Jaundice natural history, complications, and prognosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 7: Line 7:


==Natural History==
==Natural History==
* The symptoms of jaundice may develop as early as neonatal period<ref name="pmid20497361">{{cite journal| author=Gundur NM, Kumar P, Sundaram V, Thapa BR, Narang A| title=Natural history and predictive risk factors of prolonged unconjugated jaundice in the newborn. | journal=Pediatr Int | year= 2010 | volume= 52 | issue= 5 | pages= 769-72 | pmid=20497361 | doi=10.1111/j.1442-200X.2010.03170.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20497361  }}</ref> to any decade of life depending on the underlying cause, and start with symptoms such as yellowish discoloration of eyes and sclera.  
* The symptoms of jaundice may develop as early as neonatal period<ref name="pmid20497361">{{cite journal| author=Gundur NM, Kumar P, Sundaram V, Thapa BR, Narang A| title=Natural history and predictive risk factors of prolonged unconjugated jaundice in the newborn. | journal=Pediatr Int | year= 2010 | volume= 52 | issue= 5 | pages= 769-72 | pmid=20497361 | doi=10.1111/j.1442-200X.2010.03170.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20497361  }}</ref> to any decade of life depending on the underlying cause, and start with symptoms such as yellowish discoloration of eyes and sclera. Typically, jaundice is not detectable clinically until serum bilirubin reaches 2.5 mg/dL.2 It is first seen in the conjunctiva or oral mucous membranes such as the hard palate or under the tongue. As the serum concentration of bilirubin rises, jaundice proceeds caudally.  
* The symptoms of (disease name) typically develop ___ years after exposure to ___.
* Jaundice appearing over a few days to a week implies hepatitis, whether drug or toxin induced, viral<ref name="pmid4191502">{{cite journal| author=Krugman S, Giles JP| title=Viral hepatitis. New light on an old disease. | journal=JAMA | year= 1970 | volume= 212 | issue= 6 | pages= 1019-29 | pmid=4191502 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4191502  }}</ref> or bacterial (i.e., leptospirosis). Jaundice appearing over the course of weeks implies a subacute hepatitis or extrahepatic obstruction due to malignancy<ref name="pmid21460876">{{cite journal| author=Patel T| title=Cholangiocarcinoma--controversies and challenges. | journal=Nat Rev Gastroenterol Hepatol | year= 2011 | volume= 8 | issue= 4 | pages= 189-200 | pmid=21460876 | doi=10.1038/nrgastro.2011.20 | pmc=3888819 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21460876  }}</ref>, gallstone, chronic pancreatitis, or stricture in the common bile duct. Jaundice of fluctuating intensity implicates gallstones, ampullary<ref name="pmid15960930">{{cite journal| author=Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A et al.| title=Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage. | journal=Clin Transl Oncol | year= 2005 | volume= 7 | issue= 5 | pages= 189-97 | pmid=15960930 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15960930  }}</ref> carcinoma, or possible drug hepatitis.  
* If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
* If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].



Revision as of 16:31, 7 February 2018

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 natural history, complications, and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Jaundice natural history, complications, and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Jaundice natural history, complications, and prognosis

CDC on Jaundice natural history, complications, and prognosis

Jaundice natural history, complications, and prognosis in the news

Blogs on Jaundice natural history, complications, and prognosis

Directions to Hospitals Treating Jaundice

Risk calculators and risk factors for Jaundice natural history, complications, and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The type and the severity of complications depends on the underlying cause leading to jaundice. Certain individuals may not suffer any long-term complications and recovers fully, while for others the appearance of jaundice may be the first indication of a life-threatening situation.

Natural History

  • The symptoms of jaundice may develop as early as neonatal period[1] to any decade of life depending on the underlying cause, and start with symptoms such as yellowish discoloration of eyes and sclera. Typically, jaundice is not detectable clinically until serum bilirubin reaches 2.5 mg/dL.2 It is first seen in the conjunctiva or oral mucous membranes such as the hard palate or under the tongue. As the serum concentration of bilirubin rises, jaundice proceeds caudally.
  • Jaundice appearing over a few days to a week implies hepatitis, whether drug or toxin induced, viral[2] or bacterial (i.e., leptospirosis). Jaundice appearing over the course of weeks implies a subacute hepatitis or extrahepatic obstruction due to malignancy[3], gallstone, chronic pancreatitis, or stricture in the common bile duct. Jaundice of fluctuating intensity implicates gallstones, ampullary[4] carcinoma, or possible drug hepatitis.
  • If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].


Complications

Common complications of jaundice include:[5]

Prognosis

  • The prognosis for individuals with jaundice varies with the underlying cause of the condition. There are certain conditions that has the most favorable prognosis leading to full recovery. However, more serious causes of jaundice like acute suppurative cholangitis or fulminant hepatic failure can sometimes be fatal despite medical or surgical intervention. The mortality can be as high as 80% .[6]
  • The development and severity of complications as well as patient's underlying health and comorbidities have a huge impact on the prognosis of patients.

References

  1. Gundur NM, Kumar P, Sundaram V, Thapa BR, Narang A (2010). "Natural history and predictive risk factors of prolonged unconjugated jaundice in the newborn". Pediatr Int. 52 (5): 769–72. doi:10.1111/j.1442-200X.2010.03170.x. PMID 20497361.
  2. Krugman S, Giles JP (1970). "Viral hepatitis. New light on an old disease". JAMA. 212 (6): 1019–29. PMID 4191502.
  3. Patel T (2011). "Cholangiocarcinoma--controversies and challenges". Nat Rev Gastroenterol Hepatol. 8 (4): 189–200. doi:10.1038/nrgastro.2011.20. PMC 3888819. PMID 21460876.
  4. Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A; et al. (2005). "Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage". Clin Transl Oncol. 7 (5): 189–97. PMID 15960930.
  5. Sonthalia N, Rathi PM, Jain SS, Surude RG, Mohite AR, Pawar SV; et al. (2017). "Natural History and Treatment Outcomes of Severe Autoimmune Hepatitis". J Clin Gastroenterol. 51 (6): 548–556. doi:10.1097/MCG.0000000000000805. PMID 28272079.
  6. Lee WM (1993). "Acute liver failure". N Engl J Med. 329 (25): 1862–72. doi:10.1056/NEJM199312163292508. PMID 8305063.


Template:WH Template:WS