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Jaundice

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Jaundice is diseased state of body in which there occurs yellow pigmentation of skin, mucous membrane and sclera by increased or raised levels of bilirubin in the blood.


Types-

Jaundice is classified into different types-

1.      Based on underlying derangement of bilirubin metabolism- jaundice is divided further into two subtypes-
a)      Predominately unconjugated hyperbilirubinaemia.
b)      Predominately conjugated hyperbilirubinaemia.

2.       Based on pathological mechanism responsible for causing jaundice, it is further divided into three subtypes-
a)      Haemolytic jaundice.
b)      Hepatocellular jaundice.
c)      Cholestatic jaundice.

Causes-

1.      Predominately unconjugated hyperbilirubinaemia is caused due to overproduction of unconjugated bilirubin, decreased hepatic uptake and decreased conjugation of bilirubin.

2.      Predominately conjugated hyperbilirubinaemia is caused due to intrahepatic causes or due to extrahepatic causes.

3.      Haemolytic jaundice is caused due to excessive or increased destruction of red blood cells or their precursors which leads to increased bilirubin production.

4.      Hepatocellular jaundice occurs due to inability of liver to transport bilirubin into bile which further cause liver cell damage. In hepatocellular jaundice, concentration of both unconjugated and conjugated bilirubin rises in the blood.

5.      In Cholestatic jaundice, there occurs failure of bile flow and it results from or is caused due to small duct obstruction or large duct obstruction that is it can be due to intrahepatic cholestasis or due to extrahepatic cholestasis.


Investigations-

Investigations required to diagnose jaundice or to differentiate between different types of jaundice are-
1.      Liver function tests.
2.      Urine test.
3.      Serum alkaline phosphatase test.
4.      Ultrasound abdomen.
5.      Antimicrobial antibody test.
6.      ERCP test.
7.      PTC test.
8.      Liver biopsy test.
9.      Haemogram test.


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