Jaundice - Causes and Symptoms

Definition

Jaundice is a yellowish discoloration of the skin, mucous membranes, ocular scleras and body fluids. This symptom becomes evident when the level of bilirubin in the blood rises to around 2-3 mg / dL (hyperbilirubinemia).

Most of the bilirubin is produced during the catabolism, in the spleen, of hemoglobin (Hb) deriving from the process of destruction of aged or damaged red blood cells. After removal of the iron atom (then recycled), the EME group of hemoglobin is transformed into unconjugated bilirubin, a yellow compound that binds to albumin in the blood to be transported to the liver, where it is picked up by hepatocytes . At this level, the unconjugated bilirubin is further modified and the products of its degradation are secreted through the bile into the duodenum, so they are eliminated with the faeces.

Other metabolites of bilirubin, on the other hand, reach the kidney where they are eliminated in the urine (note: hyperbilirubinemia can cause dark colored urine before jaundice is visible).

In some liver pathologies, in the case of cholestasis or during hemolytic diseases, the plasma bilirubin content increases. Jaundice, therefore, can be caused by an excess of bilirubin production or a defect in the activity of the liver. In other cases, it is due to biliary stasis (bilirubin is normally produced and processed, but encounters an obstacle and cannot be eliminated in the duodenum).

Many diseases and the use of some drugs can cause jaundice. The most common causes are inflammatory hepatitis (viral, autoimmune, hepatic or toxic), alcoholic liver disease and obstruction of the bile duct (due to the presence of stones or pancreatic diseases).

Important symptoms that precede the appearance of jaundice include fever, itching, steatorrhea and abdominal pain. Sometimes, nausea, vomiting, weight loss and possible symptoms of coagulopathy are also present (easy bleeding, ecchymosis or tarry stools).