Check out this answer from Consensus:
Jaundice is a multifaceted condition with various causes and types. Understanding the underlying mechanisms and appropriate treatments is essential for effective management. Early diagnosis and intervention can prevent complications and improve outcomes for patients with jaundice.
By staying informed about the latest research and advancements in the understanding and treatment of jaundice, healthcare providers can offer better care and support to affected individuals1 2 3 4 5 6 7 8 9 10.
Jaundice is a medical condition characterized by the yellowing of the skin, mucous membranes, and the whites of the eyes. This yellow discoloration is due to elevated levels of bilirubin in the blood, a condition known as hyperbilirubinemia. Bilirubin is a yellow pigment formed by the breakdown of red blood cells (RBCs) and is processed by the liver for excretion. Understanding the causes, types, and treatments of jaundice is crucial for effective management and prevention of complications.
Causes of Jaundice
Jaundice can result from various underlying conditions that affect the normal metabolism and excretion of bilirubin. These causes can be broadly categorized into pre-hepatic, hepatic, and post-hepatic factors.
Pre-Hepatic Causes
Pre-hepatic jaundice is primarily due to the excessive breakdown of RBCs, leading to an increased production of bilirubin. Conditions such as hemolytic anemia, malaria, and certain genetic disorders like glucose-6-phosphate dehydrogenase (G6PD) deficiency can cause pre-hepatic jaundice2 3 10.
Hepatic Causes
Hepatic jaundice occurs due to liver dysfunction, which impairs the liver’s ability to process and excrete bilirubin. Common hepatic causes include viral hepatitis (A, B, C, D, and E), alcohol-induced liver disease, and genetic disorders like Gilbert’s syndrome and Crigler-Najjar syndrome2 3 5.
Post-Hepatic Causes
Post-hepatic jaundice, also known as obstructive jaundice, is caused by blockages in the bile ducts that prevent bilirubin from being excreted into the intestines. Gallstones, tumors, and biliary atresia are common causes of obstructive jaundice2 4 9.
Types of Jaundice
Jaundice can be classified based on the underlying mechanism affecting bilirubin metabolism:
Neonatal Jaundice
Neonatal jaundice is common in newborns due to the immaturity of their liver enzymes required for bilirubin conjugation. It usually appears within the first few days of life and resolves within a week. However, severe or prolonged jaundice in newborns may indicate underlying conditions that require medical intervention1 6.
Physiological Jaundice
Physiological jaundice is a mild form of jaundice that occurs in more than 50% of newborns. It is due to the immaturity of the liver’s bilirubin-processing enzymes and typically resolves without treatment2.
Pathological Jaundice
Pathological jaundice is more severe and may result from various underlying conditions such as infections, blood group incompatibilities, or genetic disorders. It requires prompt medical evaluation and treatment to prevent complications1 6.
Symptoms and Diagnosis
The primary symptom of jaundice is the yellowing of the skin and eyes. Other symptoms may include dark urine, pale stools, itching, and fatigue. Diagnosis involves a combination of clinical evaluation, blood tests to measure bilirubin levels, and imaging studies to identify any underlying causes3 5 8.
Treatment and Management
The treatment of jaundice depends on the underlying cause:
Phototherapy
Phototherapy is commonly used to treat neonatal jaundice. It involves exposing the baby to special blue light that helps break down bilirubin in the skin1 6.
Medications
Medications such as ursodeoxycholic acid, cholestyramine, and rifampicin may be used to manage pruritus (itching) associated with jaundice. In cases of hemolytic anemia, immunoglobulin infusions and steroids may be administered3 7.
Surgical Interventions
For obstructive jaundice, surgical procedures such as bile duct decompression or removal of gallstones may be necessary. In severe cases, liver transplantation may be considered3 9.