Jaundice

• Jaundice is the clinical sign associated with raised Bilirubin

• Classification

  • Pathophysiology
    • Prehepatic
    • Intrahepatic
    • Posthepatic
  • Type of bilirubin elevation
    • Conjugated
    • Uncongugated
    • Mixed

• Prehepatic (Excessive Bilirubin Production):

  • Hemolytic anemias
  • Large hematomas
  • Ineffective erythropoiesis (e.g., bone marrow disorders)

• Hepatic (Intrinsic Liver Disease):

  • Hepatocellular damage:
    • Viral hepatitis (e.g., hepatitis A, B, C)
    • Alcoholic or nonalcoholic steatohepatitis (ASH/NASH)
    • Drug-induced liver injury (e.g., acetaminophen, isoniazid)
    • Autoimmune hepatitis
    • Liver cirrhosis
  • Metabolic or genetic disorders:
    • Gilbert syndrome, Crigler-Najjar syndrome
    • Wilson disease
    • Hemochromatosis

• Posthepatic (Obstructive Cholestasis):

  • Extrahepatic obstruction:
    • Gallstones
    • Cholangiocarcinoma
    • Pancreatic head tumors
  • Intrahepatic obstruction:
    • Primary sclerosing cholangitis
    • Drug-induced cholestasis
    • Pregnancy-related cholestasis