General classification of jaundice
Jaundice is a term which is mainly used to describe an increase in the amount of bilirubin in the body, which results in the yellow colouration of white area of eye, and skin . jaundice can be categoriz
e into three different types; each results in yellowing pigmentation but for different reasons.
Physiologic jaundice is common in newborns whose livers have not fully developed the ability to process bilirubin. This period of jaundice usually resolves itself within two to three days. A type of exaggerated physiologic jaundice is referred to as “breastfeeding jaundice,” which usually appears during the first week of a newborn’s life., breastfeeding jaundice is believed to be a result of inadequate breast milk intake, leading to dehydration or low caloric intake. Breastfeeding jaundice usually peaks during an infant’s second or third week of life, and providing the infant is ingesting sufficient calories usually resolves itself without causing any medical problems. .
Pathologic jaundice can occur in children and adults and is diagnosed when jaundice presents a health risk. In infants, pathologic jaundice can occur when physiologic jaundice becomes exacerbated by dehydration or a premature or complicated birth. In adults, there are several causes of pathological jaundice, including blood incompatibilities and diseases, and hereditary syndromes. Several forms of hepatitis, cirrhosis of the liver and other liver diseases, bile duct blockage, along with infections and medications, can also cause pathological jaundice
Gilbert’s syndrome is a harmless hereditary condition that results in mild jaundice. During times of illness or stress, people with Gilbert’s syndrome will experience low levels of some bilirubin-processing enzymes in their livers.
the other types of jaundice are:
- Hemolytic Jaundice: Hemo means ‘blood’ and lytic means ‘breakdown of cells’; together ‘hemolytic’ means breakdown of red blood cells. In hemolytic jaundice or pre-hepatic jaundice, the bilirubin level is raised due to excess breakdown of red blood cells.In this form, overproduction of bilirubin results from excessive breakdown of red blood cells (hemolysis). For this process to cause jaundice, the degree of hemolysis usually has to be severe enough to produce a degree of anemia as well.
Causes include defects in the structure of the hemoglobin (thalassemia), faulty red blood cell membranes (spherocytosis) and infection in the blood cells (malaria). Each of these make the red blood cells more fragile and susceptible to hemolysis.
- Obstructive Jaundice: Also known as post-hepatic jaundice is caused by obstruction of bile flow from the liver. This increases the level of bilirubin in the blood, thereby causing obstructive jaundice. Obstructive Jaundice can cause extreme pruritus (itching) due to build up of salt and other biles constituents.When the bile duct is blocked, bilirubin builds up in the liver. As it no longer being excreted from the body the level in the bloodstream then rises and produces jaundice. The most common cause of obstructive jaundice is a gallstone leaving the gall bladder and becoming lodged in the bile duct. In older people, cancers of the gall bladder and pancreas may also obstruct the duct.
- Hepatocellular Jaundice: This type of jaundice is very common and occurs due to inability of the liver to metabolize and remove bilirubin from the biliary system.Damaged liver cells cannot remove and conjugate the normal quantity of bilirubin circulating in the blood, thus causing the level of bilirubin in the blood to rise. Viral hepatitis is the most common liver disease that causes jaundice. Liver inflammation caused by certain toxic chemicals, alcohol (alcoholic hepatitis), and glandular fever may also be associated with jaundice.
- Neonatal Jaundice:. Neontal jaundice is marked by yellow discoloration of skin and other tissues of a newborn. The symptoms generally become apparent on the second or fourth day after the baby is born and disappear on it own within two to three weeks.