jaundice /jaun·dice/ (jawn´dis) icterus; yellowness of the skin, scleras, mucous membranes, and excretions due to hyperbilirubinemia and deposition of bile pigments.
physiologic jaundice
jaundice [jawn´dis]
acholuric jaundice jaundice without bilirubinemia, associated with elevated unconjugated bilirubin that is not excreted by the kidney.
acholuric familial jaundice hereditary spherocytosis.
breast milk jaundice elevated unconjugated bilirubin in some breast-fed infants due to the presence of 5-β-pregnane-3-α-20-β-diol in breast milk, which inhibits glucuronyl transferase conjugating activity, or to dehydration.
cholestatic jaundice that resulting from abnormal bile flow in the liver.
hemolytic jaundice that due to increased production of bilirubin from hemoglobin under conditions causing accelerated degradation of erythrocytes.
hepatocellular jaundice that due to injury to or disease of liver cells.
hepatogenic jaundice , hepatogenous jaundice that due to disease or disorder of the liver.
leptospiral jaundice Weil's syndrome.
mechanical jaundice obstructive j.
neonatal jaundice , jaundice of the newborn icterus neonatorum.
nuclear jaundice kernicterus.
obstructive jaundice that due to blocking of bile flow.
physiologic jaundice mild icterus neonatorum lasting the first few days of life.
retention jaundice that due to inability of the liver to dispose of the bilirubin provided by the circulating blood.
| physiologic jaundice n. Mild jaundice of newborns caused mainly by functional immaturity of the liver. Also called physiologic icterus. |
physiologic jaundice
Etymology: Gk, physis, nature, logos, science; Fr, jaune, yellow
a simple jaundice of newborns that involves the breaking down of the excessive number of red blood cells that may be present at birth.
jaundice [jawn´dis]
yellowness of skin, sclerae, mucous membranes, and excretions due to hyperbilirubinemia and deposition of bile pigments. It is usually first noticeable in the eyes, although it may come on so gradually that it is not immediately noticed by those in daily contact with the jaundiced person. Called also icterus.
Jaundice is not a disease; it is a symptom of a number of different diseases and disorders of the liver and gallbladder and of hemolytic blood disorders. One such disorder is the presence of a gallstone in the common bile duct, which carries bile from the liver to the intestine. This may obstruct the flow of bile, causing it to accumulate and enter the bloodstream. The obstruction of bile flow may cause bile to enter the urine, making it dark in color, and also decrease the bile in the stool, making it light and clay-colored. This condition requires surgery to remove the gallstone before it causes serious liver injury.
The pigment causing jaundice is called bilirubin. It is derived from hemoglobin that is released when erythrocytes are hemolyzed and therefore is constantly being formed and introduced into the blood as worn-out or defective erythrocytes are destroyed by the body. Normally the liver cells absorb the bilirubin and secrete it along with other bile constituents. If the liver is diseased, or if the flow of bile is obstructed, or if destruction of erythrocytes is excessive, the bilirubin accumulates in the blood and eventually will produce jaundice. Determination of the level of bilirubin in the blood is of value in detecting elevated bilirubin levels at the earliest stages before jaundice appears, when liver disease or hemolytic anemia is suspected.
Jaundice is not a disease; it is a symptom of a number of different diseases and disorders of the liver and gallbladder and of hemolytic blood disorders. One such disorder is the presence of a gallstone in the common bile duct, which carries bile from the liver to the intestine. This may obstruct the flow of bile, causing it to accumulate and enter the bloodstream. The obstruction of bile flow may cause bile to enter the urine, making it dark in color, and also decrease the bile in the stool, making it light and clay-colored. This condition requires surgery to remove the gallstone before it causes serious liver injury.
The pigment causing jaundice is called bilirubin. It is derived from hemoglobin that is released when erythrocytes are hemolyzed and therefore is constantly being formed and introduced into the blood as worn-out or defective erythrocytes are destroyed by the body. Normally the liver cells absorb the bilirubin and secrete it along with other bile constituents. If the liver is diseased, or if the flow of bile is obstructed, or if destruction of erythrocytes is excessive, the bilirubin accumulates in the blood and eventually will produce jaundice. Determination of the level of bilirubin in the blood is of value in detecting elevated bilirubin levels at the earliest stages before jaundice appears, when liver disease or hemolytic anemia is suspected.
Patient Care. Assessment of the patient with jaundice includes observations of the degree and location of yellowing, noting the color of urine and stools, and the presence of itching. Since jaundice can be accompanied by severe itching, frequent skin care is important to preserve skin integrity. Tepid sponge baths can help reduce discomfort and promote rest.
Patients with severe jaundice are at risk for encephalopathic changes that produce confusion, impaired mentation, and altered levels of consciousness. The potential for injury is increased and demands vigilance and safety measures to protect the patient.
Patients with severe jaundice are at risk for encephalopathic changes that produce confusion, impaired mentation, and altered levels of consciousness. The potential for injury is increased and demands vigilance and safety measures to protect the patient.
Jaundice may be attributable to prehepatic (A), hepatic (B), or posthepatic (C) causes. From Damjanov, 2000.
acholuric jaundice jaundice without bilirubinemia, associated with elevated unconjugated bilirubin that is not excreted by the kidney. Familial acholuric jaundice is another name for the hereditary form of hemolytic jaundice.
breast milk jaundice elevated unconjugated bilirubin in some breast-fed infants due to the presence of an abnormal pregnane that inhibits glucuronyl transferase conjugating activity.
cholestatic jaundice that resulting from abnormality of bile flow in the liver.
familial nonhemolytic jaundice Gilbert disease.
hematogenous jaundice hemolytic jaundice.
hemolytic jaundice see hemolytic jaundice.
hepatocellular jaundice jaundice caused by injury to or disease of the liver cells.
leptospiral jaundice Weil's syndrome.
neonatal jaundice (jaundice of the newborn) icterus neonatorum.
nonhemolytic jaundice that due to an abnor-mality in bilirubin metabolism.
obstructive jaundice that due to blockage of the flow of bile.
physiologic jaundice mild icterus neonatorum during the first few days after birth.
jaundice
Icterus Hepatology A condition characterized by the deposition of excess–> 2 mg/dL, 34 µmol/L free or conjugated BR in peripheral circulation, and in skin, mucosa and sclerae; it is either physiologic–eg, due to
hemolysis or pathologic–eg, seen in hepatitis or bile stasis. See Breast milk jaundice, Hyperbilirubinemia, Obstructive jaundice.
Jaundice types–unconjugated hyperbilirubinemia
Physiologic jaundice Jaundice develops ≥ 72 hrs after birth; total BR rises to greater than 15 mg/dL; direct BR is < 15% of total BR; jaundice resolves within 1–2 weeks Etiology Sluggish glucuronyl transferase activity, ↑ of
BR 'load,' ↓ plasma clearance of BR Management Phototherapy, exchange transfusion
Pathological jaundice Jaundice develops in 72 hrs after birth; total BR peaks at ≤ 15 mg/dL; direct BR is > 15% of total BR; jaundice may require > 2 weeks to resolve Etiology HDN, hemolysis, extravascular loss of blood, ↑
enterohepatic circulation, breast feeding, defective BR metabolism, sepsis, metabolic disease Management Phototherapy, exchange transfusion
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