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Jaundice is a yellow discoloration of the skin and whites of the eyes. The most common causes of jaundice are liver disease, although it can also be caused by other conditions. Their diagnosis is facilitated by additional symptoms accompanying jaundice. Check what diseases jaundice indicates.
Jaundiceis a yellowish discoloration of the skin, sclera, conjunctiva, mucous membranes and internal organs.The cause of this condition is hyperbilirubinemia, i.e. an excessive amount of bilirubin in the human body.
Bilirubin is a yellow pigment that comes from the breakdown of red blood cells. After bilirubin is released from them, it is transferred to the plasma. It is either free or indirect bilirubin. Then it travels with the blood to the liver, where it undergoes chemical changes. It is already conjugated bilirubin (otherwise associated or direct). Then it is excreted into the bile ducts and concentrated in the gallbladder. It is bilirubin that gives bile its characteristic color.
Hyperbilirubinemia, and the resulting jaundice, is not a disease but a symptom of it. Depending on what descent is the cause of the excess bilirubin in the body, and thenjaundice , there may be othersymptoms , such as:
- itchy skin
- clay or fatty stools
- dark urine
- weight loss
- stomach ache
- nausea
- vomiting
- fever
- feeling unwell
- articular pain
- easy bruising, bleeding after minor injuries
Jaundice - causes
If jaundice occurs suddenly in young and previously he althy people, this is indicative of acute viral hepatitis, especially when jaundice is preceded by early symptoms of hepatitis infection and there are risk factors.
If jaundice appears suddenly in a he althy person after taking large doses of drugs or after exposure to toxic factors, they are the cause of it. In this case, paracetamol overdose is most frequently reported.
A history of long-term alcohol abuse suggests alcoholic liver disease, including alcoholic inflammation and cirrhosis.
The occurrence of a recurrent patient or his relativesslight jaundice, despite the exclusion of diseases of the liver and bile ducts, speaks for a hereditary background, usually for Gilbert's syndrome.
Pain-free jaundice in an elderly person, accompanied by a decline in the body, presence of a tumor in the abdominal cavity and slight itching, suggests obstruction of the bile ducts, most likely due to cancer.
Gradual build-up of jaundice with itching, weight loss, and clay-colored stools suggest intra- or extrahepatic cholestasis. Intrahepatic cholestasis can often be triggered by
- alcohol changes
- drug or toxin influence
- viral hepatitis
In turn, extrahepatic bile stasis is often caused by cholelithiasis (then colic-like pain appears in the upper right abdominal square, in the right shoulder and in the subscapular area). It is one of the causes of the so-called mechanical jaundice ( mechanical jaundiceis a type of jaundice caused by obstructed outflow of bile from the liver. It may be caused, among others, by urolithiasis). Pancreatic cancer could be another cause. More rarely inflammation of the bile ducts, pancreatic pseudocyst, stenosis of the common duct after previous operations.
Jaundice, accompanied by changes in mental state and coagulation disorders, is a sign of liver cell failure.
Worth knowing
Common causes of jaundice
Jaundice can be caused by many diseases and some medications, but the most common causes include:
1) Inflammatory changes in the liver:
- viral hepatitis
- autoimmune hepatitis
- toxic liver damage
2) Alcoholic liver damage 3) Biliary obstruction
Jaundice - other possible causes
- Crigler-Najjar syndrome
Jaundice can appear after eating foods that contain yellow dyes (carrots, pumpkins, and cantaloupe melons). This is called pseudo-jaundice, It is a temporary and harmless condition, because it is not related to an excess of bilirubin.
- hyperthyroidism
- hemolysis (breakdown of red blood cells)
- circulatory failure
- fasting
- Dubin-Johnson syndrome
- Rotor team
- Wilson's disease
- infiltrative changes (e.g. amyloidosis, lymphoma, sarcoidosis, tuberculosis)
- hemochromatosis
- other liver diseases, incl. cirrhosis, fatty liver
- burns
- excessive spleen activity(hypersplenism)
Is jaundice contagious? Is jaundice curable?
People may become infected when jaundice is caused by the hepatitis A, B and C viruses.
Can jaundice be cured? It depends on what disease is causing jaundice and the severity of the disease.
Jaundice - diagnosis
The interview with the patient should include questions about any measures that the patient is taking, as well as possible exposure to toxins harmful to the liver. It also explains whether the patient has been vaccinated against hepatitis. It is necessary to obtain information about the operations performed within the biliary system. The interview includes questions about risk factors for hepatitis, the amount and duration of alcohol consumption, intravenous drug use, and the type of sexual contact. The doctor should also ask about the presence of jaundice in close relatives and hereditary liver diseases.
Treatment of jaundice consists in combating the cause of its appearance.
In addition, abdominal palpation and blood tests are performed. Total and direct bilirubin levels as well as the activity of aminotransferase and alkaline phosphatase are determined in all patients. The results help to distinguish cholestasis from liver cell damage, which is important because imaging studies are required in patients with cholestasis. It usually starts with an ultrasound of the abdominal cavity. An alternative is computed tomography and magnetic resonance imaging. When extra-hepatobiliary cholestasis is diagnosed on ultrasound, further tests are required, usually resonance or retrograde endoscopic cholangiopancreatography. In some cases, a liver biopsy or laparoscopy may be necessary.
References: The Merck manual. Clinical Symptoms: A Practical Guide to Diagnostics and Therapy, pp. ed. Porter R., Kaplan J., Homeier B., Wrocław 2010
