JAUNDICE
Definition
- Yellow discolouration of sclera, skin and mucous membranes due to
elevated bilirubin (~ > 34 umol/L or 2x normal)
Pathophysiology
Pre-hepatic - ^ RBC destruction. Breakdown of heme in haemoglobin to
bilirubin (see Haemolysis
e.g. heriditary spherocytosisHepatic - Failure to conjugate (hepatocellular
disease) or excrete conjugated bilirubin into biilary tree (intrahepatic
cholestasis)
e.g. alcoholic hepatitis or cirrhosis, acute paracetamol toxicity, Wilson's
disease, haemachromatosis, Budd-Chiari syndromePost-hepatic - Obstruction to
bile drainage (extra-hepatic cholestasis)
e.g. gallstones, biliary tumours