Jaundice
Definition
Yellow discoloration of the sclera, mucous membranes and skin due to hyperbilirubinemia. It is usually apparent by clinical examination when the serum bilirubin exceeds 3mg%.
1. Hemolytic |
>80% unconjugated bilirubin |
- Hemolytic anemia (Differential diagnosis)
- Reduced bilirubin uptake: Gilbert's syndrome, severe congestive heart failure and drugs.
- Reduced bilirubin conjugation: Crigler-Najjar syndrome, breast milk jaundice.
2. Hepatocellular |
Mainly conjugated bilirubin |
1. Acute liver diseases
- Infectious hepatitis
- Drugs: alcohol, paracetamol, halothane, MAO inhibitors
- Poisons: amanita phalloides, aflatoxin, carbon tetrachloride, tetracyclines
- Wilson's disease.
2. Chronic liver diseases
- Chronic viral hepatitis
- Chronic autoimmune hepatitis
- Drugs: methyl dopa, isoniazide, ketoconazole, nitrofurantoin.
- Alpha - 1 antitrypsin deficiency
- Wilson's disease
3. Obstructive |
Mainly conjugated bilirubin |
1. Intrahepatic
- Biliary cirrhosis
- Sclerosing cholangitis
- Viral hepatitis
- Congenital: Dubin-Johnson syndrome, Rotor syndrome
2. Extrahepatic
- Cancer pancreas
- Stone
- Biliary stricture
- Sclerosing cholangitis
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