Commoner causes seen in the ICU

• Pre-hepatic—intravascular haemolysis (e.g. drugs, malaria, haemolytic uraemic syndrome), Gilbert's syndrome.

• Hepatocellular—critical illness, viral (hepatitis A, B, C, Epstein-Barr), alcohol, drugs (e.g. paracetamol, halothane), toxoplasmosis, leptospirosis.

• Cholestatic—critical illness, intrahepatic causes (e.g. drugs such as chlorpromazine, erythromycin and isoniazid, primary biliary cirrhosis), extrahepatic causes (e.g. biliary obstruction by gallstones, neoplasm, pancreatitis).

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