Hyperbilirubinemia
Definition
Hyperbilirubinemia is characterized by an elevated concentration of bilirubin in the bloodstream. It arises due to either:
1) Increased Bilirubin Production
Occurs when there is excessive breakdown of red blood cells (RBCs), leading to higher levels of bilirubin.
2) Decreased Bilirubin Clearance
Caused by impaired liver function or bile flow obstruction, reducing the liver’s ability to process and excrete bilirubin.
Jaundice
Definition
Jaundice is the clinical manifestation of hyperbilirubinemia.
It is characterized by the yellowish discoloration of the skin, eyes (sclera), and mucous membranes due to the accumulation of bilirubin.
Types of Jaundice
Jaundice is classified based on the underlying cause into three main types:
1) Pre-hepatic (Hemolytic) Jaundice
Cause: Excessive breakdown of red blood cells.
Characteristics: Elevated levels of unconjugated (indirect) bilirubin.
Conditions: Hemolytic anemias, autoimmune diseases, infections.
2) Hepatic (Hepatocellular) Jaundice
Cause: Impaired liver function due to liver diseases.
Characteristics: Increase in both unconjugated and conjugated (direct) bilirubin.
Conditions: Hepatitis, cirrhosis, liver cancer.
3) Post-hepatic (Obstructive) Jaundice
Cause: Obstruction in the bile ducts, preventing bilirubin excretion.
Characteristics: Elevated levels of conjugated bilirubin, possible bilirubin leakage back into the bloodstream.
Conditions: Gallstones, bile duct or pancreatic tumors, inflammation.
Diagnosis of Jaundice
Diagnosing jaundice involves a combination of medical history, physical examination, and laboratory tests:
Medical History and Physical Examination
To assess symptoms and identify potential underlying causes of jaundice.
Laboratory Tests
Blood tests to measure total, direct (conjugated), and indirect (unconjugated) bilirubin levels.
Further Diagnostic Tests
Liver function tests, imaging studies (e.g., ultrasound, CT scans), and possibly a liver biopsy to determine the precise cause of jaundice.
Treatment of Jaundice
The treatment for jaundice depends on addressing its underlying cause:
Medications
To treat infections, reduce bilirubin levels, or manage liver conditions.
Blood Transfusions
In cases of severe hemolytic anemia, where there is excessive destruction of RBCs.
Surgical Interventions
To remove obstructions in the bile ducts or treat tumors causing post-hepatic jaundice.
