Jaundice otherwise called icterus, which may occurs due to high bilirubin level in blood. The slides here explains the epidemiology, metabolism of bilirubin, types of jaundice, their etiology, risk factors involved, symptoms diagnosis and treatment.

1. JAUNDICE
JAUNDICE IS ALSO KNOWN AS
ICTERUS.

2. JAUNDICE
O Jaundice is characterized by the yellowish or
greenish pigmentation of the skin and whites
of the eyes due to high bilirubin level.
O Normal levels of bilirubin in blood are below
1.0mg/dl, while levels over 2-3mg/dl typically
results in jaundice.
O Jaundice is not a disease, but rather a sign
that can occur in many different diseases.

4. EPIDEMIOLOGY
O The incidence of jaundice is
approximately 40,000 per 100,000
individuals of intensive care unit patients.
O 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.

5. Depending upon gender,
O Male are more commonly affected by
hepatocellular jaundice and liver cancer
than female.
O While, Female are more commonly
affected by hemolytic jaundice.
Depending upon age,
O Hepatocellular jaundice, particularly from
viral hepatitis, commonly affects young
patients
O Cholestatic jaundice, particularly from liver
cancer, hepatitis, and liver cirrhosis,
commonly affects older patients

6. METABOLISM OF BILIRUBIN

7. TYPES OF JAUNDICE
Pre- hepatic/ Hemolytic
Jaundice
Hepato-cellular Jaundice
Post-hepatic/ Obstructive
Jaundice

8. O Pre-hepatic jaundice – Here, the bilirubin level is
disrupted prior to transportation of blood to the liver.
Examples of conditions that cause this type of jaundice
are hemolytic anemia and sickle cell disease.
O Hepatocellular jaundice – Here, the disrupted bilirubin is
caused by disease in the liver and examples of
conditions that cause this include liver cirrhosis and
Gilbert’s syndrome.
O Post-hepatic jaundice or obstructive jaundice – Here,
bile and therefore the bilirubin contained inside, is
obstructed and prevented from draining into the
digestive system from the gallbladder. Examples of
factors that may cause this are tumors and gallstones

10. Infant Jaundice
O There is also infant jaundice which usually
occurs in preterm babies. Infant jaundice occurs
due to the fact that the baby’s liver is not mature
enough to quickly remove bilirubin from the
system, causing an excess of bilirubin.

11. AETIOLOGY

12. RISK FACTORS
Some of the common risk factors for contracting jaundice
are:
O Cholestasis- This is a condition that can disrupt bile
flow coming from the liver. The conjugated bilirubin
contained in bile stays behind in the liver without being
taken out.
O Gilbert’s Syndrome- This form of the condition is
inherited which can lead to an impaired enzyme ability
to continue the bile’s excretion process.
O Hemolytic Anemia- Bilirubin production can increase
when increased levels of blood cells (red) go through a
breakdown process.

13. O Bile Duct Obstruction- This kind of
condition can contribute to the liver being
prevented from excreting bilirubin
O Bile duct inflammation- This can have
the bile removal and secretion prevented
resulting in jaundice.
O Acute liver inflammation- This can lead
to the impairment of the liver in the
conjugation and secretion of bilirubin
which can lead to waste accumulation.

15. DIAGNOSIS
O A blood test is usually performed to confirm
the diagnosis of jaundice, which includes,
bilirubin tests, full blood count of red blood
cells, white blood cells, and platelets, and
Hepatitis A, B, and C tests.
O The doctor will enquire about your personal
medical history, and do a physical exam to
feel for tumours in your abdomen, or check
the firmness of your liver. A firm liver indicates
liver cirrhosis and a hard liver indicates liver
cancer.

16. However, tests are usually needed to confirm an exact diagnosis:
Various blood tests are usually done:
O These will show whether the raised level of bilirubin is unconjugated or
conjugated . This can help to narrow down the possible causes of jaundice.
O Blood tests, called liver function tests, can also measure various liver
enzymes which help to show if the liver is inflamed or working well.
O Blood tests can also detect certain viruses or markers of other infections that
can affect the liver.
O Urine tests may help to show if the levels of various chemicals in the blood
are raised. This can help to narrow down the possible causes of jaundice.
O An ultrasound scan of the liver, common bile duct and pancreas may identify a
cause. In particular, it can often identify the cause of any blockage to the
common bile duct. For example, a gallstone or cancer of the pancreas.
O A magnetic resonance imaging (MRI) scan of the liver may be useful.
O A liver biopsy
O Other more complex tests may be needed if the diagnosis is still in doubt.

18. TREATMENT
O The medical treatment of jaundice targets the
specific cause, rather than the jaundice itself.
For example:
O Hepatocellular jaundice is treated with anti-
viral medications and steroids
O Hemolytic jaundice is treated with iron
supplements
O Obstructive jaundice is treated with surgery to
remove the obstruction followed by
medication

19. O There is also medication induced jaundice, in
other words, jaundice which occurs as a side
effect to consuming certain medicines. In
such cases the medicines are discontinued
and alternative medicines are prescribed.
For infants with jaundice the treatments include:
O Phototherapy
O Blood transfusion

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