Jaundice (icterus; hyperbilirubinemia) is characterized by yellowing of the skin and the whites of the eyes caused by an accumulation of bilirubin. Uncommon in adults; can occur in first week of up to 20% of full term births.
Three main groups of jaundice (prehepatic, hepatic, posthepatic):
1. Prehepatic (haemolytic) Jaundice:
Due to excessive breakdown of red blood cells leading to an overproduction of bilirubin.
For example: Haemolytic anemia, sickle cell anemia, malaria; thalassemia.
2. Hepatic (hepatocellular) Jaundice:
Due to diseases or damage to the liver, impairing the processing of bilirubin.
For example: Hepatitis, cirrhosis, liver cancer, alcoholic liver disease; Gilbert’s syndrome; leptospirosis.
3. Posthepatic (obstructive) Jaundice:
Due to an obstruction in the bile ducts, preventing bilirubin excretion.
For example: gallstones, tumors, pancreatic cancer; cholestasis of pregnancy; chronic pancreatitis; acute pancreatitis.
Clinical features:
Yellowing of the skin and the whites of the eyes (maybe greenish); dark urine (bilirubinuria); pale stools (acholia); itching (bilirubin is a skin irritant); fatigue
Diagnosis is via physical examination (yellowing of skin and eyes); lab tests for levels of bilirubin and liver enzymes (normal levels of bilirubin below 1.0 mg/dl (17 μmol/L); levels greater than 2–3 mg/dl (34–51 μmol/L) cause jaundice); imaging for detection of blockages or liver abnormalities.
Treatment:
Depends on the underlying cause.
Page last updated:
Comments are closed.