![]() Production - Bilirubin is the end product of heme, which is released by senescent or defective RBCs.The pathophysiology of jaundice is best explained by dividing the metabolism of bilirubin into three phases: prehepatic, hepatic, and post-hepatic. Kernicterus or Bilirubin-induced neurologic dysfunction (BIND), a complication of severe jaundice is a very rare cause of death in neonates with a death rate of 0.28 deaths per one million live births. In contrast, women demonstrate higher rates of gallbladder stones, primary biliary cirrhosis, and gallbladder cancer. Men have an increased prevalence of alcoholic and non-alcoholic cirrhosis, chronic hepatitis B, malignancy of pancreas, or sclerosing cholangitis. Bile duct stones, drug-induced liver disease, and malignant biliary obstruction occur in the elderly population. Congenital disorders, overproduction from hemolysis, defective bilirubin uptake, and defects in conjugation are also responsible for jaundice in infancy or childhood. Hepatitis A was found to be the most afflicting cause of jaundice among children. The causes of jaundice also vary with age, as mentioned above. Around 20 percent of term babies are found with jaundice in the first week of life, primarily due to immature hepatic conjugation process. The prevalence of jaundice differs among patient populations newborns and elderly more commonly present with the disease. Hemolytic anemias, extravasation of blood in tissues, dyserythropoiesis.Parasitic infections (e.g., Ascaris lumbricoides, liver flukes).Tumors (e.g., cholangiocarcinoma, head of pancreas cancer).Drugs & Toxins - oral contraceptives, rifampin, probenecid, steroids, chlorpromazine, herbal medications (e.g., Jamaican bush tea, kava kava), arsenicĮxtrahepatic cholestasis (biliary obstruction).Infiltrative diseases (e.g., amyloidosis, lymphoma, sarcoidosis, tuberculosis).Cholestatic liver disease-Primary biliary cholangitis, primary sclerosing cholangitis.Hepatocellular disease - Viral hepatitis A, B, D alcoholic hepatitis cirrhosis, nonalcoholic steatohepatitis, EBV, CMV, HSV, Wilson, autoimmune.Etiologyĭefect of canalicular organic anion transport ĭefect of sinusoidal reuptake of conjugated bilirubinĭecreased intrahepatic excretion of bilirubin Yellowing of skin sparing the sclerae is indicative of carotenoderma which occurs in healthy individuals who consume excessive carotene-rich foods. Icterus acts as an essential clinical indicator for liver disease, apart from various other insults. īilirubin has two components: unconjugated(indirect) and conjugated(direct), and hence elevation of any of these can result in jaundice. With further increase in serum bilirubin levels, the skin will progressively discolor ranging from lemon yellow to apple green, especially if the process is long-standing the green color is due to biliverdin. Sclerae have a high affinity for bilirubin due to their high elastin content. The normal serum levels of bilirubin are less than 1mg/dl however, the clinical presentation of jaundice as scleral icterus (peripheral yellowing of the eye sclera), is best appreciated only when the levels reach more than 3 mg/dl. Deposition of bilirubin happens only when there is an excess of bilirubin, a sign of increased production or impaired excretion. ![]() Jaundice, also known as hyperbilirubinemia, is a yellow discoloration of the body tissue resulting from the accumulation of an excess of bilirubin. Explain the interprofessional team strategies for improving care coordination to advance the management of jaundice and improve outcomes. ![]() Summarize the treatment and management options available for patients with jaundice.Outline the approach to performing a history and physical examination for patients with jaundice.Describe the etiology and pathophysiology of jaundice. ![]() This activity reviews the evaluation and differential diagnosis of jaundice and highlights the role of an interprofessional team in evaluating and improving care for patients with this condition. However, the clinical presentation of jaundice with peripheral yellowing of the eye sclera, also called scleral icterus, is best appreciated when serum bilirubin levels exceed 3 mg/dl. The normal serum levels of bilirubin are less than 1 milligram per deciliter (mg/dL). Deposition of bilirubin happens only when there is an excess of bilirubin, and this indicates increased production or impaired excretion. Jaundice, also known as hyperbilirubinemia, is defined as a yellow discoloration of the body tissue resulting from the accumulation of excess bilirubin. ![]()
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