The assessment of jaundice in adults: Tests, imaging, differential diagnosis

Kruger, Danielle

doi:10.1097/01720610-201106000-00009

Cited by 5 publications

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“…This is by means of an assortment of drugs and/or increase in the blood unconjugated bilirubin levels. If the higher amount of bilirubin crosses the BBB and the level of unconjugated bilirubin in the blood reaches 15–20 mg/dL, it causes bilirubin encephalopathy, or kernicterus (a bilirubin induced brain dysfunction; Kruger, 2011 ). The conjugation of bilirubin takes place across the sinusoidal membrane within the hepatocytes after the hepatic uptake, followed by the action of microsomal uridine diphosphoglucuronyl transferase (UDPGT), converting bilirubin to water-soluble form and facilitating its excretion into bile and by the urine (Kruger, 2011 ).…”

Section: Jaundice: An Overviewmentioning

confidence: 99%

“…The major manifestation of jaundice is the yellow color of skin and mucous membranes due to deposition/gathering of bile pigments in blood and body tissues by bilirubin. The color expression is the same in case of carotenemia, but in this condition the bilirubin levels are normal (Kruger, 2011 ; Schlosser et al, 2011 ). The pigment depositions are of little effect for most newborns, but in preterm infants even lower doses of bilirubin have the potential for causing kernicterus (Maisels, 2000 ; Santos et al, 2008 ).…”

Section: Jaundice: An Overviewmentioning

confidence: 99%

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Ethnopharmacological Approaches for Therapy of Jaundice: Part I

et al. 2017

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Jaundice is a very common symptom especially in the developing countries. It is associated with several hepatic diseases which are still major causes of death. There are many different approaches to jaundice treatment and the growing number of ethnomedicinal studies shows the plant pharmacology as very promising direction. Many medicinal plants are used for the treatment of jaundice, however a comprehensive review on this subject has not been published. The use of medicinal plants in drug discovery is highly emphasized (based on their traditional and safe uses in different folk medicine systems from ancient times). Many sophisticated analytical techniques are emerging in the pharmaceutical field to validate and discover new biologically active chemical entities derived from plants. Here, we aim to classify and categorize medicinal plants relevant for the treatment of jaundice according to their origin, geographical location, and usage. Our search included various databases like Pubmed, ScienceDirect, Google Scholar. Keywords and phrases used for these searches included: “jaundice,” “hyperbilirubinemia,” “serum glutamate,” “bilirubin,” “Ayurveda.” The first part of the review focuses on the variety of medicinal plant used for the treatment of jaundice (a total of 207 medicinal plants). In the second part, possible mechanisms of action of biologically active secondary metabolites of plants from five families for jaundice treatment are discussed.

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Section: Jaundice: An Overviewmentioning

confidence: 99%

Section: Jaundice: An Overviewmentioning

confidence: 99%

Ethnopharmacological Approaches for Therapy of Jaundice: Part I

et al. 2017

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“…Common endogenous interferences include hemolysis, icterus, and lipemia [ 1 , [6] , [7] , [8] , [9] ]. Icterus is caused by elevated concentrations of bilirubin, which can occur in a variety of physiologic states and disease conditions in children and adults [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Hyperbilirubinemia may be caused by a variety of conditions [ 10 , 11 ]. Increased bilirubin production is seen in conditions such as hemolysis, ineffective erythropoiesis, and skeletal muscle damage.…”

Section: Introductionmentioning

confidence: 99%

Frequency of icteric interference in clinical chemistry laboratory tests and causes of severe icterus

Mainali

Merrill

Krasowski

2021

Practical Laboratory Medicine

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Objectives The aims of this study were to identify the causes of severe icterus in an academic medical center patient population and to assess the impact of icterus on clinical chemistry testing using assay package insert thresholds. Design and Methods : In this retrospective study at an academic medical center core clinical laboratory, icteric, hemolysis, and lipemia indices were available for all serum and plasma chemistry specimens analyzed on Roche Diagnostics cobas 8000 analyzers over a 12-month period, encompassing 414,502 specimens from 94,081 unique patients (51,851 females; 42,230 males) including children, inpatient, outpatient, and emergency department patients. Extensive chart review was done for all 57 patients (4 pediatric, 53 adult; 534 total specimens) who had one or more samples with an icteric index of 40 or higher (defined as severe icterus). Results Specimen icteric index exceeded package insert icteric index thresholds in 0.14% of clinical chemistry assays, with the highest number of instances for creatinine (1358 samples, 0.6% of total tests), total protein (1194 samples, 2.2%), and ammonia (161 samples, 3.9%). The 57 patients with an icteric index of 40 or higher accounted for 49.7% of all instances where the icteric index exceeded the specific assay package insert limit. The most common etiologies of this group of 57 patients were alcohol-related liver disease (34 patients), biliary tract disease (7 patients), and neoplasms (6 patients). Conclusions Approximately half of all instances where specimen icteric index exceeded assay package insert thresholds occurred in a small cohort of patients with severe liver/biliary tract disease.

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“…Jaundice (icterus) is a clinical manifestation involving accumulation of bilirubin in the mucous membranes, skin, sclerae and the extracellular fluid in case of hyperbilirubinemia. Bilirubin is formed by a breakdown product of heme rings resulting usually from erythrocyte metabolism (1,2,3,4). hyperbilirubinemia has a very broad spectrum of causes ranging from benign factors to lifethreatening conditions.…”

Section: Introductionmentioning

confidence: 99%

Hyperbilirubinemia; Current Causes, Causal Risk Factors and Endpoints

Şimşek¹,

Şengöz²,

Pehlivanoğlu³

2014

vhd

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Objectives: Hyperbilirubinemia has a broad spectrum of causes ranging from benign lifethreatening. Classification of hyperbilirubinemia as prehepatic, hepatic and posthepatic promotes detecting its etiology. Materials and Methods: In this study, we analyzed the diagnoses, etiological risk factors and endpoints in 60 patients with hyperbilirubinemia. Inclusion criteria included moderate-bad general condition, enzyme levels >2000 U/L, bilirubin levels >5 mg/dL, impaired coagulation parameters and fever and rashes. Age, gender, etiology, contamination patterns, physical examination, laboratory findings and prognosis were analyzed retrospectively. Results: The diagnoses of the diseases based on their incidence were hepatitis B (n=34), hepatitis A (n=12), activation of chronic HBV infection (n=5), autoimmune hepatitis (n=2), malaria (n=2), hepatitis E (n=1), leptospirosis (n=1) and liver abscess (n=1). Mean age and female/male distribution ratio for viral hepatitis were 33 and 1/2, respectively. When risk factors were questioned; risk factors could not be identified in 69% of patients with viral hepatitis. Use of municipal water was found in history of 17% cases with hepatitis A whereas history of suspected sexual contact and dental treatment were found in 26% and 17% of patients with hepatitis B. Intrafamilial contamination was found in seven cases. Bicytopenia and monocytosis were observed in 15% and 84% of subjects. The mean bilirubin value was 16 mg/ dL with the highest value of 44.6 mg/dL. The highest ALT were averagely 3170 U/L and 2891 U/L in patients with hepatitis A and B, respectively. Two patients became exitus while one patient was referred to an external center for transplantation. The diagnoses in those three patients were hepatitis B and autoimmune hepatitis. Conclusion: Although, joundice is related with many diseases, in Turkey, it is most commonly associated with viral hepatitis.

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The assessment of jaundice in adults: Tests, imaging, differential diagnosis

Cited by 5 publications

References 0 publications

Ethnopharmacological Approaches for Therapy of Jaundice: Part I

Ethnopharmacological Approaches for Therapy of Jaundice: Part I

Frequency of icteric interference in clinical chemistry laboratory tests and causes of severe icterus

Hyperbilirubinemia; Current Causes, Causal Risk Factors and Endpoints

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