JAUNDICE
DEFINITION
Jaundice which is otherwise called icterus is actually a symptom and not a disease. It is characterised by yellowish or greenish pigmentation of skin and eyes due to increased bilirubin levels in the body. The normal level of bilirubin is below 1.0 mg/dL, the raise in level of about 2-3 mg/dL results in Jaundice.
TYPES
1. Pre-Hepatic
2. Hepatic
3. Post Hepatic
CAUSES
➢ Infections of liver (Hepatitis A, B, C, D, E)
➢ Gall stones or gall bladder disorders
➢ Birth disorders or defects like Gilbert’s syndrome, Dubin-Johnson syndrome, Rotor syndrome, Cringler-Najjar syndrome
➢ Chronic liver disease
➢ Liver cancer
➢ Glucose-6-phosphate dehydrogenase (G6PD) deficiency
➢ Blood disorders like Sickle cell anaemia, Thalassaemia, Spherocytosis, Haemolytic uraemic syndrome
➢ Overdose of certain drugs like Acetaminophen
➢ Thyroid problems
SYMPTOMS
✓ Yellow tinge to skin, whites of eyes
✓ Pale stools
✓ Dark urine
✓ Itchiness
✓ Fatigue
✓ Fever
✓ Vomiting
✓ Weight loss
✓ Abdominal pain
TESTS AND DIAGNOSIS
❖ Liver function tests- a series of blood tests that measure levels of certain proteins and enzymes produced by liver. The blood levels
of Aminotransferases(ALT,AST), Alkaline phosphatase(ALP) and Gamma glutamyl transpeptidase(GGT) are measured.
Normal levels are ALT-7 to 55 units per liter (U/L), AST- 8 to 48 U/L, ALP- 40 to 129 U/L and GGT- 8 to 61 U/L.
❖ Bilirubin test – a high level of unconjugated bilirubin compared to levels of conjugated bilirubin indicates haemolytic Jaundice; it measures the levels of red blood cells, white blood cells and platelets. A level of about 2.0 mg/dL can lead to Jaundice; normal total bilirubin level is 0.1 to 1.2 mg/dL.
❖ Complete blood count (CBC) is done to determine haemolytic anaemia.
❖ Abdominal ultrasounds, CT scan, MRI and X-ray can be used to identify obstructions.
❖ Liver biopsy is carried out to check inflammation, cirrhosis, cancer and fatty liver.
TREATMENT
There is no specific treatment for jaundice; the treatment is carried out to correct the cause for jaundice
● If Jaundice is due to obstruction of gall bladder, surgery is carried out to remove the obstruction.
● In Neonatal Jaundice treatment is phototherapy (fluorescent light exposure) or exchanged transfusion.
● Jaundice caused due to hepatitis infection can be cured with Interferon and Antiviral medicines like Lamivudine, Tenofovir,
Entecavir.
● Jaundice due to cancer of liver can be treated with chemotherapy.
PREVENTION
✓ Manage a healthy weight
✓ Manage cholesterol
✓ Vaccine for hepatitis
✓ Limit alcohol consumption
✓ Drink more water
