03.12 GI/GS

Written By Joan

Jaundice

= Yellowing of the skin secondary to raised bilirubin

  • Bilirubin levels need to be >50 µmol/L to produce clinically significant jaundice (ref)

    • Doesn’t seem to matter which fraction of bilirubin is raised

Bilirubin

  • Unconjugated bilirubin (UCB) is produced as a result of heme metabolism

  • UCB is insoluble, and is transported to the liver attached to albumin

  • UCB is converted to soluble conjugated bilirubin (CB) in the liver, and CB is then excreted from the body via the gut or kidneys

  • Raised levels of UCB or CB will result in hyperbilirubinaemia

    • Lab results usually note total bilirubin which includes both fractions

    • Direct bilirubin is an estimate of conjugated bilirubin – this has to be specifically requested on forms

    • Indirect bilirubin refers to unconjugated bilirubin

Causes of jaundice

Causes of jaundice can be broken down into pre-hepatic, intra-hepatic, and post-hepatic.

TO BE CONTINUED

Joan
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03.11 GI/GS