Gastroenterology Book

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Jaundice

Aka: Jaundice, Yellow Skin, Dermal Icterus
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  1. See Also
    1. Jaundice in Newborns
  2. Definition
    1. "Yellow Skin" related to Hyperbilirubinemia
  3. Pathophysiology
    1. See Hyperbilirubinemia
  4. Causes
    1. See Hyperbilirubinemia
  5. Symptoms
    1. Pruritus
      1. See Cholestasis associated Pruritus
    2. Yellow Skin
    3. Abdominal Pain
    4. Weight loss
  6. Signs
    1. See Jaundice in Newborns
    2. Sites of predilection
      1. Face
      2. Trunk
      3. Tongue frenulum (early finding)
      4. Sclera (see Scleral Icterus)
    3. Factors that accentuate Jaundice
      1. Tanned skin
    4. Factors that may hide Jaundice
      1. Artificial light
    5. Associated findings that may direct to cause
      1. Ecchymosis
      2. Spider angiomas
      3. Gynecomastia
      4. Testicular atrophy
  7. Signs: Findings suggestive of Obstructive Jaundice
    1. Dark yellow or brown colored Urine
      1. Direct Hyperbilirubinemia (increased Urobilinogen)
      2. Shaking specimen results in yellow foam
    2. Acolic Stools
      1. Gray-white, malodorous stools
    3. Sinus Bradycardia
  8. Labs: Initial
    1. Complete Blood Count
    2. Bilirubin: Diagnosis requires Bilirubin fractionation
      1. See Bilirubin
      2. Jaundice visible when Bilirubin >2-4 mg/dl
      3. See Indirect Bilirubin (Hemolytic Jaundice)
      4. See Direct Bilirubin (Obstructive Jaundice)
    3. Other Liver Function Tests
      1. Aspartate transaminase (AST)
      2. Alanine transaminase (ALT)
      3. Gamma-glutamyl transpeptidase (GGT)
      4. Alkaline Phosphatase
    4. Urinalysis
      1. Bilirubin in urine suggests Conjugated Bilirubin
  9. Evaluation: Based on labs above
    1. Unconjugated Hyperbilirubinemia
      1. Consider causes of elevated Indirect Bilirubin
    2. Conjugated Hyperbilirubinemia
      1. Screen for Viral Hepatitis
      2. Consider autoimmune condition screening
        1. Antinuclear Antibody (ANA)
        2. Anti Liver-Kidney microsomal Antibody
        3. Anti-Smooth Muscle Antibody
      3. Consider abdominal Ultrasound or abdominal CT
  10. Differential Diagnosis (Yellow Skin)
    1. See Hyperbilirubinemia
    2. Carotenemia
    3. Quinacrine
    4. Occupational exposure to Explosive manufacturing
      1. Dinitrophenol
      2. Tetryl
  11. References
    1. Degowin (1987) Diagnostic Exam, Macmillan, p.480-1
    2. Feldman (1998) Sleisenger and Fordtran's, p. 220-231
    3. Pasha (1996) Med Clin North Am 80:995-1019
    4. Roche (2003) Am Fam Physician 69:299-304

Icterus (C0022346)

Definition (CHV) skin yellowing due to excessive bilirubin in body
Definition (CHV) skin yellowing due to excessive bilirubin in body
Definition (CHV) skin yellowing due to excessive bilirubin in body
Definition (MEDLINEPLUS)

Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver. If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow.

Many healthy babies have some jaundice during the first week of life. It usually goes away. However, jaundice can happen at any age and may be a sign of a problem. Jaundice can happen for many reasons, such as:

  • Blood diseases
  • Genetic syndromes
  • Liver diseases, such as hepatitis or cirrhosis
  • Blockage of bile ducts
  • Infections
  • Medicines
Definition (NCI) A condition in which the skin and the whites of the eyes become yellow, urine darkens, and the color of stool becomes lighter than normal. Jaundice occurs when the liver is not working properly or when a bile duct is blocked.
Definition (CSP) clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes.
Definition (MSH) A clinical manifestation of HYPERBILIRUBINEMIA, characterized by the yellowish staining of the SKIN; MUCOUS MEMBRANE; and SCLERA. Clinical jaundice usually is a sign of LIVER dysfunction.
Concepts Pathologic Function (T046)
MSH D007565
ICD10 R17
SnomedCT 274245007, 206897003, 263780001, 158249005, 158250005, 18165001, 139122003, 161866005
English Icterus, Jaundice, ICTERUS, JAUNDICE, Icterus NOS, Icterus, NOS, Jaundice, NOS, [D]Icterus NOS, [D]Jaundice, [D]Icterus (context-dependent category), [D]Icterus NOS (context-dependent category), Unspecified jaundice, YELLOW SKIN, Icterus [D], jaundice (diagnosis), yellow skin (symptom), jaundice, yellow skin (jaundice), yellow skin and eyes (symptom), yellow skin, yellow skin and eyes, Jaundice (disorder), Icterus [D] (situation), Jaundice NOS, [D]Icterus NOS (situation), [D]Icterus (situation), [D]Icterus, Jaundice [Disease/Finding], icteric, Icteric, Jaundiced, Jaundice (finding), icterus, Icterus [D] (context-dependent category), Jaundice - symptom
French ICTERE, JAUNISSE, Ictère SAI, Ictere, Jaunisse, Ictère
Portuguese ICTERICIA, Icterícia NE, Ictericia, Icterícia
Spanish ICTERICIA, Ictericia NEOM, Icterus, [D]ictericia, SAI (categoría dependiente del contexto), ictericia [D] (categoría dependiente del contexto), Jaundice - symptom, Icterus [D], Jaundice, ICTERUS, [D]ictericia, SAI, [D]ictericia, SAI (situación), ictericia [D] (situación), [D]ictericia, ictericia (hallazgo), ictericia [D], ictericia, Ictericia
German IKTERUS, Gelbsucht NNB, GELBSUCHT, Gelbsucht, nicht naeher bezeichnet, Gelbsucht/Ikterus, Gelbsucht, Ikterus
Dutch geelzucht NAO, icterus, Niet gespecificeerde geelzucht, geelzucht, Geelzucht, Cholemie, Icterus
Italian Ittero NAS, Ittero
Japanese 黄疸ＮＯＳ, ｵｳﾀﾞﾝ, ｵｳﾀﾞﾝNOS, 黄疸
Swedish Gulsot, GULSOT/ICTERUS
Czech žloutenka, ikterus, Ikterus NOS, Ikterus
Finnish Ikterus, KELTAISUUS
Russian ZHELTUKHA, ЖЕЛТУХА
Norwegian GULSOTT/IKTERUS
Danish Gulsot icterus
Hungarian sargasag, Sárgaság k.m.n., Sárgaság, Icterus
Korean 상세불명의 황달
Basque IKTERIZIA
Hebrew tzahevet
Polish Żółtaczka
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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