QS Study

Jaundice types with Clinical Condition

Jaundice is a clinical condition characterized by yellow coloration of skin, sclera, and mucous membrane due to excessive bilirubin Conc. in the blood. It is a sign of an underlying disease process. It is caused by a build-up of bilirubin in the blood and body tissue. That build-up is often due to conditions affecting the liver, such as cirrhosis, hepatitis, or gallstones.

  • Normal bilirubin level: 02 – 0.8 mg/di of blood
  • Latent Jaundice: Bilirubin level = 0.8 – 2 mg %
  • Clinical Jaundice: Bilirubin level = > 2 mg % (Clinically not detected)

Types

(i) Pre hepatic/haemolytic: Jaundice in these cases is caused by rapid increase in the breakdown and destruction of the red blood cells (hemolysis), overwhelming the liver’s ability to adequately remove the increased levels of bilirubin from the blood.

Causes- Abnormal haemolysis and therapy cause excess bilirubin production.

(ii) Hepatic/Hepatocellular: Jaundice in these cases is caused by the liver’s inability to properly metabolize and excrete bilirubin.

Cause – Distruction of Hepatocyte.

(iii) Obstructive / cholestatic / Post hepatic: Jaundice in these cases, also termed obstructive jaundice, is caused by conditions which interrupt the normal drainage of conjugated bilirubin in the form of bile from the liver into the intestines.

Cause – Obstruction of bile duct.

Site of observation: [See at day light]

  1. Upper sclera.
  2. Ventral surface of tongue.
  3. Nail bed.
  4. Palm of hand.
  5. Whole body skin.

Fig: Jaundice types

Haemolytic Jaundice

Cause-

  1. Hereditary – Spherocytosis, Eliptocytosis
  2. Sickle cell anaemia
  3. Thalassemia
  4. Infection – Malaria
  5. Glucose 6-PO4 deficiency.

Clinical feature

  • Urine dark
  • Splenomegaly
  • Skin pallor due to Anaemia
  • Stool dark or normal

Hepatocellular Jaundice

Clinical features of Hepatocellular Jaundice-

  1. Severe Jaundice.
  2. Oedema.

Cause

  • Acute parenchymal liver disease- (a) Viral hepatitis, b) Drug: Hepatotoxic drug
  • Chronic alcohol abuse
  • Cirrhosis of Liver

Cholestatic Jaundice

Clinical feature of cholestatic Jaundice

Dark urine, Pale stool, Itching, Rigor, Fever, Abdominal pain.

Cause of cholestatic Jaundice:

  1. Viral infection
  2. Gall stone
  3. Ascaris lumbricoides.