Jaundice
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Jaundice
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Hyperbilirubinemia
jaundice with p. 402
Jaundice p. 402
alcoholic cirrhosis and p. 401
biliary tract disease p. 404
cholangitis p. 377, 404
cirrhosis p. 398
Crigler-Najjar syndrome p. 718
as drug reaction p. 250
fructose intolerance p. 78
galactosemia p. 78
graft-versus-host disease p. 117
hepatitis B p. 180
hepatocellular carcinoma p. 401
hereditary hyperbilirubinemias p. 403
leptospirosis p. 145
newborn hemolytic disease p. 416
painless p. 717
pancreatic cancer p. 404
ToRCHeS infections p. 181
transfusion reaction p. 112
yellow fever p. 165
Neonates
jaundice in p. 402
Obstructive jaundice p. 407
Phototherapy for jaundice p. 402
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Jaundice, which doesn’t have the most intuitive name, comes from the french jaunice, meaning yellowing.
It’s also sometimes referred to as icterus though, the origin of which is even less intuitive, coming from the thought that jaundice could once be cured by looking at a yellow bird, the more you know!
Anyways, as you’ve probably gathered, jaundice involves someone taking on yellow pigments, specifically in the skin and eyes.
The yellowing pigment is caused by a compound called bilirubin, a component of bile and the main cause of bruises being yellow, and after its metabolism, the yellow-ness of urine and brown-ness of feces.
So since bilirubin’s our main culprit of yellow-ness, it’s super important to know where it comes from.
As red blood cells near the end of their lifespan—which is about 120 days—they’re eaten up or phagocytosed by macrophages in the reticuloendothelial system, aka the macrophage system, where the spleen plays the largest part, but it’s also made of parts of the lymph nodes.
K so first the macrophage eats up the blood cell, and hemoglobin is broken up into heme and globin, the globin is further broken into amino acids.
The heme on the other hand is split into iron and protoporphyrin, protoporphyrin is then converted into unconjugated bilirubin, or UCB.
Unconjugated bilirubin is the form of bilirubin that’s lipid-soluble, meaning it’s not water-soluble, sometimes it’s also known as indirect bilirubin.
Albumin in the blood then binds to UCB and gives it a lift over to the liver where it’s taken up by hepatocytes, where it’s conjugated by an enzyme called uridine glucuronyl transferase (UGT), making it now water soluble.
At this point the conjugated bilirubin is secreted out the bile canaliculi where it drains into the bile ducts and sent to the gallbladder for storage as bile.
Now when you eat a donut or something, your gallbladder secretes the bile and CB, it moves through the common bile duct to the duodenum of the small intestine and is converted to urobilinogen, or UBG, by intestinal microbes in the gut.
Sources
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Yen & Jaffe's Reproductive Endocrinology" Saunders W.B. (2018)
- "Bates' Guide to Physical Examination and History Taking" LWW (2016)
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "A Systematic Approach to Patients with Jaundice" Seminars in Interventional Radiology (2016)
- "Unconjugated Hyperbilirubinemia and Early Childhood Caries in a Diverse Group of Neonates" American Journal of Perinatology (2009)
- "Jaundice in Older Children and Adolescents" Pediatrics In Review (2001)
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