Prehepatic jaundice: Difference between revisions
(Created page with "{{CMG}} {{SI}} ==Overview== ''''''Pre-hepatic'''''' -(or hemolytic) jaundice is caused by anything which causes an increased rate of hemolysis (breakdown of [[red blood c...") |
No edit summary |
||
| Line 3: | Line 3: | ||
==Overview== | ==Overview== | ||
''Pre-hepatic'' jaundice is caused by anything which causes an increased rate of [[hemolysis]] (breakdown of [[red blood cell]]s). In tropical countries, [[malaria]] can cause jaundice in this manner. Certain [[Genetic disorder|genetic diseases]], such as [[sickle cell anemia]], [[spherocytosis]], [[thalassemia]] and [[glucose 6-phosphate dehydrogenase deficiency]] can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as [[hemolytic uremic syndrome]], can also lead to coloration. Defects in [[bilirubin metabolism]] also present as jaundice, as in [[Gilbert's syndrome]] (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population) and [[Crigler-Najjar syndrome]]. | |||
In jaundice secondary to hemolysis, the increased production of bilirubin, leads to the increased production of urine-urobilinogen. Bilirubin is not usually found in the urine because unconjugated bilirubin is not water-soluble, so, the combination of increased urine-urobilinogen with no bilirubin (since, unconjugated) in urine is suggestive of hemolytic jaundice. | |||
* Urine: no bilirubin present, | |||
[[Kernicterus]] is associated with increased unconjugated bilirubin, neonates are especially vulnerable to this. | |||
Laboratory findings include: | |||
* Urine: no bilirubin present, urobilinogen > 2 units (i.e., hemolytic anemia causes increased heme metabolism; exception: infants where [[gut flora]] has not developed). | |||
* Serum: increased unconjugated bilirubin. | * Serum: increased unconjugated bilirubin. | ||
Revision as of 19:11, 16 July 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pre-hepatic jaundice is caused by anything which causes an increased rate of hemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as sickle cell anemia, spherocytosis, thalassemia and glucose 6-phosphate dehydrogenase deficiency can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as hemolytic uremic syndrome, can also lead to coloration. Defects in bilirubin metabolism also present as jaundice, as in Gilbert's syndrome (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population) and Crigler-Najjar syndrome.
In jaundice secondary to hemolysis, the increased production of bilirubin, leads to the increased production of urine-urobilinogen. Bilirubin is not usually found in the urine because unconjugated bilirubin is not water-soluble, so, the combination of increased urine-urobilinogen with no bilirubin (since, unconjugated) in urine is suggestive of hemolytic jaundice.
Kernicterus is associated with increased unconjugated bilirubin, neonates are especially vulnerable to this.
Laboratory findings include:
- Urine: no bilirubin present, urobilinogen > 2 units (i.e., hemolytic anemia causes increased heme metabolism; exception: infants where gut flora has not developed).
- Serum: increased unconjugated bilirubin.