Prof. Dr. Hedef Dhafir El-Yassin 1
1. To define jaundice 2. To describe the types of jaundice 3. To tabulate and evaluate Laboratory results in all types of jaundice 2
} This is a condition where there is yellowing of the skin, sclera and mucous membranes as a result of increased bilirubin concentration in bodily fluids. } Normal bilirubin level is: } Conjugated: 0.0-0.4 mg/dl } Unconjugated: 0.2-0.8 mg/dl } Total: 0.2-1 mg/dl } It is usually detectable when bilirubin concentrations reach 2mg/dl 3
} Jaundice is the clinical sign of hyperbilirubinaemia. } It indicates disease of the liver or biliary tree. 4
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} Results from excessive RBC (or their precursors in bone marrow) breakdown. newborn babies have a reduced ability to remove bilirubin, (Neonatal Jaundice): } Stools are dark } Urine will be dark if left to stand, due to increased urobillogens. } Pallor due to anaemia is usually present } There is often splenomegaly as a result of increased reticuloendothelial activity. 7
} A full blood count may show evidence of haemolytic anaemia. } The most common causes are sickle-cell anaemia and thalassemia. Some drugs are also known to cause this, such as sulfasalazine and methyldopa. } The condition has an excellent prognosis, and normally requires no treatment. It is only really important because it can be mistaken for serious liver disease. 8
} LFT s are normal, plasma bilirubin is usually increased } There is no bilirubinuria because the excess bilirubin is mainly unconjugated Serum bilrubin Urine Urine Fecal Conjugated Unconjugated Urobilinogen Bilirubin Urobilinog en Normal 0.1-0.4 mg/dl 0.2-0.7mg/dl 0.4 mg/day Absent 40-280 mg/day Prehepatic Normal Increased Increased Absent Increased 9
} This results from an inability of the liver to excrete and/or conjugate bilirubin, as a result of liver tissue damage. } Bilirubin transport is impaired somewhere between the stages of unconjugated bilirubin uptake and conjugated bilirubin secretion into the calliculi. } Levels of both conjugated and unconjugated bilirubin increase. } Many diseases and conditions might lead to hepatocellular jaundice, including hepatitis, malaria, cirrhosis, autoimmune disorders and drug induced liver injury. Paracetamol and halothane are two main causes of drug induced hepatitis. 10
} Hepatitis is a term that refers to any inflammation of the liver -- the irritation or swelling of liver cells from any cause. It can be acute (inflammation of the liver that lasts less than six months) or chronic (inflammation of the liver that lasts more than six months) and has many different causes 11
1. Hepatitis viruses including A, B, C, D, and E.). 12
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Serum bilrubin Urine Urine Fecal Conjugated Unconjugated Urobilinogen Bilirubin Urobilinogen Normal 0.1-0.4 mg/dl 0.2-0.7mg/dl 0.4 mg/day Absent 40-280 mg/day Hepatic Increased Increased N/Decreasd Present Decreased 17
} This results in obstruction of the bile duct. It will result in lots of conjugated bilrubin causing dark urine and pale stools 18
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Serum bilrubin Urine Urine Fecal Conjugated Unconjugated Urobilinogen Bilirubin Urobilinog en Normal 0.1-0.4 mg/dl 0.2-0.7mg/dl 0.4 mg/day Absent 40-280 mg/day Prehepatic Normal Increased Increased Absent Increased Hepatic Increased Increased N/Decreasd Present Decreased Post hepatic Increased Normal Absent Present Trace to absent 20
1.Jaundice is a condition where there is yellowing of the skin, sclera and mucous membranes as a result of increased bilirubin concentration in bodily fluids. 2.Types of jaundice Pre hepatic Hepatic Post hepatic 21
Serum bilrubin Urine Urine Fecal Conjugated Unconjugated Urobilinogen Bilirubin Urobilinog en Normal 0.1-0.4 mg/dl 0.2-0.7mg/dl 0.4 mg/day Absent 40-280 mg/day Prehepatic Normal Increased Increased Absent Increased Hepatic Increased Increased N/Decreasd Present Decreased Post hepatic Increased Normal Absent Present Trace to absent 22
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