Jaundice: symptoms, causes, complications
Jaundice (also known as ikterus) is a yellowish pigmentation of the skin, eye proteins and other mucous membranes, caused by hyperbilirubinemia (elevated bilirubin level in the blood). Subsequently, hyperbilirubinemia causes an increase in the substance in the extracellular fluid. The concentration of bilirubin in the blood plasma usually does not exceed 1.5 mg, and when it crosses the boundary of 2.5 mg, jaundice is observed, the symptoms of which are very obvious. This disorder can often occur in liver diseases, such as hepatitis or cancer. It can also indicate leptospirosis or blockage of the biliary tract with a gallstone or a malignant tumor of the pancreas. Less commonly, the disorder is congenital, for example, in atresia of the bile ducts.
Yellowing of the skin, especially the feet and palms, must be distinguished from a condition such as jaundice, the symptoms of which are expressed in the pigmentation of proteins and mucous membranes.Carotenemia, elevated levels of carotene in the blood is a completely harmless phenomenon.
Jaundice - Symptoms
The main symptom of the disorder, as mentioned earlier, is the pigmentation of proteins and skin. With an increase in the level of bilirubin, the conjunctiva of the eye first of all stains, the protein membrane itself, as a rule, is not affected by the bile pigment.
By itself, jaundice, signs of which are few, is not a disease, but is a sign of many possible pathological processes associated with disturbed metabolism of bilirubin. After the red blood cells complete their life cycle, lasting about 120 days, or their destruction, the membranes become fragile and prone to ruptures. Passing through the macrophage system, the cell membranes are destroyed if they are not dense enough, and their contents, including hemoglobin, enter the blood. Hemoglobin is phagocytosed by macrophages and cleaved into heme and globin. Globin protein is dehydrated into an amino acid and has no effect on a condition such as jaundice, the symptoms of which manifest as yellowing of the eyes and skin.With a hemma molecule, two reactions occur that lead to the formation of bilirubin. About 4 mg of a substance is produced daily for each kilogram of blood, which is associated with the natural death of red blood cells and some other phenomena. Free bilirubin is transported to the liver by the blood stream, where it binds to glucuronic acid and becomes soluble. From the liver, the substance is secreted into the biliary and cystic ducts as part of the bile. Next, intestinal bacteria convert bilirubin to urobilinogen, which is partially excreted in the feces, and partially resorbed by intestinal cells, moves through the blood to the kidneys, from where it is excreted with urine.
Jaundice - consequences
Jaundice can cause complications, including sepsis, in particular cholangitis, biliary cirrhosis, pancreatitis, coagulopathy, renal and hepatic failure. Other effects include disorders that cause the disorder, and procedures related to diagnosis and treatment.