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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

1.)  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

2.)  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

3.)  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 the cause in-order-to improve the symptoms.
–  Seek medical attention in most cases.