Jaundice: symptoms, diseases accompanyingjaundice

Update: December 2018

When a person without medical education hears the word jaundice,
most often it implies an independent disease – hepatitis
or Botkin’s disease. However, in medicine the term jaundice is not related
not only with hepatitis, but also with a number of pathological conditions
only the liver, but also other organs. About the symptoms of jaundice, her
varieties and causes of our article.

The occurrence of jaundice necessarily associated with metabolic disorders
bilirubin in the body for various reasons. Symptoms of jaundice
manifested by staining in yellow skin, sclera of the eyes, mucous membranes
shells, this is due to the accumulation of bilirubin in them due to
hyperbilirubinemia (see causes of elevated bilirubin in
blood).

Etiology of jaundice, all about bilirubin

Под истинной jaundice подразумевают симптомокомплекс, который
manifested icteric staining of mucous membranes and skin in
various shades of yellow due to the accumulation of
blood and bilirubin tissues.

According to the mechanism of occurrence, jaundice can
arise for one of three main reasons:

  • excessive destruction of red blood cells – hemolytic
    jaundice,
  • violation of the outflow of bile – obstructive or mechanical
    jaundice
  • нарушение метаболизма билирубина — паренхиматозная jaundice

Each of the described species includes many subspecies of reasons for
которым может возникнуть jaundice. Among them: liver disease,
pancreas, gallbladder and its ducts, various
отравления, физиологическая jaundice новорожденных и многие другие
the reasons.

The etiological factor in the occurrence of jaundice is
Bilirubin is a peculiar hemoglobinogenic pigment. Fine
its main mass is formed by the breakdown of red blood cells in the bone
brain, liver and spleen. A small part of bilirubin occurs when
destruction of cytochromes and myoglobin. There are bilirubin direct and
indirect, such a separation is based on the features of its
metabolism. Jaundice симптомы

  • Indirect bilirubin (synonyms: unconjugated, free)
    has toxicity – it is a breakdown product of gems. His concentration
    in the blood should not be higher than 16.2 µmol / l.
  • Direct bilirubin (synonyms: conjugated or linked)
    formed by binding with glucuronic acid. He passes
    the process of detoxification in the liver and is ready to be eliminated from the body.
    Its rate in the blood is not more than 4.3 µmol / l.
  • Total bilirubin in the blood corresponds to the indicator of 0.5 – 20.5
    μmol / l.

If the amount of bilirubin is moderate, the liver binds it
surplus, and if its concentration is too high (or
violation of the flow of bile), the liver does not have time to bind bilirubin and
hyperbilirubinemia occurs.

Jaundice staining of mucous membranes and human skin
it is noted already at increase in concentration of bilirubin in blood to 34
μmol / l. At first, yellowness appears on the sclera of the eyes and on
oral mucosa, then it spreads over the face,
palms, soles, after which the entire skin of the body turns yellow. Should
note that with jaundice in children, the symptoms are similar to
symptomatology in adults.

Sometimes yellowish skin and mucous is not a sign
hyperbilirubinemia. For example, yellow skin may be observed.
a person who consumes products that contain too much
carotene (carrots, tomatoes, pumpkin) – in this case occurs
каротиновая jaundice, симптомы которой имеют сходство с обычной
jaundice.

Ложная jaundice может сопровождать гипотиреоз (гипофункция
thyroid) and diabetes. However, it should be noted that
in the absence of true hyperbilirubinemia, yellowness
only skin is spread, and yellow staining of the eye sclera
the eye is not marked.

Liver diseases and their symptoms

The most common cause of jaundice is liver disease. So,
печеночная jaundice (паренхиматозная) возникает в связи с массивным
damage to the liver cells that disrupts them
structure, the functions performed, which leads to a violation of disposal
bilirubin by the liver and a violation of its removal from the body. Main
causes of parenchymal jaundice are:

  • hepatitis – viral hepatitis A, B, C, mononucleosis,
    autoimmune, bacterial, toxic, medicinal
  • cirrhosis of the liver
  • liver cancer

Гепатиты являются обобщенным понятием для
groups of inflammatory lesions of the liver. For hepatitis,
проявляющегося jaundice, симптомы будут такими:

  • The first symptoms of jaundice with hepatitis are common.
    intoxication of the body – fever, weakness, presence
    pains in the joints and muscles, pains in the area of ​​the right costal arch,
    shifts in laboratory blood and urine tests
  • Hepatomegaly – liver enlargement
  • Liver pain
  • Discoloration of feces and urine
  • Symptoms of jaundice у взрослого — это также наличие пятнистого
    palm staining (“liver palms”), pruritus and
    spider veins – telangiectasia located throughout
    to the body.

Цирроз the liver – это заболевание, при котором
the structural features of the liver parenchyma are significantly impaired.
Hepatocytes (hepatic cells) die, causing a violation
the location of the bile capillaries and blood vessels in place
dead cells appear large foci of connective tissue.

The liver loses its detoxification functions, including
the ability to bind bilirubin with its subsequent removal from
organism. Cirrhosis of the liver is the final stage of hepatitis,
which is not treated in time. With cirrhosis of the liver to the already existing
manifestations of parenchymal jaundice join these symptoms
as:

  • hepato-and splenomegaly – enlarged liver and spleen
  • severe itching of the skin
  • ascites – the appearance of fluid in the abdominal cavity
  • generalized varicose veins – rectum,
    esophagus, anterior abdominal wall in the form of a “jellyfish head”

In a far advanced stage of the disease to everything above
to the listed joins: liver failure,
a bleeding disorder, causing throughout the body
hemorrhages and internal bleedings appear (uterine,
nasal, gastric), there are irreversible changes in the brain
the brain.

Gallbladder diseases and their symptoms

Diseases of the gallbladder cause
obstructive jaundice, in which the outflow of bile into the duodenal
the gut is broken. Violation of the outflow of bile through the bile ducts
It occurs for various reasons:

  • gallstone disease – the presence of stones in the common bile duct
    (see cholecystitis diet, gallstones – symptoms,
    treatment)
  • neoplasms of different etiology – the gallbladder, ducts, and
    also pancreas or liver
  • worm infestations (see worms in humans)
  • hepatic artery aneurysm
  • the presence of postoperative cicatricial changes
  • duodenal diverticula
  • compression of the bile ducts
  • atresia (absence) of the biliary tract or their hypoplasia (abnormality
    development)
  • narrowing (stenosis) of the bile ducts

Mechanical jaundice symptoms are somewhat different:

  • yellowish green staining of skin, mucous membranes and
    ophthalmic sclera
  • pruritus and fever
  • multiple scratching is observed on the patient’s skin (for a given
    in the form of jaundice, the amount of bilirubin in the blood is prohibitive
    high)
  • Acholic (colorless) patient’s feces are absent
    sterkobilin
  • urine has a rich dark color
  • there are also pains in the liver, signs of violation
    work of the intestine and stomach (loss of appetite, flatulence, diarrhea,
    constipation, nausea, etc.).

Recently there has been a progressive growth.
benign and malignant pathology
hepatopancreaticoduodenal zone. Especially often these tumors
are found in older people and one of the manifestations
опухолевого процесса является холестатическая jaundice, которая
characterized by a high concentration of conjugated blood,
direct bilirubin.

Другие заболевания, сопровождающиеся jaundice

In addition to hepatitis, cirrhosis and gallbladder disease
There are many other diseases and conditions
accompanied by icteric syndrome and high concentration
bilirubin in the blood. These include:

  • alcohol poisoning, accompanied by acute lesion
    the liver
  • физиологическая jaundice у новорожденных, симптомы которой
    pass through a few days – this is a transitory state
    small children associated with destruction in the first days of life
    fetal red blood cell hemoglobin
  • congenital hemolytic anemia (sickle cell,
    spherocytic, thallicemia, etc.), a type of jaundice
    новорожденных является ядерная jaundice, при которой в крови ребенка
    high concentration of indirect bilirubin is detected
  • jaundice беременных
  • some hereditary type of jaundice – Dabin-Johnson syndrome,
    Rotor
  • some infectious diseases – sepsis, typhoid fever,
    malaria
  • drug-induced hemolytic anemia may occur with
    taking cephalosporins, aspirin and other NSAIDs, insulin,
    chloramphenicol, levofloxacin
  • toxic hemolytic anemia – snake bites, insects,
    poisoning with copper sulfate, lead, arsenic
  • acquired hemolytic anemia occurring in the background
    autoimmune processes in the body – rheumatoid arthritis, systemic
    lupus erythematosus, lymphogranulomatosis, lymphocytic leukemia
  • ложная jaundice — кожа становится желтой при длительном
    eating carrots, pumpkins, oranges, tomatoes, as well as
    the use of some chemical compounds – picric acid,
    Akrikhina
  • Crigler-Nayar syndrome, Gilbert, Lucy-Driscola

Many people are interested in: what are the symptoms of jaundice and how is it?
transmitted? Jaundice is not an independent disease, it is
just one of the pathological symptoms of the underlying disease,
which is important to timely identify and begin to heal. Jaundice
is an alarming bell of the body about the altered state of it
health

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