Jaundice is a medical term when an individual has a yellowish pigmentation change to the skin.

Jaundice is also known as icterus.

 The word comes from the french word meaning yellow – jaune

The cause of jaundice includes an increased level of bilirubin in the blood. [Hyperbilirubinemia]

With the increase of bilirubin in the body – this transfers into the extracellular fluid around the body.

Typically but not always – has something to do with the liver

 

Areas of the skin that can retain a yellowish color include:

1.) Conjunctival membrane

2.) Mucus membrane

3.) Overall pigmentation of skin

 

Diseases that typically cause Jaundice:

1.)   Hepatitis C infection

2.)  Chronic Hepatitis

3.)  Alcohol induced liver disease

4.)  Liver Cancer

5.)  Obstruction of biliary tract [usually by gallstones]

6.)  Pancreatic Cancer

 

Icterus

  • Is when the conjunctiva of the eye changes.
  • Often one of the first changes seen.
  • The area of of the eye that changes color is the conjunctival membrane overlying the eye.

 

Catagories of Jaundice

1.) Pre-hepatic

2.) Hepatic or Hepatocellular

3.) Post-Hepatic

 

Pre-Hepatic

  • This reaction occurs somewhere before the liver.
  • An increased rate of the breakdown of red blood cells [hemolysis]
  • This breakdown can casue an increase in bilirubin
  • Therefore this is termed jaundice secondary to hemolysis – then the cause needs to be identified.

 

Causes of Pre-Hepatic Jaundice:

  • Malaria
  • Sickle Cell anemia
  • Thalassemia
  • Hemolytic Uremic Syndrome
  • Gilbert’s syndrome
  • Crigler-Najjar syndrome
  • Others

Hepatic

  • Also referred to as Hepatocellular jaundice – causes in the liver
  • Death or destruction of the liver cell reduces its ability to function properly.
  • The liver typically metabolizes and helps excrete bilirubin on a daily basis.
  • When cell damage occurs – the liver can not get rid of the unconjugated bilirubin in the blood.

 

Causes Hepatic Jaundice:

  • Acute Hepatitis
  • Hepatotoxicity
  • Alcoholic Liver Disease
  • Primary biliary cirrhosis

 

Post-Hepatic

  • Problems occur after the liver or obstructive jaundice.
  • Occurs when a blockage or stoppage of the draining of bile.
  • Urobilinogen, instead of being released into the urine, is released into general circulation.
  • Conjugated bilirubin will be found in urine – this points to either intra-hepatic or post-herpatic cause.

Symptom:

  • Pale Stools
  • Dark urine
  • Elevated cholesterol in serum
  • Severe itching [pruritus]

 

Causes of Post-Hepatic Jaundice:

  • Gallstones to common bile duct
  • Pancreatic Cancer
  • Parasites – liver flukes that are living in the common bile duct
  • Ductal carcinoma
  • Pancreatitis
  • Biliary atresia
  • Mirizzi’s syndrome – very rare

 

Complications of Jaundice

1.) Sepsis

2.) Renal failure

3.) Liver failure

4.) Biliary Cirrhosis

5.) Pancreatitis
Treatment

  • Depends on underlining cause
  • Treat cause to improve symptoms.
  • Seek medical attention in most cases.

 

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