A 4-Week-Old Male Newborn Is Brought to the Physician Because

A 4-week-old male newborn is brought to the physician because of increasing yellowing of his eyes and skin for 2 weeks. The mother has noticed that his urine has appeared dark yellow, and he has had a few pale-colored stools.  . The boy has been exclusively breastfeeding every 2-3 hours and is making 6 or 7 wet diapers a day. The patient was delivered vaginally at 39 weeks' gestation to a healthy woman without any complications. Vital signs are within normal limits. He is at the 50th percentile for length and at the 65th percentile for weight. Abdominal examination reveals a mildly enlarged and firm liver.  Liver function results are as follows: Which of the following is the most likely mechanism for the patient's presentation?

A) Extrahepatic obstruction of bile ducts
B) Genetic mutation causing reduced glucuronidation
C) Impaired galactose metabolism
D) Increased enterohepatic circulation of bilirubin
E) Maternal antibody-mediated red blood cell destruction

Correct Answer:

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