Information AboutJaundice |
| CATEGORIES ABOUT JAUNDICE | |
| diseases | |
| digestive system | |
| gastroenterology | |
| hepatology | |
Jaundice, also known as '''icterus''' (attributive adjective: "icteric"), is a yellowing of the Skin , Conjunctiva (a clear covering over the Sclera , or whites of the eyes) and Mucous Membrane s caused by hyperbilirubinemia (increased levels of Bilirubin in red blooded animals). Usually the concentration of bilirubin in the Blood must exceed 2–3 Mg / DL for the coloration to be easily visible. ''Jaundice'' comes from the French word ''jaune'', meaning yellow. Jaundice typically appears in a 'top to bottom' progression (starting with the face, progressing toward the feet), and resolves in a 'bottom to top' manner. CAUSES When Red Blood Cell s die, the Heme in their Hemoglobin is converted to Bilirubin in the Spleen and in the hepatocytes in the liver. The Bilirubin is processed by the Liver , enters Bile and is eventually excreted through Feces . Consequently, there are three different classes of causes for jaundice. ''Pre-hepatic'' or ''hemolytic'' causes, where too many red blood cells are broken down, ''hepatic'' causes where the processing of Bilirubin in the liver does not function correctly, and ''post-hepatic'' or ''extrahepatic'' causes, where the removal of bile is disturbed. Pre-hepatic Pre-hepatic -(or hemolytic) jaundice is caused by anything which causes an increased rate of Hemolysis (breakdown of Red Blood Cell s). In tropical countries, Malaria can cause jaundice in this manner. Certain Genetic Diseases , such as Sickle Cell Anemia and Glucose 6-phosphate Dehydrogenase Deficiency can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as Hemolytic Uremic Syndrome , can also lead to coloration. Defects in Bilirubin Metabolism also present as jaundice. Jaundice usually comes with high fevers. The laboratory findings include
Hepatic from Feline Hepatic Lipidosis . Note the ears and eye-membrane.]] Hepatic causes include acute Hepatitis , Hepatotoxicity and Alcoholic Liver Disease , whereby cell necrosis reduces the liver's ability to metabolise and excrete Bilirubin leading to a buildup in the blood. Less common causes include Primary Biliary Cirrhosis , Gilbert's Syndrome (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population) and Metastatic Carcinoma . Jaundice seen in the newborn, known as neonatal jaundice, is common, occurring in almost every newborn as Hepatic machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age.. Laboratory Findings: Urine: bilirubin present, Urobilirubin > 2 units but variable (Except in children) Post-hepatic Post-hepatic (or obstructive) jaundice, also called Cholestasis , is caused by an interruption to the drainage of Bile in the biliary system. The most common causes are Gallstone s in the Common Bile Duct , and Pancreatic Cancer in the head of the Pancreas . Also, a group of parasites known as " Liver Fluke s" live in the common bile duct, causing obstructive jaundice. Other causes include strictures of the common bile duct, Biliary Atresia , Ductal Carcinoma , Pancreatitis and Pancreatic Pseudocyst s. A rare cause of obstructive jaundice is Mirizzi's Syndrome . The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from Bile Pigment s. Patients often complain of severe itching. NEONATAL JAUNDICE See Also: Neonatal jaundice Neonatal jaundice is usually harmless: this condition is often seen in can occur; there are concerns that this condition has been rising in recent years due to inadequate detection and treatment of neonatal hyperbilirubinemia. Neonatal jaundice is a risk factor for hearing loss.1 JAUNDICED EYE It was once believed persons suffering from the medical condition jaundice saw everything as yellow. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. Alexander Pope , in 'An Essay on Criticism' (1711), wrote: "All seems infected that the infected spy, As all looks yellow to the jaundiced eye." From "The Dictionary of Cliches" by James Rogers (Ballantine Books, New York, 1985). SEE ALSO Cholestasis {Link without Title} FOOTNOTES |
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