Jaundice Secondary
to Unconjugated Hyperbilirubinemia |
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I.
Acute or Chronic Hepatocellular Dysfunction |
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A.
Infection |
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Viral
hepatitis A-E |
Psora/ Sycosis/ Syphilis |
Arn. aur. bell. carc.
Card-m. Corn. crot-h. Lach. lact. LYC. mag-m. nat-c.
Nat-m. NAT-S. Nit-ac. Nux-v. Phos. phyt. podo. Psor. ptel.
ran-s. sel. sil. Sulph. tub. |
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Cytomegalovirus (CMV) hepatitis- mild transient increases
in hepatocellular enzymes may be present, and, rarely,
jaundice may develop. The disease typically has a
favorable prognosis, but death has been reported in
immunosuppressed patients. Pathology typically shows
mononuclear cell infiltration of the portal areas but may
also reveal granulomatous inflammation |
Psora/ Sycosis/ Syphilis |
sil. carb-an. sulph. iod.
kali-c. lyc. bry. nux-v. rhus-t. sep.
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Epstein-Barr virus hepatitis- an acute febrile illness,
spread by saliva transfer; characterized by fever, sore
throat, enlargement of lymph nodes and spleen, and
leukopenia that changes to lymphocytosis of abnormal
monocytes which are collected not only in the lymph nodes
and spleen, but in various other sites, such as the
meninges, brain, and myocardium. Syn: glandular fever,
benign lymphadenosis. |
Psora/ Sycosis |
calen. carc. influ. mur-ac.
ph-ac.
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Sepsis |
Psora/ Syphilis |
Acon. agar. am-c. ant-t.
anthraci. Apis arg-met. arg-n. Arn. ARS. ars-i. arum-t.
atro. Bapt. bell. bor-ac. both. Bry. bufo calc. calc-ar.
calen. camph. Carb-ac. CARB-V. Cench. chin. Chinin-ar.
Chinin-s. colch. CROT-H. ECHI. Elaps. eucal. Ferr. ferr-p.
gels. hell. hep. Hippoz. hydroph. hyos. indol. Ip. irid-met.
kali-bi. kali-br. kali-c. kali-chl. Kali-p. kreos. LACH.
lob-p. Lyc. mag-c. Merc. merc-cy. mur-ac. Naja. Nit-ac.
op. ph-ac. Phos. phyt. Puls. PYROG. rad-br. Rhus-t.
Sal-ac. Sec. sil. skat. staphycoc. stram. streptoc. sul-ac.
sulfonam. Sulph. tarax. tarent. tarent-c. ter. toxo-g. vac.
vario. Verat. Verat-v. vince. Vip. zinc. |
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B.
Inflammation Without Infection |
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Toxic
liver injury |
Psora |
agn. teucr. hydr. bapt.
Aloe. kali-i. sec. op. camph. laur. |
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Drug
toxicity (eg, acetaminophen) |
Psora |
nux-v. sulph. Aloe. bry.
hydr. lach. nit-ac. ph-ac. agar. ars. |
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Halothane hepatitis |
Psora/ Sycosis |
acet-ac. adren. am-caust.
aml-ns. crot-chlol. hep. keroso. nux-v. op. phos. plb. |
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Alcoholic hepatitis |
Psora/ Sycosis |
Med.
Nux- vom. |
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Iron
overload (hemochromatosis) |
Psora |
ars. calc-p. Chin.
chinin-ar. cupr. Hep. iod. ip. merc. nat-m. Puls. Sulph.
Zinc. |
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Copper overload (Wilson disease) |
Psora |
camph. Hep. Ip. lyc. Merc.
nux-v. op. Puls. |
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Autoimmune hepatitis |
Psora/ Syphilis |
carc. crot-h.phos. sulph.
stann. |
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C.
Metabolic Dysfunction |
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Ischemia ("shock liver") |
Psora |
carc. crot-h. phos. stann.
sulph. |
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Acute
fatty liver of pregnancy |
Psora |
crot-h. phos. sil. ther. |
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Alpha-1 antitrypsin deficiency |
Psora |
vanad. uran-n.
ther. crot-h. phos. pneu. grin. morg-p. lac-d. |
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Preeclampsia |
Psora |
plat.
hyos. ign. bell. cic. cocc. cham. cupr. gels. op. |
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Reye
syndrome- an acquired encephalopathy of young children
that follows an acute febrile illness; characterized by
recurrent vomiting, agitation, and lethargy, which may
lead to coma with intracranial hypertension; ammonia and
serum transaminases are elevated; death may result from
edema of the brain and resulting cerebral herniation. |
Psora/ sycosis |
calc-p. hell. ip. gels. abrot. op. iod. cupr. crot-c.
canth. |
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Total
parenteral nutrition |
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Causa occasionalis |
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D.
Inborn Errors of Metabolism |
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Dubin-Johnson syndrome- an
inherited defect in hepatic excretory function
characterized by jaundice with levels of serum bilirubin
up to about 6 mg/dL, over half of which is conjugated, and
excretion of abnormal proportions of coproporphyrin I in
urine. |
Psora |
acon. card-m. chel. iod.
lach. lyc. merc. nat-s. nit-ac. nux-v. |
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Rotor
syndrome- jaundice appearing in childhood due to impaired
biliary excretion; most of the plasma bilirubin is
conjugated, liver function tests are usually normal, and
there is no hepatic pigmentation. |
Psora |
acon. aesc. agar-ph. agar.
agn. Aloe. alum. am-m. ambr. anders. |
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Benign recurrent
cholestasis |
Psora |
sep.
nux-v. lyc. lach. phos. acon. calc. sulph. ars. caust. |
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II.
Diseases that Prevent Flow of Bile into the Intestine |
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A.
Damage to Intrahepatic Bile Ducts or Portal Tracts |
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Primary biliary cirrhosis |
Psora/ Sycosis / Syphilis |
card-m. hydr. iod. phos. calc-ar. chin. lyc. mur-ac. ars-i.
aur-m. |
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Graft-versus-host disease |
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Causa occasionalis |
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Veno-occlusive disease-
Hepatic veno-occlusive disease (VOD) is a common
complication occurring within 20 days of bone marrow
transplantation. |
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Causa occasionalis |
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Sclerosing cholangitis-
Primary sclerosing cholangitis (PSC) is a chronic liver
disease characterized by inflammation, destruction and
fibrosis of the intrahepatic and extrahepatic bile ducts
that leads to cirrhosis of the liver. It is often
complicated by recurrent episodes of bacterial cholangitis.
Patients with PSC also have an increased risk of
cholangiocarcinoma. |
Psora/ Sycosis / Syphilis |
calc-ar.
hydr. mur-ac. card-m. kali-i. iod. aur. plb. Urea. chin. |
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B.
Damage to or Obstruction of Larger Bile Ducts |
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Choledocholithiasis-
presence of a stone in the common bile duct. |
Psora/ Sycosis
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podo. merc-d. card-m. nat-s.
chel. verat. lach. bell. euon-a. chion. |
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Sclerosing cholangitis |
Psora/ Sycosis / Syphilis |
hydr. calc-ar. card-m. iod.
phos. chin. lyc. mur-ac. aur. kali-i. |
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AIDS
cholangiopathy- a syndrome of biliary obstruction
resulting from infection-related strictures of the biliary
tract. |
Psora/ Sycosis / Syphilis |
phos. crot-h. carb-v. med.
acet-ac. am-caust. anan. arg-met. germ-met. tub-r. |
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Hepatic arterial chemotherapy |
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Causa occasionalis |
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Postsurgical strictures |
Psora/ Sycosis
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rhus-t. am-m.
calc. caust. chim. coloc. graph. lyc. med. nat-m. |
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Bile
duct cancers |
Psora/ Sycosis / Syphilis |
card-m. mag-p. mag-s. nat-m. nat-s. phos. |
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Developmental disorders of the bile ducts (eg, Caroli) |
Psora/ Syphilis |
bell.
chel. chin. lach. merc. nux-v. podo. bapt. lept. sulph. |
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Extrinsic compression of the bile duct |
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Causa occasionalis |
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Tumors |
Psora/ Sycosis / Syphilis |
phos. bell. chel. lach.
nat-s. chin. merc. nux-v. podo. sulph. |
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Acute pancreatitis |
Psora |
con.
spong. atro. iod.iris kali-i. merc. achy. atro-s. bar-m. |
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C.
Diffuse Infiltrative Diseases |
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Granulomatous diseases |
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Sarcoidosis
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Psora/ Sycosis/ Syphilis |
ars-i. beryl. mang-s.
tub-m. ars-br. lyc. nat-ar. parathyr. pin-s. puls. |
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Disseminated mycobacterial infections |
Psora/ Syphilis |
agar.
arist-cl. ars. aven. Bac. Bell. beta brom. Calc. calc-f.
CALC-P. calo. carc. chinin-ar. coli. diphtox. dros. elaps
ferr-i. form. formal. hed. Hep. hippoz. Ichth. iod. iodof.
KALI-C. kali-s. kreos. lach. Lachn. lap-a. lec. led. LYC.
med. myrt-c. nat-ar. nat-m. nit-ac. ol-j. Oscilloc. ox-ac.
phel. phos. pneu. psor. PULS. pyrog. sang. senec. Sep. Sil.
spong. Stann. Sulph. Ther. titan. tub. tub-sp. urea v-a-b.
vac. vanad. x-ray zinc. |
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Lymphoma |
Psora/ Sycosis |
ars. ars-i. aur-m. Bar-c.
bar-i. calc. Calc-f. carb-an. carc. cist. con. Iod.
kali-m. mur-ac. nat-m. ph-ac. phos. phyt. rad-br. scroph-n.
sec. sil. syph. Thuj. tub. |
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Wegener granulomatosis- is
characterized by necrotizing granulomas and ulceration of
the upper respiratory tract, with purulent rhinorrhea,
nasal obstruction, and sometimes with otorrhea, hemoptysis,
pulmonary infiltration and cavitation, and fever;
exophthalmos, involvement of the larynx and pharynx, and
glomerulonephritis may occur; the underlying condition is
a vasculitis affecting small vessels, and is possibly due
to an immune disorder. |
Psora/ Syphilis |
Aur. |
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Amyloidosis- the disease
characterized by extracellular accumulation of amyloid in
various organs and tissues of the body; may be local or
generalized; may be primary or secondary. |
Psora/ Sycosis/ Syphilis |
arn. ars. med. vanad.
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Diffuse malignancy |
Psora/ Sycosis/ Syphilis |
alum-sil.
anan. ant-ar. ant-i. arg-met. bell-p. benzq. cadm-act.
cadm-ar. cadm-br. cadm-chl. cadm-chr. cadm-f. cadm-gl.
cadm-i. cadm-m. cadm-met. cadm-n. cadm-o. cadm-s. cadm-sel.
calc-f. con. hydr. kali-tcy. lap-a. oxyg. phos. phyt. scir.
scroph-n. symph. |
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D. Diseases that Interfere
with Biliary Secretion of Bilirubin |
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Drug-induced cholestasis, as with the following: |
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Chlorpromazine |
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Causa occasionalis |
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Erythromycin |
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Causa occasionalis |
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Estrogens |
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Causa occasionalis |
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Anabolic steroids |
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Causa occasionalis |
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Many
others |
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Causa occasionalis |
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