Jaundice: Difference between revisions

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__NOTOC__
{{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 |
}}
}}


{{CMG}} '''Assosciate Editor(s)-In-Chief:''' [[User: Prashanthsaddala|Prashanth Saddala M.B.B.S]]
'''For patient information, click [[Jaundice (patient information)|here]].'''
 
'''For the approach to a patient with jaundice, click [[Approach to a patient with jaundice|here]].'''
 
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{FKH}}, {{FA}}, {{EG}}, {{MJ}}
 
{{Jaundice}}
{{Jaundice}}


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


==[[Jaundice overview|Overview]]==
==[[Jaundice overview|Overview]]==
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==[[Jaundice classification scheme|Classification]]==
==[[Jaundice classification scheme|Classification]]==
[[Neonatal jaundice]] | [[Prehepatic jaundice]] | [[Hepatic jaundice]] | [[Posthepatic jaundice]]


==[[Jaundice pathophysiology|Pathophysiology]]==
==[[Jaundice pathophysiology|Pathophysiology]]==


==[[Jaundice causes of jaundice|Causes]]==
==[[Jaundice causes|Causes]]==
[[Jaundice causes of jaundice#Common Causes|Common Causes]]  | [[Jaundice causes of jaundice#Causes by Organ System|Causes by Organ System]] | [[Jaundice causes of jaundice#Causes in Alphabetical Order|Causes in Alphabetical Order]]


==[[Jaundice diagnosis|Diagnosis]]==
==[[Jaundice differential diagnosis|Differentiating Jaundice from other Conditions]]==
[[Jaundice history & symptoms|History and Symptoms]] | [[Jaundice physical examination|Physical Examination]] | [[Jaundice lab tests|Lab tests]] | [[Jaundice ct|CT]] | [[Jaundice mri|MRI]] | [[Jaundice other diagnostic studies|Other Diagnostic Studies]]  
===History and Symptoms ===
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.  It was once believed persons suffering from the medical condition jaundice saw everything as yellow, but this is not true. 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>


The caregiver should ask questions regarding
==[[Jaundice epidemiology and demographics|Epidemiology and Demographics]]==
* Alcohol/hepatotoxic medication use


'''Various Symptoms'''
==[[Jaundice risk factors|Risk Factors]]==
* '''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 screening|Screening]]==
* 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


===Lab tests===  
==[[Jaundice natural history|Natural History, Complications and Prognosis]]==
* Total and unconjugated bilirubin
** 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
* Aspartate aminotransferase
* Alanine aminotransferase
* Albumin
* Alkaline phosphatase
* HIV serologies
* Hepatitis serologies
* Antinuclear antibody (ANA)
* Antimitochondrial antibodies
* Haptoglobin
* Reticulocyte count
* Lactic dehydrogenase (LDH)


=== MRI and CT ===
==Diagnosis==
* Abdominal CT scan may be helpful
[[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]]
=== 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


==Case Studies==


==See also==
[[Jaundice case study one|Case #1]]
 
==Related Chapters==
*[[Cholestasis]]
*[[Cholestasis]]
 
*[[Bilirubin]]
==References==
==References==
{{Reflist|2}}
{{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]]
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
 
<references />


[[Category:Disease]]
[[Category:Disease]]
[[Category:Digestive system]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Signs and symptoms]]
[[Category:Grammar]]

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]

Jaundice Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Jaundice from other Conditions

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Electrocardiogram

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Jaundice On the Web

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X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Jaundice

CDC on Jaundice

Jaundice in the news

Blogs on Jaundice

Directions to Hospitals Treating Jaundice

Risk calculators and risk factors for Jaundice

Synonyms and keywords: Icterus; hyperbilirubinemia, yellow discolouration.

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Jaundice from other Conditions

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

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

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

References

Template:WikiDoc Sources