Types of jaundice Jaundice is a sign indicating the presence of an underlying diseases involving abnormal bilirubin metabolism, liver dysfunction, or biliary-tract obstruction. In general, jaundice is present when blood levels of bilirubin exceed 3 mg/dl. Jaundice is classified into three categories, depending on which part of the physiological mechanism the pathology affects. The three categories are: Category Definition Prehepatic/hemolytic The pathology occurs prior to the liver metabolism, due to either intrinsic causes to red blood cell rupture or extrinsic causes to red blood cell rupture. Hepatic/hepatocellular The pathology is due to damage of parenchymal liver cells. Posthepatic/cholestatic The pathology occurs after bilirubin conjugation in the liver, due to obstruction of the biliary tract and/or decreased bilirubin excretion. Prehepatic causes Prehepatic jaundice is most commonly caused by a pathological increased rate of red blood cell (erythrocyte) hemolysis. The increased breakdown of erythrocytes → increased unconjugated serum bilirubin → increased deposition of unconjugated bilirubin into mucosal tissue. These diseases may cause jaundice due to increased erythrocyte hemolysis: * Sickle-cell anemia * Spherocytosis * Thalassemia * Pyruvate kinase deficiency * Glucose-6-phosphate dehydrogenase deficiency * Microangiopathic hemolytic anemia * Hemolytic-uremic syndrome *<unk> e malaria (in endemic countries) Hepatic causes Microscopy of a biopsy of a cholestatic liver showing bilirubin pigment (brown pigment), H&E stain Hepatic jaundice is caused by abnormal liver metabolism of bilirubin. The major causes of hepatic jaundice are significant damage to hepatocytes due to infectious, drug/medication-induced, autoimmune etiology, or less commonly, due to inheritable genetic diseases. The following is a partial list of hepatic causes to jaundice: * Acute hepatitis * Chronic hepatitis * Hepatotoxicity * Cirrhosis * Drug-induced hepatitis * Alcoholic liver disease * Gilbert's syndrome (found in about 5% of the population, results in induced mild jaundice) * Crigler-Najjar syndrome, type I * Crigler-Najjar syndrome, type II * Leptospirosis Posthepatic causes (Obstructive jaundice) Posthepatic jaundice (obstructive jaundice), is caused by a blockage of bile ducts that transport bile containing conjugated bilirubin out of the liver for excretion. This is a list of conditions that can cause posthepatic jaundice: * Choledocholithiasis (common bile duct gallstones). It is the most common cause of obstructive jaundice. * Pancreatic cancer of the pancreatic head * Biliary tract strictures * Biliary atresia * Primary biliary cholangitis * Cholestasis of pregnancy * Acute Pancreatitis * Chronic Pancreatitis * Pancreatic pseudocysts * Mirizzi's syndrome * Parasites ("liver flukes" of the Opisthorchiidae and Fasciolidae)
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symptom of Listeriosis
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