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JAUNDICE
JAUNDICE OR ICTERUS
 Jaundice or icterus is the condition characterized by
yellow coloration of the skin, mucous membrane and
deeper tissues due to increased bilirubin level in
blood.
 The word jaundice is derived from the French word
‘jaune’ meaning yellow.
 The normal serum bilirubin level is 0.5 to 1.5 mg/dL.
Jaundice occurs when bilirubin level exceeds 2
mg/dL.
Types of Jaundice
 Jaundice is classified into three types:
1. Prehepatic or hemolytic jaundice
2. Hepatic or hepatocellular jaundice
3. Posthepatic or obstructive jaundice.
1. Prehepatic or Hemolytic Jaundice
 Hemolytic jaundice is the type of jaundice that
occurs because of excessive destruction of RBCs
resulting in increased blood level of free
(unconjugated) bilirubin.
 In this condition, the excretory function of liver is
normal. But the quantity of bilirubin increases
enormously.
 The liver cells cannot excrete that much excess
bilirubin rapidly.
 Unconjugated bilirubin is insoluble in water and is
not excreted in urine.
 So, it accumulates in the blood resulting in jaundice.
 Formation of urobilinogen also increases resulting in
the excretion of more amount of urobilinogen in
urine.
Causes
 Any condition that causes hemolytic anemia can lead
to hemolytic jaundice.
 Common causes of hemolytic jaundice are:
i. Renal disorder
ii. Hypersplenism
iii. Burns
iv. Infections such as malaria
v. Hemoglobin abnormalities such as sickle cell
anemia or thalassemia
vi. Drugs or chemical substances causing red cell
damage
vii. Autoimmune diseases.
2. Hepatic or Hepatocellular or Cholestatic
Jaundice
 Hepatic jaundice is the type of jaundice that occurs
due to the damage of hepatic cells.
 Because of the damage, the conjugated bilirubin
from liver cannot be excreted and it returns to blood.
Causes
i. Infection (infective jaundice) by virus, resulting in
hepatitis (viral hepatitis)
ii. Alcoholic hepatitis
iii. Cirrhosis of liver
iv. Exposure to toxic materials.
3. Posthepatic or Obstructive or Extrahepatic
Jaundice
 Posthepatic type of jaundice occurs because of the
obstruction of bile flow at any level of the biliary
system.
 The bile cannot be excreted into small intestine.
 So, bile salts and bile pigments enter the circulation.
 The blood contains more amount of conjugated
bilirubin.
Causes
i. Gallstones
ii. Cancer of biliary system or pancreas.
jaundice

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jaundice

  • 2. JAUNDICE OR ICTERUS  Jaundice or icterus is the condition characterized by yellow coloration of the skin, mucous membrane and deeper tissues due to increased bilirubin level in blood.  The word jaundice is derived from the French word ‘jaune’ meaning yellow.  The normal serum bilirubin level is 0.5 to 1.5 mg/dL. Jaundice occurs when bilirubin level exceeds 2 mg/dL.
  • 3. Types of Jaundice  Jaundice is classified into three types: 1. Prehepatic or hemolytic jaundice 2. Hepatic or hepatocellular jaundice 3. Posthepatic or obstructive jaundice.
  • 4. 1. Prehepatic or Hemolytic Jaundice  Hemolytic jaundice is the type of jaundice that occurs because of excessive destruction of RBCs resulting in increased blood level of free (unconjugated) bilirubin.  In this condition, the excretory function of liver is normal. But the quantity of bilirubin increases enormously.  The liver cells cannot excrete that much excess bilirubin rapidly.
  • 5.  Unconjugated bilirubin is insoluble in water and is not excreted in urine.  So, it accumulates in the blood resulting in jaundice.  Formation of urobilinogen also increases resulting in the excretion of more amount of urobilinogen in urine. Causes  Any condition that causes hemolytic anemia can lead to hemolytic jaundice.
  • 6.  Common causes of hemolytic jaundice are: i. Renal disorder ii. Hypersplenism iii. Burns iv. Infections such as malaria v. Hemoglobin abnormalities such as sickle cell anemia or thalassemia vi. Drugs or chemical substances causing red cell damage vii. Autoimmune diseases.
  • 7. 2. Hepatic or Hepatocellular or Cholestatic Jaundice  Hepatic jaundice is the type of jaundice that occurs due to the damage of hepatic cells.  Because of the damage, the conjugated bilirubin from liver cannot be excreted and it returns to blood. Causes i. Infection (infective jaundice) by virus, resulting in hepatitis (viral hepatitis) ii. Alcoholic hepatitis iii. Cirrhosis of liver iv. Exposure to toxic materials.
  • 8. 3. Posthepatic or Obstructive or Extrahepatic Jaundice  Posthepatic type of jaundice occurs because of the obstruction of bile flow at any level of the biliary system.  The bile cannot be excreted into small intestine.  So, bile salts and bile pigments enter the circulation.  The blood contains more amount of conjugated bilirubin. Causes i. Gallstones ii. Cancer of biliary system or pancreas.