Jaundice: Difference between revisions

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{{CMG}}
__NOTOC__
 
{{Editor Help}}
 
{{DiseaseDisorder infobox |
{{DiseaseDisorder infobox |
   Name          = Jaundice, NOS |
   Name          = Jaundice, NOS |
   Image          = PHIL 2860 lores.jpg|
   Image          = PHIL 2860 lores.jpg|
   Caption        = Yellowing of the [[skin]] and [[sclera]] caused by [[Hepatitis|Hepatitis A]].|
   Caption        = Yellowing of the [[skin]] and [[sclera]], via Wikimedia Commons<ref>By Photo Credit: Content Providers(s): CDC/Dr. Thomas F. Sellers/Emory University [Public domain], <"https://commons.wikimedia.org/wiki/File%3AJaundice_eye.jpg"></ref>|
  ICD10          = {{ICD10|R|17||r|10}} |
  ICD9          = {{ICD9|782.4}} |
  OMIM          = |
  MedlinePlus    = 003243 |
  eMedicineSubj  = |
  eMedicineTopic = |
  DiseasesDB    = 7038 |
  MeshID        = D007565 |
}}
}}


{{SI}}
'''For patient information, click [[Jaundice (patient information)|here]].'''


==Overview==
'''For the approach to a patient with jaundice, click [[Approach to a patient with jaundice|here]].'''
'''Jaundice''', also known as '''icterus''' (attributive adjective: "icteric"), is  yellowish discoloration of the [[skin]], [[conjunctiva]] (a clear covering over the [[sclera]], or whites of the eyes) and [[mucous membrane]]s caused by hyperbilirubinemia (increased levels of [[bilirubin]] in red blooded animals). Usually the concentration of bilirubin in the [[blood]] must exceed 2–3 [[milligram|mg]]/[[decilitre|dL]] for the coloration to be easily visible. ''Jaundice'' comes from the French word ''jaune'', meaning yellow.  Jaundice typically appears in a 'top to bottom' progression (starting with the face, progressing toward the feet), and resolves in a 'bottom to top' manner.


'''[[Neonatal jaundice]]'''
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{FKH}}, {{FA}}, {{EG}}, {{MJ}}


Neonatal jaundice can be '''physiological''' or '''pathological'''. Neonatal physiological jaundice is usually harmless: this condition is often seen in [[infants]] around the second day after birth, lasting until day 8 in normal births, or to around day 14 in [[premature birth]]s. Serum [[bilirubin]] normally drops to a low level without any intervention required: the jaundice is presumably a consequence of metabolic and physiological adjustments after birth. In extreme cases, a brain-damaging condition known as [[kernicterus]] can occur; there are concerns that this condition has been rising in recent years due to inadequate detection and treatment of neonatal hyperbilirubinemia. Neonatal jaundice is a risk factor for hearing loss.<ref>{{cite web|url=http://aapnews.aappublications.org/cgi/content/full/18/5/231 |title=Increased vigilance needed to prevent kernicterus in newborns --O�Keefe 18 (5): 231 -- AAP News |accessdate=2007-06-27 |format= |work=}}</ref>
{{Jaundice}}


'''Jaundiced eye'''
'''''Synonyms and keywords:''''' Icterus; hyperbilirubinemia, yellow discolouration.


It was once believed persons suffering from the medical condition jaundice saw everything as yellow. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. [[Alexander Pope]], in 'An Essay on Criticism' (1711), wrote: "All seems infected that the infected spy, As all looks yellow to the jaundiced eye." <ref name=eye>From "The Dictionary of Cliches" by James Rogers (Ballantine Books, New York, 1985).</ref>
==[[Jaundice overview|Overview]]==


==Pathophysiology==
==[[Jaundice historical perspective|Historical Perspective]]==
* Bilirubin is the major breakdown product of hemoglobin that is released from dying or damaged erythrocytes
* The normal bilirubin range is 0.3-1.0 mg/dL
* Jaundice is visible in conjunctiva, skin and mucosa when the serum bilirubin level rises above 2 mg/dL
==Causes==
When  [[red blood cell]]s die, the [[heme]] in their [[haemoglobin]] is converted to [[bilirubin]] in the [[spleen]] and in the hepatocytes in the liver. The [[bilirubin]] is processed by the [[liver]], enters [[bile]] and is eventually excreted through [[feces]].


Consequently, there are three different classes of causes for jaundice. ''Pre-hepatic'' or ''hemolytic'' causes, where too many red blood cells are broken down, ''hepatic'' causes where the processing of [[bilirubin]] in the liver does not function correctly, and ''post-hepatic'' or ''extrahepatic'' causes, where the removal of bile is disturbed.
==[[Jaundice classification scheme|Classification]]==
===Common Causes===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Eclampsia]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"|[[1,2-Dibromoethane  ]], [[2-acetylamino-fluorene  ]], [[2-Nitropropane  ]], [[3,3-Dichlorobenzidine  ]], [[4-Dimethylaminoazobenzene  ]], [[8-Hydroxyquinolone  ]], [[Acer rubrum]], [[Acetates  ]], [[Acetonitrile  ]], [[Acetylene Tetrabromide  ]], [[Acrylonitrile  ]], [[Aflatoxin  ]], [[Albitocin]], [[Alicyclic Hydrocarbons  ]], [[Aliphatic Amines  ]], [[Aliphatic Hydrocarbons  ]], [[Aliphatic hydrogenated hydrocarbons  ]], [[Allyl alcohol  ]], [[Amanita phalloides]], [[Aromatic amines  ]], [[Aromatic halogenated hydrocarbons  ]], [[Aromatic Hydrocarbons  ]], [[Arsenic  ]], [[Arsine  ]], [[Benzene  ]], [[Benzyl chloride  ]], [[Beryllium  ]], [[Biliary colic]], [[Bipyridyl pesticides  ]], [[Black nightshade poisoning  ]], [[Boron  ]], [[Cadmium  ]], [[Carbarsone  ]], [[Carbolic Acids and Anhydrides  ]], [[Carbon Disulfide  ]], [[Carbon Tetrachloride  ]], [[Chloramphenicol  ]], [[Chlorate salts  ]], [[Chlordane]], [[Chlorinated benzenes  ]], [[Chlorinated naphthalene  ]], [[Chlorodiphenyls and derivatives  ]], [[Chloroform]], [[Chloromethane  ]], [[Chloroprene  ]], [[Chromium  ]], [[Comfrey  ]], [[Copper  ]], [[Cresol  ]], [[Cycasin]], [[Cyclochlorotine  ]], [[Dibromochloropropane  ]], [[Diethylene Glycol  ]], [[Dimethyl sulfate  ]], [[Dimethylnitrosamine  ]], [[Dinitrobenzene  ]], [[Dinitrocresol  ]], [[Dinitrophenol  ]], [[Dinitrotoluene  ]], [[Ethanolamines  ]], [[Ethyl Acetate  ]], [[Ethyl alcohol  ]], [[Ethyl benzene  ]], [[Ethyl Ether  ]], [[Ethyl Salicylate  ]], [[Ethylene chlorohydrin  ]], [[Ethylene Dibromide  ]], [[Ethylene dichloride  ]], [[Ethylene oxide  ]], [[Ethylenediamine  ]], [[Germander  ]], [[Germanium  ]],, [[Gold  ]], [[Hafnium  ]], [[Horse nettle ]], [[Hydrogen bromides  ]], [[Hydrogen Cyanide  ]], [[Icterogenin]], [[Indospicine]], [[Isopropyl acetate  ]], [[Kepone pesticides  ]], [[Lanthanides  ]], [[Lead  ]], [[Mercaptans  ]], [[Mercury  ]], [[Methoxyflurane  ]], [[Methyl acetate  ]], [[Methyl Bromide  ]], [[Methy,  Chloride  ]], [[Methylene chloride  ]], [[Methylene Dianiline  ]], [[Metolachlor]], [[Monomethylhydrazine]], [[N,N-Dimethylformamide  ]], [[Naphthalene]], [[Naphthol  ]], [[N-butyl acetate  ]], [[Ngaione]], [[Nickel  ]], [[Niobium  ]], [[Nitriles  ]], [[Nitrobenzene  ]], [[Nitromethane  ]], [[Nitroparaffins  ]], [[N-N-Dimethylacetamide  ]], [[N-Nitrosodimethylamine  ]], [[N-propyl acetate  ]], [[Ochratoxin  ]], [[Para-Dichlorobenzene  ]], [[Phosphine  ]], [[Phosphorus]], [[Phthalic Anhydride  ]], [[Picric Acid  ]], [[Polybrominated biphenyls  ]], [[Polychlorinated biphenyls  ]], [[Polygonum multiflorum  ]], [[Propylene dichloride  ]], [[Psoralea Corylifolia  ]], [[Pyrogallol  ]], [[Pyrrolidizine]], [[Ragwort]], [[Rubratoxin  ]], [[Safrole]], [[Solanine]], [[Solder  ]], [[Sterigmatocystin  ]], [[Stibine  ]], [[Tellurium]], [[Tetrachloroethane]], [[Tetrachloroethylene  ]], [[Tetramethylthiuram disulfide  ]], [[Thallium]], [[Thioxanthene]], [[Thorium dioxide  ]], [[Thorotrast  , ]], [[Toluene  ]], [[Trichloroethylene  ]], [[Trinitrotoluene  ]], [[Uranium  ]], [[Vicia faba]], [[Vinyl Chloride  ]], [[White Phosphorus  ]], [[Xylene  ]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"|[[Griscelli disease  ]], [[NISCH syndrome  ]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|[[5-Fluorocytosine  ]], [[Allopurinol  ]], [[Alprazolam]], [[Amineptine]], [[Amiodarone]], [[Amlodipine]], [[Amodiaquine  ]], [[Amphotericin  ]], [[Anabolic C-17  ]], [[Bicalutamide]], [[Bromazepam]], [[Buprenorphine]], [[Butyrophenones]], [[Cefaclor]], [[Cephalosporins]], [[Cimetidine  ]], [[Clarithromycin]], [[Clavulanic acid]], [[Clindamycin]], [[Co-amoxiclav]], [[Colchicine  ]], [[Cyclopropane  ]], [[Cycloserine  ]], [[Cytarabine  ]], [[Dantrolene  ]], [[Dapsone]], [[Daptomycin]], [[Deracoxib]], [[Diazepam]], [[Diflunisal  ]], [[Diphenoxylate and Atropine]], [[Disulfiram  ]], [[Docetaxel]], [[Doxepine]], [[Duloxetine]], [[Dydrogesterone]], [[Erythromycin estolate  ]], [[Erythromycin Ethyl succinate  ]], [[Estrogen and Progestin]], [[Ethionamide  ]], [[Fenoprofen  ]], [[Flucloxacillin]], [[Framycetin]], [[Fusidic acid]], [[Griseofulvin  ]], [[Halothane  ]], [[Hycanthone  ]], [[Ibuprofen  ]], [[Idoxuridine  ]], [[Imipramine]], [[Indomethacin  ]], [[Isoniazid  ]], [[Itraconazole]], [[Ketoconazole  ]], [[Loprazolam]], [[Lorazepam]], [[Lormetazepam]], [[Mepacrine  ]], [[Mephenytoin  ]], [[Methimazole]], [[Methyldopa]], [[Metronidazole  ]], [[Minocycline]], [[Mirtazapine]], [[Monoamine oxidase inhibitors]], [[Naproxen  ]], [[Nitrofurantoin]], [[Nitrous Oxide  ]], [[Novobiocin  ]], [[Oxycodone]], [[p-aminosalicylic acid  ]], [[Papaverine]], [[Paroxetine]], [[Penicillin  ]], [[Phenol  ]], [[Phenothiazine]], [[Phenylbutazone  ]], [[Phenytoin  ]], [[Pyridine  ]], [[Quinidine-induced Immune Hemolytic Anemia]], [[Quinolone  ]], [[Ranitidine  ]], [[Rifampicin]], [[Salicylate  ]], [[Sibutramine]], [[Spectinomycin  ]], [[Sulindac  ]], [[Sulphonamides]], [[Tamoxifen]], [[Tegaserod]], [[Telithromycin]], [[Tetracycline  ]], [[Thiabendazole  ]], [[Trazodone]], [[Valproic acid]], [[Vidarabine  ]], [[Zoxazolamine  ]],
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|[[Gestational diabetes]], [[Growth hormone deficiency]], [[Hypopitutarism]], [[Hypothyroidism]], [[Thyroid agenesis]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|[[Accessory pancreas]], [[Acinic cell carcinoma]], [[Acral dysostosis -- dyserythropoiesis ]], [[Acute Cholecystitis]], [[Acute fatty liver of pregnancy]], [[Acute hepatitis]], [[Acute liver failure]], [[Addison-Gull syndrome]], [[Alagille syndrome]], [[Alcoholic Hepatitis]], [[Alcoholic liver disease]], [[Angiosarcoma of the liver  ]], [[Arthrogryposis -- renal dysfunction -- cholestasis syndrome  ]], [[Ascending cholangitis]], [[Autoimmune Hepatitis  ]], [[Baber's syndrome  ]], [[Banti's syndrome]], [[Bile duct cancer]], [[Bile duct paucity, non syndromic form  ]], [[Bile plug syndrome  ]], [[Biliary atresia]], [[Biliary cirrhosis  ]], [[Budd-Chiari syndrome]], [[Byler Disease  ]], [[Caroli's Disease]], [[Chlorpropamide]], [[Cholangiocarcinoma]], [[Cholangitis]], [[Choledochal cyst, hand malformation  ]], [[Choledochal cysts]], [[Choledocholithiasis]], [[Cholestasis  ]], [[Cholestasis -- pigmentary retinopathy -- cleft palate  ]], [[Chronic cholecystitis]], [[Chronic Hepatitis  ]], [[Cirrhosis o,  liver  ]], [[Colorectal cancer]], [[Crigler-Najjar syndrome]], [[Eosinophilic gastroenteritis]], [[Esophageal cancer]], [[Gallbladder cancer]], [[Gallstones  ]], [[Gilbert's syndrome]], [[Hemosuccus pancreaticus]], [[Hepatic amyloidosis with intrahepatic cholestasis  ]], [[Hepatic encephalopathy syndrome  ]], [[Hepatoma  ]], [[Hyperemesis gravidarum]], [[Idiopathic liver cirrhosis  ]], [[Intrahepatic cholangiocarcinoma  ]], [[Intrahepatic cholestasis of pregnancy]], [[Islet Cell adenoma]], [[Liver cancer  ]], [[Mirizzi's syndrome]], [[Mosse syndrome  ]], [[Neonatal hepatitis  ]], [[Neuroma biliary tract  ]], [[Non-alcoholic fatty liver disease]], [[Obliterative portal venopathy  ]], [[Pancreatic adenoma]], [[Pancreatic cancer]], [[Pancreatitis]], [[Pancreatoblastoma]], [[Papillary stenosis]], [[Peliosis hepatis]], [[Portal hypertension]], [[Primary biliary cirrhosis]], [[Primary sclerosing cholangitis]], [[Sarcoma botryoides of common bile duct]], [[Secondary Biliary Cirrhosis]], [[Spleen Cance, ]], [[Xanthogranulomatous cholecystitis]], [[Xanthomatous biliary cirrhosis]], [[Zieve's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"|[[Aagenaes syndrome ]], [[Aldolase A deficiency ]], [[Benign intrahepatic cholestasis ]], [[Chediak-Higashi syndrome  ]], [[Cholesteryl ester storage disease]], [[Dubin-Johnson syndrome]], [[Exocrine Pancreatic Insufficiency, Dyserythropoietic Anemia, And Calvarial Hyperostosis  ]], [[Familial progressive intrahepatic cholestasis  ]], [[Familial Selective Vitamin B12 Malabsorption  ]], [[Galactosemia  ]], [[Glucose-6-phosphate dehydrogenase deficiency]], [[Glutaric aciduria  ]], [[Hemochromatosis  ]], [[Hereditary elliptocytosis  ]], [[Hereditary fructose intolerance]], [[Hereditary xerocytosis]], [[Imerslund-Najman-Grasbeck Syndrome  ]], [[Lucey-Driscoll syndrome]], [[Lymphoproliferative syndrome, EBV-Associated, Autosomal]], [[Niemann-Pick disease  ]], [[Porphyria]], [[Progressive familial intrahepatic cholestasis (PFIC) ]], [[Pseudo-torch syndrome]], [[Rotor syndrome]], [[Sotos syndrome]], [[Summerskill-Walshe-Tygstrup syndrome]], [[Trichomegaly cataract hereditary spherocytosis]], [[Tyrosinemia]], , [Wilson's Disease]], [[Wolman disease]], [[X-linked alpha thalassemia mental retardation syndrome (ATR-X)]], [[X-linked lymphoproliferative syndrome]], [[X-linked sideroblastic anaemia]], [[Zellweger syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|[[Achrestic anemia]], [[Autoimmune hemolytic anemia]], [[Evans syndrome]], [[Fanconi-ichthyosis-dysmorphism  ]], [[Favism  ]], [[Hashimoto-Pritzker syndrome  ]], [[HELLP syndrome  ]], [[Hemoglobin C homozygous (CC)  ]], [[Hemolytic anemia]], [[Hemolytic disease of the newborn]], [[Hemophagocytic lymphohistiocytosis familial]] ,[[Hepatic veno-occlusive disease with immunodeficiency ]], [[Heptaosplenic T-cell Lymphoma  ]], [[Hereditary spherocytosis]], [[HLH (Hemophagocytic lymphohistiocytosis)]], [[Hodgkin's Disease  ]], [[Kawasaki disease  ]], [[Langerhans Cell Histiocytosis  ]], [[Lymphoma  ]], [[Myelofibrosis-osteosclerosis  ]] ,[[Pernicious anemia]], [[Rh deficiency syndrome]], [[Thalassemia]], [[Thrombotic thrombocytopenic purpura]],
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"|[[Post operative jaundice]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|[[Alveolar Hydatid Disease .]], [[Aspergillosis]], [[Congenital TORCH infections]], [[Fascioliasis  ]], [[Infective endocarditis  ]], [[Malignant boutonneuse fever]], [[Nanukayami  ]], [[Neonatal sepsis  ]], [[Omphalitis]], [[Pneumonia]], [[Sepsis]], [[Tuberculosis]], [[Q fever]], [[Relapsing fever]], [[Syphilis]], [[Weil's disease]], [[Histoplasmosis]], [[Malaria  ]], [[Cytomegalovirus]], [[Hepadnaviruses  ]], [[Herpes]], [[Infectious mononucleosis]], [[Lábrea fever]], [[Marburg virus]], [[Viral Hepatitis A]], [[Viral Hepatitis B]], [[Viral Hepatitis C]], [[Viral Hepatitis D]], [[Viral Hepatitis E]], [[Viral hepatitis X (non-A,-B,-C,-D,-E)]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"|[[Deal-Barratt-Dillon syndrome  ]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"|[[Absence of septum pellucidum and septo-optic dysplasia ]], [[Acute meningitis]],
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|[[Breast feeding jaundice]], [[Breast milk jaundice  ]], [[Congenital disorders of glycosylation]], [[Fructose intolerance]], [[Manganese deficiency]], [[Molybdenum deficiency]], [[Organic acidemia]], [[Pyruvate kinase deficiency]], [[Selenium deficiency]], [[Vitamin A overdose]], [[Vitamin B12 Deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [Breast cancer]], [[Embryonal rhabdomyosarcoma]], [[Kaposiform hemangio-endothelioma  ]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"|[[Goldstein-Hutt syndrome  ]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"|[[Acetaminophen]], [[Iron  ]], [[Vitamin C ]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"|[[Alpha 1-Antitrypsin Deficiency ]], [[Mesothelioma]], [[Sarcoidosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"|[[Cephalhematoma]], [[Hepatic trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"|[[Brown Recluse spider bite ]], [[Neonatal adrenal hemorrhage]], [[Neonatal physiological jaundice]], [[Premature birth]], [[Reye's syndrome]]
|-
|}


===Causes in Alphabetical Order===
==[[Jaundice pathophysiology|Pathophysiology]]==
{{MultiCol}}
*[[1,2-Dibromoethane  ]]
*[[2-acetylamino-fluorene  ]]
*[[2-Nitropropane  ]]
*[[3,3-Dichlorobenzidine  ]]
*[[4-Dimethylaminoazobenzene  ]]
*[[5-Fluorocytosine  ]]
*[[8-Hydroxyquinolone  ]]
*[[Aagenaes syndrome ]]
*[[Absence of septum pellucidum and septo-optic dysplasia ]]
*[[Accessory pancreas]]
*[[Acer rubrum]]
*[[Acetaminophen]]
*[[Acetates  ]]
*[[Acetonitrile  ]]
*[[Acetylene Tetrabromide  ]]
*[[Achrestic anemia]]
*[[Acinic cell carcinoma]]
*[[Acral dysostosis -- dyserythropoiesis ]]
*[[Acrylonitrile  ]]
*[[Acute Cholecystitis]]
*[[Acute fatty liver of pregnancy]]
*[[Acute hepatitis]]
*[[Acute liver failure]]
*[[Acute meningitis]]
*[[Addison-Gull syndrome]]
*[[Aflatoxin  ]]
*[[Alagille syndrome]]
*[[Albitocin]]
*[[Alcoholic Hepatitis]]
*[[Alcoholic liver disease]]
*[[Aldolase A deficiency ]]
*[[Alicyclic Hydrocarbons  ]]
*[[Aliphatic Amines  ]]
*[[Aliphatic Hydrocarbons  ]]
*[[Aliphatic hydrogenated hydrocarbons  ]]
*[[Allopurinol  ]]
*[[Allyl alcohol  ]]
*[[Alpha 1-Antitrypsin Deficiency ]]
*[[Alprazolam]]
*[[Alveolar Hydatid Disease .]]
*[[Amanita phalloides]]
*[[Amineptine]]
*[[Amiodarone]]
*[[Amlodipine]]
*[[Amodiaquine  ]]
*[[Amphotericin  ]]
*[[Anabolic C-17  ]]
*[[Angiosarcoma of the liver  ]]
*[[Aromatic amines  ]]
*[[Aromatic halogenated hydrocarbons  ]]
*[[Aromatic Hydrocarbons  ]]
*[[Arsenic  ]]
*[[Arsine  ]]
*[[Arthrogryposis -- renal dysfunction -- cholestasis syndrome  ]]
*[[Ascending cholangitis]]
*[[Aspergillosis]]
*[[Autoimmune hemolytic anemia]]
*[[Autoimmune Hepatitis  ]]
*[[Baber's syndrome  ]]
*[[Babesiosis  ]]
*[[Banti's syndrome]]
*[[Benign intrahepatic cholestasis ]]
*[[Benzene  ]]
*[[Benzyl chloride  ]]
*[[Beryllium  ]]
*[[Bicalutamide]]
*[[Bile duct cancer]]
*[[Bile duct paucity, non syndromic form  ]]
*[[Bile plug syndrome  ]]
*[[Biliary atresia]]
*[[Biliary cirrhosis  ]]
*[[Biliary colic]]
*[[Bipyridyl pesticides  ]]
*[[Black nightshade poisoning  ]]
*[[Boron  ]]
*[[Breast cancer]]
*[[Breast feeding jaundice]]
*[[Breast milk jaundice  ]]
*[[Bromazepam]]
*[[Brown Recluse spider bite ]]
*[[Budd-Chiari syndrome]]
*[[Buprenorphine]]
*[[Butyrophenones]]
*[[Byler Disease  ]]
*[[Cadmium  ]]
*[[Carbarsone  ]]
*[[Carbolic Acids and Anhydrides  ]]
*[[Carbon Disulfide  ]]
*[[Carbon Tetrachloride  ]]
*[[Caroli's Disease]]
*[[Cefaclor]]
*[[Cephalhematoma]]
*[[Cephalosporins]]
*[[Chediak-Higashi syndrome  ]]
*[[Chloramphenicol  ]]
*[[Chlorate salts  ]]
*[[Chlordane]]
*[[Chlorinated benzenes  ]]
*[[Chlorinated naphthalene  ]]
*[[Chlorodiphenyls and derivatives  ]]
*[[Chloroform]]
*[[Chloromethane  ]]
*[[Chloroprene  ]]
*[[Chlorpropamide]]
*[[Cholangiocarcinoma]]
*[[Cholangitis]]
*[[Choledochal cyst, hand malformation  ]]
*[[Choledochal cysts]]
*[[Choledocholithiasis]]
*[[Cholestasis  ]]
*[[Cholestasis -- pigmentary retinopathy -- cleft palate  ]]
*[[Cholesteryl ester storage disease]]
*[[Chromium  ]]
*[[Chronic cholecystitis]]
{{ColBreak}}
*[[Chronic Hepatitis  ]]
*[[Cimetidine  ]]
*[[Cirrhosis of liver  ]]
*[[Clarithromycin]]
*[[Clavulanic acid]]
*[[Clindamycin]]
*[[Co-amoxiclav]]
*[[Colchicine  ]]
*[[Colorectal cancer]]
*[[Comfrey  ]]
*[[Congenital disorders of glycosylation]]
*[[Congenital TORCH infections]]
*[[Copper  ]]
*[[Cresol  ]]
*[[Crigler-Najjar syndrome]]
*[[Cycasin]]
*[[Cyclochlorotine  ]]
*[[Cyclopropane  ]]
*[[Cycloserine  ]]
*[[Cytarabine  ]]
*[[Cytomegalovirus]]
*[[Dantrolene  ]]
*[[Dapsone]]
*[[Daptomycin]]
*[[Deal-Barratt-Dillon syndrome  ]]
*[[Deracoxib]]
*[[Diazepam]]
*[[Dibromochloropropane  ]]
*[[Diethylene Glycol  ]]
*[[Diflunisal  ]]
*[[Dimethyl sulfate  ]]
*[[Dimethylnitrosamine  ]]
*[[Dinitrobenzene  ]]
*[[Dinitrocresol  ]]
*[[Dinitrophenol  ]]
*[[Dinitrotoluene  ]]
*[[Diphenoxylate and Atropine]]
*[[Disulfiram  ]]
*[[Docetaxel]]
*[[Doxepine]]
*[[Dubin-Johnson syndrome]]
*[[Duloxetine]]
*[[Dydrogesterone]]
*[[Eclampsia  ]]
*[[Embryonal rhabdomyosarcoma]]
*[[Eosinophilic gastroenteritis]]
*[[Erythromycin estolate  ]]
*[[Erythromycin Ethyl succinate  ]]
*[[Esophageal cancer]]
*[[Estrogen and Progestin]]
*[[Ethanolamines  ]]
*[[Ethionamide  ]]
*[[Ethyl Acetate  ]]
*[[Ethyl alcohol  ]]
*[[Ethyl benzene  ]]
*[[Ethyl Ether  ]]
*[[Ethyl Salicylate  ]]
*[[Ethylene chlorohydrin  ]]
*[[Ethylene Dibromide  ]]
*[[Ethylene dichloride  ]]
*[[Ethylene oxide  ]]
*[[Ethylenediamine  ]]
*[[Evans syndrome]]
*[[Exocrine Pancreatic Insufficiency, Dyserythropoietic Anemia, And Calvarial Hyperostosis  ]]
*[[Familial progressive intrahepatic cholestasis  ]]
*[[Familial Selective Vitamin B12 Malabsorption  ]]
*[[Fanconi-ichthyosis-dysmorphism  ]]
*[[Fascioliasis  ]]
*[[Favism  ]]
*[[Fenoprofen  ]]
*[[Flucloxacillin]]
*[[Framycetin]]
*[[Fructose intolerance]]
*[[Fusidic acid]]
*[[Galactosemia  ]]
*[[Gallbladder cancer]]
*[[Gallstones  ]]
*[[Germander  ]]
*[[Germanium  ]]
*[[Gestational diabetes]]
*[[Gilbert's syndrome]]
*[[Glucose-6-phosphate dehydrogenase deficiency]]
*[[Glutaric aciduria  ]]
*[[Gold  ]]
*[[Goldstein-Hutt syndrome  ]]
*[[Graft-versus-host disease  ]]
*[[Griscelli disease  ]]
*[[Griseofulvin  ]]
*[[Growth hormone deficiency]]
*[[Hafnium  ]]
*[[Halothane  ]]
*[[Hashimoto-Pritzker syndrome  ]]
*[[HELLP syndrome  ]]
*[[Hemochromatosis  ]]
*[[Hemoglobin C homozygous (CC)  ]]
*[[Hemolytic anemia]]
*[[Hemolytic disease of the newborn]]
*[[Hemophagocytic lymphohistiocytosis familial]]
*[[Hemosuccus pancreaticus]]
*[[Hepadnaviruses  ]]
*[[Hepatic amyloidosis with intrahepatic cholestasis  ]]
*[[Hepatic encephalopathy syndrome  ]]
*[[Hepatic trauma]]
*[[Hepatic veno-occlusive disease with immunodeficiency ]]
*[[Hepatoma  ]]
*[[Heptaosplenic T-cell Lymphoma  ]]
*[[Hereditary elliptocytosis  ]]
*[[Hereditary fructose intolerance]]
*[[Hereditary spherocytosis]]
*[[Hereditary xerocytosis]]
*[[Herpes]]
*[[Histoplasmosis]]
*[[HLH (Hemophagocytic lymphohistiocytosis)]]
*[[Hodgkin's Disease  ]]
{{ColBreak}}
*[[Horse nettle ]]
*[[Hycanthone  ]]
*[[Hydrogen bromides  ]]
*[[Hydrogen Cyanide  ]]
*[[Hyperemesis gravidarum]]
*[[Hypopitutarism]]
*[[Hypothyroidism]]
*[[Ibuprofen  ]]
*[[Icterogenin]]
*[[Idiopathic liver cirrhosis  ]]
*[[Idoxuridine  ]]
*[[Imerslund-Najman-Grasbeck Syndrome  ]]
*[[Imipramine]]
*[[Indomethacin  ]]
*[[Indospicine]]
*[[Infectious mononucleosis]]
*[[Infective endocarditis  ]]
*[[Intrahepatic cholangiocarcinoma  ]]
*[[Intrahepatic cholestasis of pregnancy]]
*[[Iron  ]]
*[[Islet Cell adenoma]]
*[[Isoniazid  ]]
*[[Isopropyl acetate  ]]
*[[Itraconazole]]
*[[Kaposiform hemangio-endothelioma  ]]
*[[Kawasaki disease  ]]
*[[Kepone pesticides  ]]
*[[Ketoconazole  ]]
*[[Lábrea fever]]
*[[Langerhans Cell Histiocytosis  ]]
*[[Lanthanides  ]]
*[[Lead  ]]
*[[Lissencephalic syndromes]]
*[[Liver cancer  ]]
*[[Loprazolam]]
*[[Lorazepam]]
*[[Lormetazepam]]
*[[Lucey-Driscoll syndrome]]
*[[Lupus]]
*[[Lymphoma  ]]
*[[Lymphoproliferative syndrome, EBV-Associated, Autosomal]]
*[[Malaria  ]]
*[[Malignant boutonneuse fever]]
*[[Manganese deficiency]]
*[[Marburg virus]]
*[[Mepacrine  ]]
*[[Mephenytoin  ]]
*[[Mercaptans  ]]
*[[Mercury  ]]
*[[Mesothelioma]]
*[[Methimazole]]
*[[Methoxyflurane  ]]
*[[Methyl acetate  ]]
*[[Methyl Bromide  ]]
*[[Methyl Chloride  ]]
*[[Methyldopa]]
*[[Methylene chloride  ]]
*[[Methylene Dianiline  ]]
*[[Metolachlor]]
*[[Metronidazole  ]]
*[[Minocycline]]
*[[Mirizzi's syndrome]]
*[[Mirtazapine]]
*[[Molybdenum deficiency]]
*[[Monoamine oxidase inhibitors]]
*[[Monomethylhydrazine]]
*[[Mosse syndrome  ]]
*[[Myelofibrosis-osteosclerosis  ]]
*[[N,N-Dimethylformamide  ]]
*[[Nanukayami  ]]
*[[Naphthalene]]
*[[Naphthol  ]]
*[[Naproxen  ]]
*[[N-butyl acetate  ]]
*[[Neonatal adrenal hemorrhage]]
*[[Neonatal hepatitis  ]]
*[[Neonatal physiological jaundice]]
*[[Neonatal sepsis  ]]
*[[Neuroma biliary tract  ]]
*[[Ngaione]]
*[[Nickel  ]]
*[[Niemann-Pick disease  ]]
*[[Niobium  ]]
*[[NISCH syndrome  ]]
*[[Nitriles  ]]
*[[Nitrobenzene  ]]
*[[Nitrofurantoin]]
*[[Nitromethane  ]]
*[[Nitroparaffins  ]]
*[[Nitrous Oxide  ]]
*[[N-N-Dimethylacetamide  ]]
*[[N-Nitrosodimethylamine  ]]
*[[Non-alcoholic fatty liver disease]]
*[[Novobiocin  ]]
*[[N-propyl acetate  ]]
*[[Obliterative portal venopathy  ]]
*[[Ochratoxin  ]]
*[[Omphalitis]]
*[[Organic acidemia]]
*[[Oxycodone]]
*[[p-aminosalicylic acid  ]]
*[[Pancreatic adenoma]]
*[[Pancreatic cancer]]
*[[Pancreatitis]]
*[[Pancreatoblastoma]]
*[[Papaverine]]
*[[Papillary stenosis]]
*[[Para-Dichlorobenzene  ]]
*[[Paroxetine]]
*[[Peliosis hepatis]]
*[[Penicillin  ]]
*[[Pernicious anemia]]
*[[Phenol  ]]
*[[Phenothiazine]]
{{ColBreak}}
*[[Phenylbutazone  ]]
*[[Phenytoin  ]]
*[[Phosphine  ]]
*[[Phosphorus]]
*[[Phthalic Anhydride  ]]
*[[Picric Acid  ]]
*[[Pneumonia]]
*[[Polybrominated biphenyls  ]]
*[[Polychlorinated biphenyls  ]]
*[[Polygonum multiflorum  ]]
*[[Porphyria]]
*[[Portal hypertension]]
*[[Postoperative Jaundice]]
*[[Premature birth]]
*[[Primary biliary cirrhosis]]
*[[Primary sclerosing cholangitis]]
*[[Progressive familial intrahepatic cholestasis (PFIC) ]]
*[[Propylene dichloride  ]]
*[[Pseudo-torch syndrome]]
*[[Psoralea Corylifolia  ]]
*[[Pyridine  ]]
*[[Pyrogallol  ]]
*[[Pyrrolidizine]]
*[[Pyruvate kinase deficiency]]
*[[Q fever]]
*[[Quinidine-induced Immune Hemolytic Anemia]]
*[[Quinolone  ]]
*[[Ragwort]]
*[[Ranitidine  ]]
*[[Relapsing fever]]
*[[Reye's syndrome]]
*[[Reynolds syndrome]]
*[[Rh deficiency syndrome]]
*[[Rh disease]]
*[[Rifampicin]]
*[[Rotor syndrome]]
*[[Rubratoxin  ]]
*[[Safrole]]
*[[Salicylate  ]]
*[[Sarcoidosis]]
*[[Sarcoma botryoides of common bile duct]]
*[[Secondary Biliary Cirrhosis]]
*[[Selenium deficiency]]
*[[Sepsis]]
*[[Sibutramine]]
*[[Solanine]]
*[[Solder  ]]
*[[Sotos syndrome]]
*[[Spectinomycin  ]]
*[[Spleen Cancer]]
*[[Sterigmatocystin  ]]
*[[Stibine  ]]
*[[Sulindac  ]]
*[[Sulphonamides]]
*[[Summerskill-Walshe-Tygstrup syndrome]]
*[[Syphilis]]
*[[Tamoxifen]]
*[[Tegaserod]]
*[[Telithromycin]]
*[[Tellurium]]
*[[Tetrachloroethane]]
*[[Tetrachloroethylene  ]]
*[[Tetracycline  ]]
*[[Tetramethylthiuram disulfide  ]]
*[[Thalassemia]]
*[[Thallium]]
*[[Thiabendazole  ]]
*[[Thioxanthene]]
*[[Thorium dioxide  ]]
*[[Thorotrast  ]]
*[[Thrombotic thrombocytopenic purpura]]
*[[Thyroid agenesis]]
*[[Toluene  ]]
*[[Transfusion Reaction]]
*[[Trazodone]]
*[[Trichloroethylene  ]]
*[[Trichomegaly cataract hereditary spherocytosis]]
*[[Trinitrotoluene  ]]
*[[Tuberculosis]]
*[[Tyrosinemia]]
*[[Uranium  ]]
*[[Valproic acid]]
*[[Vicia faba]]
*[[Vidarabine  ]]
*[[Vinyl Chloride  ]]
*[[Viral Hepatitis A]]
*[[Viral Hepatitis B]]
*[[Viral Hepatitis C]]
*[[Viral Hepatitis D]]
*[[Viral Hepatitis E]]
*[[Viral hepatitis X (non-A,-B,-C,-D,-E)]]
*[[Vitamin A overdose]]
*[[Vitamin B12 Deficiency]]
*[[Vitamin C ]]
*[[Weil's disease]]
*[[White Phosphorus  ]]
*[[Wilson's Disease]]
*[[Wolman disease]]
*[[Xanthogranulomatous cholecystitis]]
*[[Xanthomatous biliary cirrhosis]]
*[[X-linked alpha thalassemia mental retardation syndrome (ATR-X)]]
*[[X-linked lymphoproliferative syndrome]]
*[[X-linked sideroblastic anaemia]]
*[[Xylene  ]]
*[[Yellow fever]]
*[[Zellweger syndrome]]
*[[Zieve's syndrome]]
*[[Zoxazolamine  ]]
{{EndMultiCol}}


===Differential Diagnosis<ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:98</ref><ref>Sailer, Christian, Wasner, Susanne.  Differential Diagnosis Pocket.  Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:51-54</ref> ===
==[[Jaundice causes|Causes]]==
* Abdominal mass
* Acute [[alcoholic hepatitis]]
* [[Alcoholic Hepatitis]]
* [[Alpha-1 Antitrypsin Deficiency ]]
* [[Amyloidosis]]
* Annular pancreas
* Autoimmune [[hepatitis]]
* Autoimmunohemolysis
* Benign recurring cholestasis
* [[Bile duct tumor]]
* [[Biliary atresia]]
* Biliary tract obstruction
* [[Cholangitis]]
* [[Cholecystitis]]
* [[Choledocholithiasis]]
* [[Choledochal cyst]]
* Conditions following [[hemorrhage]]
* [[Congestive Heart Failure]]
* [[Crigler-Najjar Syndrome]]
* [[Cystic Fibrosis]]
* [[Cytomegalovirus]] (CMV)
* Decompensated [[cirrhosis]]
* [[Dubin-Johnson Syndrome]]
* [[Drugs]] and toxins
* [[Eclampsia]]
* [[Epstein-Barr Virus]] (EBV)
* Fetal [[erythroblastosis]]
* Following [[hemolytic disease of the newborn]] syndrome
* [[Galactosemia]]
* [[Gallbladder tumor]]
* [[Gilbert's Syndrome]]
* [[Glucose-6-phosphate dehydrogenase deficiency]]
* [[Graft-versus-host disease]]
* [[HELLP Syndrome]] ('''H'''emolysis, '''E'''levated '''L'''iver enzymes, '''L'''ow '''P'''latelet count)
* Hepatic trauma
* [[Hepatitis]]
* Hepatotoxic liver damage
* Hyperbilirubinemia after heart surgery
* Hyperbilirubinemia after portocaval shunt insertion
* [[Hyperemesis gravidarum]]
* Hypermethioninemia
* [[Hypopituitarism]]
* [[Hypothyroidism]]
* Intrauterine viral infections
* Intrahepatic cholestasis of [[pregnancy]]
* Intrahepatic and extrahepatic [[biliary atresia]]
* Intravascular [[hemolysis]]
* Jaundice of newborn
* [[Liver abscess]]
* Liver allograft rejection
* [[Liver cell carcinoma]]
* [[Lucey-Driscoll Syndrome]]
* [[Lymphoma]]
* [[Malignancy]]
* Neonatal [[hepatitis]]
* Nonalcoholic steatohepatitis or [[non-alcoholic fatty liver disease]]
* [[Pancreatic cancer]]
* [[Pancreatitis]]
* [[Parasite]]s
* [[Pernicious anemia]]
* [[Polycythemia vera]]
* Postoperative jaundice
* [[Primary biliary cirrhosis]]
* [[Hyperbilirubinemia|Primary hyperbilirubinemia]]
* [[Primary sclerosing cholangitis]]
* [[Rotor's Syndrome]]
* [[Sarcoidosis]]
* [[Sepsis]]
* [[Shock]]
* [[Sickle Cell Anemia]]
* [[Spherocytosis]]
* Storage diseases
* Strictures
* [[Thalassemia]]
* Total parenteral nutrition
* [[Transfusion]] reaction
* [[Trisomy 18]]
* [[Tuberculosis]]
* [[Tyrosinemia]]
* [[Viral hepatitis]] ([[Hepatitis A|A]], [[Hepatitis B|B]], [[Hepatitis C|C]], [[Hepatitis D|D]], [[Hepatitis E|E]])


== Diagnosis ==
==[[Jaundice differential diagnosis|Differentiating Jaundice from other Conditions]]==
=== History ===
The caregiver should ask questions regarding
* Alcohol/hepatotoxic medication use


'''Various Symptoms'''
==[[Jaundice epidemiology and demographics|Epidemiology and Demographics]]==
* '''Alcohol Hepatitis'''
*:* Aspartate aminotransferase:alanine aminotransferase ratio > 2 (AST:ALT)
*:* [[Ddx:Fever|Fever]]
*:* [[Leukocytosis]]
* '''Viral Hepatitis'''
*:* [[Anorexia]]
*:* Dark urine
*:* [[Ddx:Fatigue|Fatigue]]
*:* [[Hepatomegaly]]
*:* Light-colored (acholic) loss stools
*:* [[Ddx:Nausea and Vomiting|Nausea]]
*:* [[Ddx:Pruritis|Pruritis]]
*:* [[Abdominal pain|Right upper quadrant (RUQ) pain]]
*:* [[Nausea and Vomiting]]


===Physical Examination===
==[[Jaundice risk factors|Risk Factors]]==
* Complete physical exam including evidence of:
*:* [[Ddx:Hepatomegaly|Hepatomegaly]]
*:* [[Ddx:Splenomegaly|Splenomegaly]]
*:* Palpable gallbladder
*:* Signs of chronic liver disease
'''Appearance of the Patient'''
'''Skin'''
* Jaundice is visible in conjunctiva, skin and mucosa when the serum bilirubin level rises above 2 mg/dL
'''Eyes'''
* Jaundice is usually best seen in the periphery of the ocular conjunctivae
'''Abdomen'''
* Hepatomegaly may be present
'''Neurologic'''
* A flap may be present


===Laboratory Findings===
==[[Jaundice screening|Screening]]==
* Total and unconjugated bilirubin
* Aspartate aminotransferase
* Alanine aminotransferase
* Albumin
* Alkaline phosphatase
* HIV serologies
* Hepatitis serologies
* Antinuclear antibody (ANA)
* Antimitochondrial antibodies
* Haptoglobin
* Reticulocyte count
* Lactic dehydrogenase (LDH)


''''''Pre-hepatic'''''' -(or hemolytic) 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]] 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. Jaundice usually comes with high fevers.
==[[Jaundice natural history|Natural History, Complications and Prognosis]]==


The laboratory findings include
==Diagnosis==
* Urine: no bilirubin present, urobilirubin > 2 units (except in infants where [[gut flora]] has not developed).
[[Jaundice history & symptoms|History and Symptoms]] | [[Jaundice physical examination|Physical Examination]] | [[Jaundice lab tests|Laboratory Findings]] | [[Jaundice chest x ray|Chest X Ray]] | [[Jaundice CT|CT]] | [[Jaundice MRI|MRI]] | [[Jaundice echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Jaundice other imaging findings|Other Imaging Findings]] | [[Jaundice other diagnostic studies|Other Diagnostic Studies]]
* Serum: increased unconjugated bilirubin.
 
 
''''''Hepatic causes'''''' include acute [[hepatitis]], [[hepatotoxicity]] and [[alcoholic liver disease]], whereby cell necrosis reduces the liver's ability to metabolise and excrete [[bilirubin]] leading to a buildup in the blood. Less common causes include [[primary biliary cirrhosis]],[[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 [[metastasis|metastatic]] [[carcinoma]]. Jaundice seen in the newborn, known as neonatal jaundice, is common, occurring in almost every newborn as [[hepatic]] machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age..
 
Laboratory Findings: Urine: bilirubin present, Urobilirubin > 2 units but variable (Except in children)
 
 
''''''Post-hepatic'''''' (or obstructive) jaundice, also called [[cholestasis]], is caused by an interruption to the drainage of [[bile]] in the biliary system. The most common causes are [[gallstone]]s in the [[common bile duct]], and [[pancreatic cancer]] in the head of the [[pancreas]].  Also, a group of parasites known as "[[liver fluke]]s" live in the common bile duct, causing obstructive jaundice.  Other causes include strictures of the common bile duct, [[biliary atresia]], [[ductal carcinoma]], [[pancreatitis]] and [[pancreatic pseudocyst]]s. A rare cause of obstructive jaundice is [[Mirizzi's syndrome]].
 
The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from [[bile pigment]]s. 
 
Patients also can present with elevated serum cholesterol.
 
Patients often complain of severe itching or "pruritus".
 
=== MRI and CT ===
* Abdominal CT scan may be helpful
=== Echocardiography or Ultrasound ===
* Abdominal ultrasound
=== Other Diagnostic Studies ===
* Endoscopic retrograde cholangio-pancreatography (ERCP)


== Treatment ==
== Treatment ==
* Discontinue (and avoid) use of hepatotoxic medications
[[Jaundice medical therapy|Medical Therapy]] | [[Jaundice surgery|Surgery]] | [[Jaundice primary prevention|Primary Prevention]] | [[Jaundice secondary prevention|Secondary Prevention]] | [[Jaundice cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Jaundice future or investigational therapies|Future or Investigational Therapies]]
* Rehydrate
* Treat underlying etiologies
=== Acute Pharmacotherapies ===
* Steroids
===Surgery and Device Based Therapy===
* Cholecystectomy or ERCP
 


==External links==
==Case Studies==


[http://www.childliverdisease.org/education/yellowalert - Children's Liver Disease Foundation: information on jaundice in infants]
[[Jaundice case study one|Case #1]]


==See also==
==Related Chapters==
*[[Cholestasis]]
*[[Cholestasis]]
 
*[[Bilirubin]]
==External Links==
* [http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=11737 Beth Israel Deaconess Medical Center: Jaundice]
 
==References==
==References==
{{Reflist|2}}
{{SIB}}
{{Symptoms and signs}}
[[ar:يرقان]]
[[bs:Žutica]]
[[ca:Icterícia]]
[[cs:Žloutenka]]
[[da:Gulsot]]
[[de:Ikterus]]
[[es:Ictericia]]
[[eo:Iktero]]
[[fr:Ictère]]
[[it:Ittero]]
[[he:צהבת]]
[[la:Icterus]]
[[lt:Gelta]]
[[ml:മഞ്ഞപ്പിത്തം]]
[[ms:Demam kuning jaundis]]
[[nl:Geelzucht]]
[[ja:黄疸]]
[[no:Gulsott]]
[[nn:Gulsot]]
[[pl:Żółtaczka (medycyna)]]
[[pt:Icterícia]]
[[sk:Žltačka]]
[[sl:Zlatenica]]
[[fi:Keltaisuus]]
[[sv:Gulsot]]
[[te:పచ్చకామెర్లు]]
[[tr:Sarılık]]
[[zh:黄疸]]
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Digestive system]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Signs and symptoms]]

Latest revision as of 22:26, 29 July 2020

Template:DiseaseDisorder infobox

For patient information, click here.

For the approach to a patient with jaundice, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Farnaz Khalighinejad, MD [2], Fatima Shaukat, MD [3], Eiman Ghaffarpasand, M.D. [4], Mehrian Jafarizade, M.D [5]

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Synonyms and keywords: Icterus; hyperbilirubinemia, yellow discolouration.

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Jaundice from other Conditions

Epidemiology and Demographics

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History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

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