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Jaundice

 
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Overview

  • Look For

  • Yellow discolouration of the skin and mucous membranes, due to deposition of bilirubin.
  • Causes of Jaundice

  • Haemolytic Jaundice

  • Erythrocyte defects - sickle cell anaemia, thalassaemia, B12 / folate / iron deficiency anaemia, sideroblastic anaemia, spherocytosis, lead poisoning
  • Excessive erythrocyte destruction - haemolytic anaemia, thermal injury, DIC, haemodialysis, breast milk jaundice
  • Hepatocellular Jaundice

  • Dysfunctional uptake - drugs
  • Dysfunctional conjugation - Crigler-Najar, Gilbert’s disease
  • Dysfunctional bilirubin storage / excretion - Dubin-Johnson
  • Hepatocyte damage - cirrhosis, hepatitis, tuberculosis, EBV, CMV, varicella, drug-induced hepatitis, autoimmunity, alpha-1 antitrypsin deficiency, Wilson’s disease
  • Cholestatic Jaundice

  • Intrahepatic cholestasis - drugs, pregnancy, cystic liver disease, sepsis, TPN, Hodgkin’s disease, biliary cirrhosis, sclerosing cholangitis, liver cancer (primary / metastatic)
  • Extrahepatic cholestasis - cholangitis, cholelithiasis, pancreatitis, tumours (eg. pancreatic), bile duct (stenosis or extrinsic compression)
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