Low serum albumin, or irregular coagulation not giving an answer to supplement K, indicates liver synthetic failure.. A kid with jaundice: is that one for the family doctor? An important basic principle in childhood liver disease is that some disorders are curable if diagnosed and treated early but can result in end-stage liver disease if missed. The first step is certainly to determine if the jaundice is because of haematological or hepatobiliary disorders, i.e. Unconjugated or conjugated hyperbilirubinaemia. Childhood liver disease leading to jaundice can be because of either acute liver damage or an severe exacerbation or decompensation of chronic hepatobiliary disease.Petersen-Jones, D.Veterinarian.Med., Ph.D., Michel Michaelides, M.D., F.R.C.Ophth., L. Ingeborgh van den Born, M.D., Ph.D., Andrew Stockman, Ph.D., Alexander J. Smith, Ph.D., Gary Rubin, Ph.D., and Robin R. Ali, Ph.D. The encoded retinoid isomerase converts all-trans retinyl esters to 11-cis retinal for the regeneration of visual pigment after contact with light. RPE65 insufficiency causes photoreceptor-cell dysfunction and impaired eyesight from birth. The function of cone photoreceptor cells, which mediate vision in daylight, is relatively preserved in childhood because cones have access to an alternative source of 11-cis retinal.2 However, progressive degeneration of both rod and cone photoreceptor cells, in association with local accumulation of toxic retinyl esters,3 outcomes in severe sight impairment by early adulthood.