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Different Types of Jaundice and their Diagnosis

Mar 30, 2017

Different Types of Jaundice and their Diagnosis

Jaundice comes from the French word Jaune meaning yellow. It also known as icterus and is characterized by yellowish or greenish pigmentation of the skin and whites of the eyes.  

  • Pre-hepatic jaundice is caused due to hemolysis or breakdown of red blood cells. The hemoglobin which is present in the RBCs is broken down to produce unconjugated bilirubin which is deposited in various tissues of the body, causing jaundice. The causes are severe malaria, thalassemia, pyruvate kinase deficiency, sickle cell anemia, Crigler-Najjar syndrome, glucose 6-phosphate dehydrogenase deficiency, spherocytosis, etc.
  • Hepatocellular jaundice is caused by diseases like acute or chronic hepatitis, alcoholic liver disease, drug-induced hepatitis, hepatotoxicity, leptospirosis, etc., in which there is liver cell necrosis which reduces the ability of the liver to metabolize and excrete bilirubin which results in increased unconjugated bilirubin content in blood.
  • Post-hepatic jaundice or obstructive jaundice is caused by obstruction to drainage of bile containing conjugated bilirubin into biliary system. The common causes are gallstones, pancreatic CA, cholangiocarcinoma, parasites like "liver flukes", strictures of the common bile duct, pancreatitis, biliary atresia, etc. Neonatal jaundice occurs in infants around the second day after birth due to physiological causes, formula supplementation, G6PD deficiency, spherocytosis, ABO/Rh mismatch etc.

Diagnostics of the different types of Jaundices

Liver Function Tests are essential for diagnosis of jaundice. In pre hepatic jaundice, no bilirubin is present in urine and urobilinogen content is more that 2 units. The serum contains excess of unconjugated bilirubin. In hepatocellular jaundice, conjugated bilirubin is present in urine and is dark in color; plasma albumin level is low but plasma level is high. In obstructive jaundice, no urobilinogen is found in the urine, stool is pale and urine is dark in color. Patient also suffers from severe itching or ‘pruritus’ due to deposition of bile salts in body tissues.

Latest Development In Treatment Of Jaundice

University of Guelph researchers have found that a liver enzyme called cytochrome P4502A5 forms in the blood when it contains excess bilirubin and it removes bilirubin and prevents death of liver cells. It may pave way to better treatment of patients with jaundice in future.

Disclaimer: The information given in this write-up is purely for educating the reader. It is not meant to be a substitute for any advice from a medical expert.

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