Jaundice

Jaundice a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin
level

The most common signs of jaundice in adults are a yellowish discoloration of the white
area of the eye (sclera) and skin
dark urine (bilirubinuria) and pale (acholia) fatty stool (steatorrhea).
, jaundice is commonly associated with severe itchines
Headache, diarrhea, weight loss, loss of appetite, vomiting

A much less common sign of jaundice specifically during childhood is yellowish or

greenish teeth due to bilirubin deposition during the process of tooth calcification

Jaundice is a sign indicating the presence of an underlying diseases involving abnormal

bilirubin metabolism,
liver dysfunction,
biliary-tract obstruction. In general, jaundice is present when blood levels of bilirubin
exceed 3 mg/dl

Jaundice is classified into three categories, depending on which part of the physiological
mechanism the pathology affects. The three categories are:

1- Pre-hepatic jaundice is most commonly caused by a pathological increased

rate of red blood cell (erythrocyte) hemolysis.

These diseases may cause jaundice due to increased erythrocyte hemolysis:

1- Sickle-cell anemia
2- Thalassemia
3- Severe malaria

2- Hepatic jaundice is caused by abnormal liver metabolism of bilirubin.

The major causes of hepatic jaundice are significant damage to hepatocytes due
to infectious, drug/medication-induced, autoimmune etiology, or less commonly,
due to inheritable genetic diseases.
hepatic causes to jaundice:

• Acute hepatitis
• Chronic hepatitis
• Hepatotoxicity
• Cirrhosis
• Drug-induced hepatitis
• Alcoholic liver disease

3-Posthepatic jaundice (obstructive jaundice), is caused by a blockage of

bile ducts that transport bile containing conjugated bilirubin out of the liver for
excretion.

conditions that can cause posthepatic jaundice:

 • Choledocholithiasis (common bile duct gallstones). It is the most common
cause of obstructive jaundice.
• Pancreatic cancer of the pancreatic head
• Biliary tract strictures
•
Acute Pancreatitis
• Chronic Pancreatitis

Laboratory tests

1- Bilirubin Blood Test

2- Total serum bilirubin
3- Conjunctive bilirubin
4- Stool color

Treatment
Treatment of jaundice varies depending on the underlying cause. If a bile duct blockage
is present, surgery is typically required; otherwise, management is medical

Complications
Hyperbilirubinemia, more precisely hyperbilirubinemia due to the unconjugated fraction,
may cause bilirubin to accumulate in the grey matter of the central nervous system,
potentially causing irreversible neurological damage, leading to a condition known
as kernicterus ( a type of brain damage that can result from high levels of bilirubin in a
baby's blood )

Risk factors
Major risk factors for jaundice, particularly severe jaundice that can cause
complications, include:

• Premature birth. A baby born before 38 weeks of gestation may

not be able to process bilirubin as quickly as full-term babies do.
Premature babies also may feed less and have fewer bowel
movements, resulting in less bilirubin eliminated through stool.

• Significant bruising during birth. Newborns who become

bruised during delivery gets bruises from the delivery may have
higher levels of bilirubin from the breakdown of more red blood
cells.
 • Blood type. If the mother's blood type is different from her baby's,
the baby may have received antibodies through the placenta that
cause abnormally rapid breakdown of red blood cells.

• Breast-feeding. Breast-fed babies, particularly those who have

difficulty nursing or getting enough nutrition from breast-feeding,
are at higher risk of jaundice. Dehydration or a low caloric intake
may contribute to the onset of jaundice. However, because of the
benefits of breast-feeding, experts still recommend it. It's
important to make sure your baby gets enough to eat and is
adequately hydrated.

• Race. Studies show that babies of East Asian ancestry have an

increased risk of developing jaundice.

References:
Torre DM, Lamb GC, JV, Schapira RM (2009). Lippincott Williams & Wilkins. p. 101.

Jaundice. MedlinePlus. Archived from the original on 27 August 2016. Retrieved 13

August 2016.