DISEASE
JAUNDICE CAUSES, TYPES & TREATMENT

JAUNDICE CAUSES, TYPES & TREATMENT

Jaundice or icterus refers to yellow pigmentation of the skin due to bilirubin. Jaundice causes because of disturbed level of bilirubin.

jaundice causes

CAUSES OF JAUNDICE:

Jaundice caused as a result of elevated levels of bilirubin in the blood termed hyperbilirubinaemia. Normal serum bilirubin concentration generally ranges between 0.3-1.3 mg/dl. About 80% of which is basically unconjugated. Jaundice becomes clinically evident when total serum bilirubin exceeds 2 mg/dl. A rise of serum bilirubin between the normal and 2 mg/dl is generally not visible. Thus known as latent jaundice.

FEATURES OF JAUNDICE:

Based on pathophysiology, jaundice may result from one or more of the following mechanisms:

  1. Increased bilirubin production
  2. Decreased hepatic uptake
  3. Hepatic conjugation decreased
  4. Decreased excretion of bilirubin into bile

SYMPTOMS OF JAUNDICE:

Common symptoms of jaundice include following:

  • a yellow tinge to the skin and the whites of the eyes, generally starting at the head and spreading down the body
  • pale stools
  • dark urine
  • itchiness
jaundice causes

Accompanying symptoms of jaundice resulting from low bilirubin levels include the following:

  • fatigue
  • abdominal pain
  • weight loss
  • vomiting
  • fever
  • pale stools
  • dark urine

CLASSIFICATION OF JAUNDICE:

Accordingly, a simple age-old classification of jaundice divides it into 3 predominant types:

  • pre-hepatic (haemolytic),
  • hepatic, and
  • post-hepatic cholestatic
jaundice causes

Pathophysiologic Classification of Jaundice:

  1. PREDOMINANTLY UNCONJUGATED HYPERBILIRUBINAEMIA
    • Increased bilirubin production (i.e. Haemolytic, acholuric or prehepatic jaundice)
      • Intra- and extravascular haemolysis
      • Ineffective erythropoiesis
    • Decreased hepatic uptake
      • Drugs
      • Prolonged starvation
      • Sepsis
    • Decreased bilirubin conjugation
  2. PREDOMINANTLY CONJUGATED HYPERBILIRUBINAEMIA (i.e. CHOLESTASIS)
    • Intrahepatic cholestasis (i.e. Impaired hepatic excretion)      
      • Hereditary disorders or ‘pure cholestasis’ e.g.
      • Acquired disorders or ‘hepatocellular cholestasis’ e.g.
        • viral hepatitis
        • drugs
        • alcohol-induced injury
        • sepsis
        • cirrhosis
    • Extrahepatic cholestasis (i.e. Extrahepatic biliary obstruction)
      • Mechanical obstruction e.g.
        • firstly gallstones
        • inflammatory strictures
        • carcinoma head of pancreas
        • tumours of bile ducts
        • sclerosing cholangitis
        • and lastly congenital atresia of extrahepatic ducts

INTRAHEPATIC CHOLESTASIS:

Intrahepatic cholestasis is due to damaged hepatic excretion of bile and may occur from hereditary or acquired disorders.

  1. Hereditary disorders producing intrahepatic obstruction to biliary excretion are characterized by ‘pure cholestasis’ e.g.
    • fibrocystic disease of the pancreas
    • benign familial recurrent cholestasis
    • intrahepatic atresia and
    • also cholestatic jaundice of pregnancy.
  2. Acquired disorders with an intrahepatic excretory defect of bilirubin are largely due to hepatocellular diseases and hence are termed ‘hepatocellular cholestasis’ e.g.
    • in viral hepatitis,
    • alcoholic hepatitis, and
    • drug-induced cholestasis. such as from administration of chlorpromazine and oral contraceptives.

EXTRAHEPATIC CHOLESTASIS:

Extrahepatic cholestasis basically results from mechanical obstruction to large bile ducts outside the liver or within the porta hepatis.

The common causes are as following:

  • firstly gallstones
  • inflammatory strictures
  • carcinoma head of pancreas
  • tumors of bile duct
  • sclerosing cholangitis and
  • lastly congenital atresia of extrahepatic ducts.

The obstruction basically may be complete and sudden with eventual progressive obstructive jaundice. The obstruction may also be partial and incomplete resulting in intermittent jaundice.

types of jaundice

STRANGE MIND

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