Is it jaundice... or too many carrots?

  • TOO MUCH BILIRUBIN BEING PRODUCED ("hemolytic jaundice")
    • Ineffective hematopoiesis", i.e., normoblasts dying in the bone marrow
      • Thalassemias (even mild ones like beta-thal minor)
      • Megaloblastic anemias (folate or B12 deficiencies)
    • Intravascular hemolysis (many causes)
    • Extravascular hemolysis
      • Big hematomas
      • GI bleeding

  • LIVER FAILS TO TAKE UP AND/OR CONJUGATE BILIRUBIN ("hepatocellular jaundice")
    • Newborns (don’t give opiates (except meperidine), sulfonamides)
    • Hypoperfusion (CHF)
    • Bad alcoholism
    • Hepatitis (many causes)
    • Cirrhosis (many causes)
    • Glucuronyl transferase (solubilizes bilirubin)
      • Gilbert’s non-disease [worse w/ fasting)
      • Crigler-Najjar

  • LIVER DOESN'T SEND BILIRUBIN TO THE RIGHT PLACE ("cholestatic jaundice" water soluble so urine can be darker)
    • Problems with the liver cells
      • Drugs (estrogen, anabolic steroids)
    • Dubin-Johnson (pigmented) non-disease
      • These people lack a pump
    • Rotor (non-pigmented) non-disease.
    • Problems with the bile ducts in the liver
      • Biliary cirrhosis
      • Biliary atresia
    • Problems with the bile ducts beyond the liver (surgical)
      • Gallstone in the common duct (the only time a gallstone in the gallbladder will cause jaundice is in Mirizzi Syndrome)Cancer (i.e., biliary, pancreatic, ampullary)
      • Iatrogenic (i.e., the surgeon nicked the common bile duct)

BTW: the eye sclera should never be yellow if the "jaundice" from carrots.

1 comment:

  1. I take a girl with jaundice, each month I’ll send some money for medical expenses, I did not know what that looked like jaundice was in a web page and a known resultaque commented me and adotamos girl and every month we send photos.

    http://www.jaundiceweb.com/

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