JAUNDICE

        Jaundice is a yellow discoloration of the skin, mucous membranes, and the whites of the eyes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids. Jaundice is a sign of an underlying disease process. The term "icterus" is sometimes incorrectly used to refer to jaundice that is noted in the sclera of the eyes, however its more common and more correct meaning is entirely synonymous with jaundice.

Causes

      Jaundice may be caused by several different disease processes.

Pre-hepatic (before bile is made in the liver)

       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.

Examples of conditions with increased breakdown of red blood cells include:

       Malaria,

       Sickle cell crisis,

       Spherocytosis,

       Thalassemia,

       Drugs or other toxins, and

       Autoimmune disorders.

         Jaundice in these cases is caused by the liver's inability to properly metabolize and excrete bilirubin. Examples include:

       Hepatitis (commonly viral or alcohol related),

       Cirrhosis,

       Drugs or other toxins,

       Crigler-Najjar syndrome,

       Gilbert's syndrome, and

       Cancer.

Post-hepatic (after bile has been made in the liver)

        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.

Causes of obstructive jaundice include:

       Gallstones in the bile ducts,

       Cancer (pancreatic and gallbladder/bile duct carcinoma),

       Strictures of the bile ducts,

       Cholangitis,

       Congenital malformations,

       Pancreatitis,

       Parasites,

       Pregnancy, and

       Newborn jaundice.

Jaundice in newborn babies can be caused by several different conditions.

The following are some common causes of newborn jaundice:

Physiological Jaundice

         This form of jaundice is usually evident on the second or third day of life. It is the most common cause of newborn jaundice.

Maternal-fetal blood group incompatibility (Rh, ABO)

Signs and symptoms

         Often symptomatic of certain diseases such as hepatitis Yellowing of the eyes sclera and cornea form the external covering of the eye

          Head ache, weakness, loss of appetite, pain abdomen, constipation, urine yellow, anemia, light colored stool.

CASE

          This is the case of a girl [pari] aged five years old. She came to me with her parents. She had pain abdomen, head ache, weakness, constipation, loss of appetite, fever, urine yellow. She has Yellowing of eyes. She was advised for HB, TLC, DLC, ESR and LFT

         On 22/01/11 her report was [HB-12.2, TLC-11500, ESR-17, BILI T-7.8, BILI. D. -6.8, BILI. I.-1, SGPT-655 SGOT-384, ALKL PHOS-1023

She was prescribed R-7, R-1, Natrum Sulf, iris v, chinonthus for 20 days.

        On14/02/11 her parents reported that she is much better. She have no fever, no nausea, no pain abdomen but urine still yellow. Prescribed medicines for fifteen days and advised for LFT.

  

       She came on12/03/11 with report of LFT [BILI T - 0.7, BILI D - 0.3, BILI I- 0.4, SGPT - 33, SGOT- 45, ALKALI  PHOS-478, TLC- 9200] No symptoms of jaundice. She was cured.   

Dr. G. S. Bhatnagar

D.H.M.S. B.H.M.S.

Research officer

Sewa Mandir

Mobile: 9829978284

E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com