Icterus Flashcards
Definition of Icterus
Icterus is a clinical manifestation of an underlying condition where there is an abnormal accumulation of bilirubin in the body, leading to yellow discoloration of the skin, mucous membranes, and eyes.
Causes of Icterus
Icterus can be caused by various factors, including:
Increased production of bilirubin:
Excessive breakdown of red blood cells (hemolysis) due to conditions like hemolytic anemia, malaria, or sickle cell disease.
Impaired bilirubin metabolism or excretion:
Liver diseases: Hepatitis (viral or alcoholic), cirrhosis, or liver damage due to drugs or toxins.
Bile duct obstruction: Gallstones, tumors, or strictures that block the flow of bile from the liver to the intestines.
Inherited disorders: Gilbert’s syndrome, Dubin-Johnson syndrome, or Crigler-Najjar syndrome.
Newborn jaundice:
Common in newborns due to immature liver function and increased breakdown of fetal red blood cells.
Other causes:
Certain medications, infections, autoimmune disorders, or blood disorders.
Diagnosis of Icterus
The diagnosis of icterus involves a combination of medical history, physical examination, and specific tests, including:
Evaluation of symptoms: Yellowing of the skin, eyes, and mucous membranes.
Blood tests: Measurement of bilirubin levels, liver function tests, and specific markers for underlying causes.
Imaging studies: Ultrasound, CT scan, or MRI may be performed to assess the liver, bile ducts, and gallbladder.
Liver biopsy: In some cases, a small sample of liver tissue may be taken for examination under a microscope to determine the underlying cause.
Symptoms:
The main symptom of icterus is yellow discoloration of the skin, eyes, and mucous membranes. Other associated symptoms may include:
Dark urine: Urine may appear dark or tea-colored due to the presence of excess bilirubin.
Pale stools: Stools may become pale or clay-colored due to the absence of bilirubin reaching the intestines.
Itching: Pruritus (itching) can occur due to the accumulation of bilirubin in the skin.
Symptoms of Icterus
The main symptom of icterus is yellow discoloration of the skin, eyes, and mucous membranes. Other associated symptoms may include:
Dark urine: Urine may appear dark or tea-colored due to the presence of excess bilirubin.
Pale stools: Stools may become pale or clay-colored due to the absence of bilirubin reaching the intestines.
Itching: Pruritus (itching) can occur due to the accumulation of bilirubin in the skin.
Treatment of Icterus
The treatment of icterus depends on the underlying cause. It may involve:
Managing the underlying condition: Treating infections, liver diseases, or other specific causes.
Bile duct clearance: If there is a bile duct obstruction, procedures like endoscopic retrograde cholangiopancreatography (ERCP) or surgery may be performed to remove or bypass the obstruction.
Symptomatic relief: Itching may be managed with antihistamines, bile acid sequestrants, or medications to relieve the discomfort.
Complications of Icterus
Liver damage: If the cause is a liver disease or chronic condition, it can lead to liver damage or cirrhosis.
Gallstones: Prolonged bile duct obstruction may lead to the formation of gallstones.
Hepatic encephalopathy: In severe cases, liver dysfunction can lead to neurological symptoms like confusion, disorientation, and coma.
Malnutrition and weight loss: Chronic liver diseases or bile duct obstructions can affect nutrient absorption and lead to weight loss.
