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Jaundice
| Jaundice | |
|---|---|
| Other names | Icterus[1] |
 | |
| Jaundice of the skin caused by pancreatic cancer | |
| Pronunciation | |
| Specialty | Gastroenterology, hepatology, general surgery |
| Symptoms | Yellowish coloration of skin and sclera, itchiness[2][3] |
| Causes | High bilirubin levels[3] |
| Risk factors | Pancreatic cancer, pancreatitis, liver disease, certain infections |
| Diagnostic method | Blood bilirubin, liver panel[3] |
| Differential diagnosis | Carotenemia, taking rifampin[4] |
| Treatment | Based on the underlying cause[5] |
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels.[3][6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction.[7] The prevalence of jaundice in adults is rare, while jaundice in babies is common, with an estimated 80% affected during their first week of life.[8] The most commonly associated symptoms of jaundice are itchiness,[2] pale feces, and dark urine.[4]
Normal levels of bilirubin in blood are below 1.0 mg/dl (17 μmol/L), while levels over 2–3 mg/dl (34–51 μmol/L) typically result in jaundice.[4][9] High blood bilirubin is divided into two types: unconjugated and conjugated bilirubin.[10]
Causes of jaundice vary from relatively benign to potentially fatal.[10] High unconjugated bilirubin may be due to excess red blood cell breakdown, large bruises, genetic conditions such as Gilbert's syndrome, not eating for a prolonged period of time, newborn jaundice, or thyroid problems.[4][10] High conjugated bilirubin may be due to liver diseases such as cirrhosis or hepatitis, infections, medications, or blockage of the bile duct,[4] due to factors including gallstones, cancer, or pancreatitis.[4] Other conditions can also cause yellowish skin, but are not jaundice, including carotenemia, which can develop from eating large amounts of foods containing carotene—or medications such as rifampin.[4]
Treatment of jaundice is typically determined by the underlying cause.[5] If a bile duct blockage is present, surgery is typically required; otherwise, management is medical.[5] Medical management may involve treating infectious causes and stopping medication that could be contributing to the jaundice.[5] Jaundice in newborns may be treated with phototherapy or exchanged transfusion depending on age and prematurity when the bilirubin is greater than 4–21 mg/dl (68–365 μmol/L).[9] The itchiness may be helped by draining the gallbladder, ursodeoxycholic acid, or opioid antagonists such as naltrexone.[2] The word jaundice is from the French jaunisse, meaning 'yellow disease'.[11][12]
- ^ Ziebert M (2009). "Jaundice". In Torre DM, Lamb GC, van Ruiswyk J, Schapira RM (eds.). Kochar's Clinical Medicine for Students. Lippincott Williams & Wilkins. p. 101. ISBN 978-0-7817-6699-9.
- ^ a b c Bassari R, Koea JB (February 2015). "Jaundice associated pruritis: a review of pathophysiology and treatment". World Journal of Gastroenterology. 21 (5): 1404–1413. doi:10.3748/wjg.v21.i5.1404. PMC 4316083. PMID 25663760.
- ^ a b c d Jaundice. Archived from the original on 27 August 2016. Retrieved 13 August 2016.
{{cite book}}:|website=ignored (help) - ^ a b c d e f g Roger J (2004). Oxford Textbook of Primary Medical Care. Oxford University Press. p. 758. ISBN 978-0-19-856782-0. Archived from the original on 8 September 2017.
- ^ a b c d Ferri FF (2014). Ferri's Clinical Advisor 2015: 5 Books in 1. Elsevier Health Sciences. p. 672. ISBN 978-0-323-08430-7. Archived from the original on 8 September 2017.
- ^ Buttaro TM, Trybulski JA, Polgar-Bailey P, Sandberg-Cook J (2012). Primary Care: A Collaborative Practice (4th ed.). Elsevier Health Sciences. p. 690. ISBN 978-0-323-07585-5. Archived from the original on 8 September 2017.
- ^ Al-Tubaikh JA (2017). Internal Medicine. doi:10.1007/978-3-319-39747-4. ISBN 978-3-319-39746-7.
- ^ Kaplan M, Hammerman C (2017). "Hereditary Contribution to Neonatal Hyperbilirubinemia". Fetal and Neonatal Physiology. Elsevier: 933–942.e3. doi:10.1016/b978-0-323-35214-7.00097-4. ISBN 978-0-323-35214-7.
- ^ a b Maisels MJ (March 2015). "Managing the jaundiced newborn: a persistent challenge". CMAJ. 187 (5): 335–343. doi:10.1503/cmaj.122117. PMC 4361106. PMID 25384650.
- ^ a b c Winger J, Michelfelder A (September 2011). "Diagnostic approach to the patient with jaundice". Primary Care. 38 (3): viii, 469–482. doi:10.1016/j.pop.2011.05.004. PMID 21872092.
- ^ Dr. Chase's Family Physician, Farrier, Bee-keeper, and Second Receipt Book: Being an Entirely New and Complete Treatise ... Chase Publishing Company. 1873. p. 542. Archived from the original on 8 September 2017.
- ^ Sullivan KM, Gourley GR (2011). "Jaundice". Pediatric Gastrointestinal and Liver Disease. Elsevier. pp. 176–186.e3. doi:10.1016/b978-1-4377-0774-8.10017-x. ISBN 978-1-4377-0774-8.
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