Liam Hyland 6M2

13/04/2014

What is Jaundice?
Jaundice is a condition whereby the whites of the eyes (sclerae and the s!in become yellowish in colour due to an e"cess of the yellow #i$ment bilirubin in the blood and tissues of the body% this is !nown as hy#erbilirubinemia& 'ery hi$hly ele(ated concentrations of bilirubin may e(en cause the sclerae and s!in to turn brown in colour& )ilirubin is a waste #roduct found in the bloodstream once the iron (*e has been remo(ed from haemo$lobin from the brea! down of red blood cells (erythrocytes & Hi$h le(els of bilirubin can cause it to see# out into the surroundin$ tissues #roducin$ the yellowish tin$e to the s!in& +ther common sym#toms of ,aundice can include #ruritis (itchin$ - abdominal #ain- (omitin$- yellowin$ of the mucus membranes (in #articular around the nose - #ale coloured faeces and dar! coloured urine& .hree main ty#es of ,aundice occur due to the amount of chan$e brou$ht about by the le(els of bilirubin& .hey are #re/he#atic- intra/he#atic and #ost he#atic& Pre-hepatic jaundice: this is a chan$e in bilirubin le(els e(en before bilirubin has been trans#orted to the li(er from the blood& 0t can be caused by conditions such as haemolytic anaemia and sic!le cell anaemia& Intra-hepatic jaundice: this is where the chan$e occurs inside the li(e and can be brou$ht about by cirrhosis and 1ilbert2s syndrome& Post-hepatic jaundice: the chan$e in bilirubin le(els #re(ents the bile (and the bilirubin inside it from drainin$ out of the $allbladder and into the di$esti(e system% can be caused by conditions such as $allstones or tumours& 3re/he#atic ,aundice affects mostly children and babies as neonatal ,aundice whereas intra/he#atic and #ost/he#atic affects most commonly middle a$ed #eo#le and the elderly& +ther rare conditions that can lead to ,aundice include 4ublin/Johnson syndrome which #re(ents coa$ulated bilirubin from bein$ secreted out of the cells- 3seudo ,aundice which occurs from an e"cess of beta/carotene instead of bilirubin- and 5i$ler/6a,,ar syndrome which im#airs the s#ecific en7yme re8uired to #rocess bilirubin& Jaundice can be dia$nosed in a (ariety of ways by usin$ bilirubin tests- *ull blood count (*)5 and He#atitis 9- ) and 5 tests& .here are more ad(anced dia$nosis methods where it2s sus#ected that the li(er is at #articular ris!& .hese can com#rise of ma$netic resonance ima$in$ (M:0 com#uterised tomo$ra#hy scan and endosco#ic retro$rade cholan$io#ancreato$ra#hy (;:53 & .reatments for ,aundice d#end on the ty#e of ,aundice& 3re/he#atic ,aundice is usually treated with eatin$ more iron/rish foods or ta!in$ iron su##lements to o(erall increase the concentration of iron in the blood& 0ntra/he#atic ,aundice is treatable with steroid or anti/(iral medications& 3ost/he#atic ,aundice is treated with sur$ery to remo(e the obstruction within the $all bladder&