DEFINITION & TYPES OF JAUNDICEBy: Fahad Al HulaibiKing Faisal University

College of medicine

:DEFINITION

Jaundice is a yellow discoloration of the sclerae and skin, as a result of raised serum bilirubin, and is usually detectable clinically when the bilirubin is greater than 3mg/dL.

Clinical Medicine, Kumar & Clark, 4th edition

TYPES: 1- Haemolytic jaundice 2- Congenital hyperbilirubinemia. 3- Cholestatic jaundice.

Clinical Medicine, Kumar & Clark, 4th edition

TYPE 1: HAEMOLYTIC JAUNDICE

Clinical Medicine, Kumar & Clark, 4th edition

The increased breakdown of red cells leads to an increase in production of bilirubin.

causes of haemolytic jaundice are those of haemolytic Anaemia.

The resulting jaundice is usually mild.

level of unconjugated bilirubin is raised, but the serum transferases and alkaline

phposphate are normal.

TYPE 2: CONGENITAL HYPERBILIRUBINEMIA

Most common is Gilbert’s syndrome . Mutation in the gene coding for : UDP-glucuronosyl transferase . asymptomatic and is usually detected

as an incidental finding of a slightly raised Bilirubin (1–6mg/dL).

There is a family history of jaundice in 5–15% of patients.

The reticulocyte count is normal, excluding haemolysis, and no treatment is necessary.

Clinical Medicine, Kumar & Clark, 4th edition

TYPE 3: CHOLESTATIC JAUNDICE

Can be devided into:

Intra-hepatic Cholestatic:Cased by hepatocellular swelling in

parenchymal liver disease or abnormalities at a cellular level of bile excertion.

aminotransferases and alkaline phposphate ??

Extra-hepatic Cholestasis:Resulting from obstruction of bile flow at any

point distal to the bile canaliculi.

Clinical Medicine, Kumar & Clark, 4th edition

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