Adult Jaundice Meaning, Facts, Causes, Symptoms, Diagnosis, Treatment, Complications, Side Effects, Prognosis & Prevention

Adult Jaundice Meaning

Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver.

If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow. Jaundice has many causes, including hepatitis, gallstones, and tumors. In adults, jaundice usually does not need to be treated, however, the causes and complications can be treated.

Facts About Jaundice

The term” jaundice” is derived from the French word “jaune”, which means yellow.

• Jaundice is not a disease per se, but rather a visible sign of an underlying disease process.
• Jaundice is typically seen when the level of bilirubin in the blood exceeds 2.5-3 mg/dL (milligrams per deciliter).
• Jaundice in adults can be caused by a variety of medical conditions, some of which are serious and potentially life-threatening.
• Any adult who develops jaundice needs to undergo a comprehensive medical evaluation in order to determine its cause.
• Neonatal jaundice, a condition seen in newborns, is most often a benign condition that improves without serious after effects).

The risk factors for developing jaundice vary based upon the underlying cause.

• Certain people with hereditary conditions (for example, thalassemia or hereditary spherocytosis) are at an increased risk of developing jaundice from hemolysis.
• People who consume alcohol heavily are at an increased risk of developing alcoholic hepatitis, pancreatitis, and cirrhosis leading to jaundice.
• People who are at an increased risk of exposure to the different types of viral hepatitis (for example, hepatitis B and hepatitis C) are at risk of developing jaundice at the time of infection or subsequently, if the liver disease occurs or if liver cancer develops later.
• Other risk factors include:
  • Eating raw shellfish
  • Drug injections of other substances
  • Tattooing
  • Birth between 1945 and 1965
  • Being an unvaccinated (for hepatitis)
  • Healthcare professionals
  • Participating in high-risk sexual activity

Adult Jaundice Causes | What Causes Adult Jaundice?

Jaundice is rare in adults, but you can get it for many reasons. Jaundice can be caused by a problem in any of the three phases in bilirubin production.

1). Before the production of bilirubin, you may have what is called unconjugated jaundice due to increased levels of bilirubin caused by:

• Reabsorption of a large hematoma. This is a collection of clotted or partially clotted blood under the skin.
• Hemolytic anemias. This is when the blood cells are destroyed and removed from the bloodstream before their normal lifespan is over.

2). During the production of bilirubin, jaundice can be caused by:

• Viruses, including Hepatitis A, chronic Hepatitis B and C, and Epstein-Barr virus infection (infectious mononucleosis)
• Alcohol.
• Autoimmune disorders.
• Rare genetic metabolic defects.
• Medicines, including acetaminophen toxicity, penicillins, oral contraceptives, chlorpromazine (Thorazine) and estrogenic or anabolic steroids.

3). After bilirubin is produced, jaundice may be caused by an obstruction (blockage) of the bile ducts from:

• Gallstones.
• Inflammation (swelling) of the gallbladder
• Gallbladder cancer.
• Pancreatic tumor.

Jaundice caused during the hepatic phase can arise from abnormalities in the metabolism and/or excretion of bilirubin. This can lead to an increase in both unconjugated and/or conjugated bilirubin levels. Conditions with a hepatic cause of jaundice include:

• Acute or chronic hepatitis (commonly viral [Hepatitis A, B, C, D, E] or alcohol-related)
• Cirrhosis (caused by various conditions including alcohol toxicity)
• Drugs or other toxins
• Crigler-Najjar syndrome
• Autoimmune disorders
• Gilbert’s syndrome
• Liver cancer

Jaundice from a post-hepatic cause arises from a disruption (an obstruction) in the normal drainage and excretion of conjugated bilirubin in the form of bile from the liver into the intestine. This leads to increased levels of conjugated bilirubin in the bloodstream. Conditions that can cause post-hepatic jaundice include

• Gallstones,
• Cancer (pancreatic cancer, gallbladder cancer, and bile duct cancer),
• Strictures of the bile ducts,
• Cholangitis,
• Pancreatitis, and
• Parasites (for example, liver flukes).

Adult Jaundice Symptoms

In Jaundice, sometimes the person may not have symptoms of jaundice, and the condition may be found accidentally. The severity of symptoms depends on the underlying causes and how quickly or slowly the disease develops.

If you have a short-term case of jaundice (usually caused by infection), you may have the following symptoms and signs:

• Fever
• Chills
• Abdominal pain
• Flu-like symptoms
• Change in skin color
• Dark-colored urine and/or clay-colored stool.

If jaundice is not caused by an infection, you may have symptoms such as weight loss or itchy skin (pruritus). If the jaundice is caused by pancreatic or biliary tract cancers, the most common symptom is abdominal pain. Sometimes, you may have jaundice occurring with liver disease if you have:

• Chronic hepatitis or inflammation of the liver
• Pyoderma gangrenosum (a type of skin disease)
• Acute hepatitis A, B or C
• Polyarthralgias (inflammation of the joints)

Adult Jaundice Diagnosis

Doctors diagnose jaundice by checking for signs of liver disease such as:

• Bruising of the skin
• Spider angiomas (abnormal collection of blood vessels near the surface of the skin)
• Palmar erythema (red coloration of the palms and fingertips)

Urinalysis (urine testing) that is positive for bilirubin shows that the patient has conjugated jaundice. The findings of urinalysis should be confirmed by serum testing. The serum testing will include a complete blood count (CBC) and bilirubin levels.

Your doctor will also do an exam to determine the size and tenderness of your liver. He or she may use imaging (ultrasonography and computer tomographic (CT) scanning) and liver biopsy (taking a sample of the liver) to further confirm the diagnosis.

The presence of jaundice requires a comprehensive medical evaluation to determine the cause. Initially, your health-care professional will take a detailed history of your illness and perform a physical exam, which can sometimes determine the cause of jaundice. Initial blood testing will also be undertaken, with special attention being given to your:

• Liver blood tests
• Complete blood count (CBC)
• Electrolyte panel
• Lipase levels

Blood testing for exposure to hepatitis may also be ordered. Additional blood testing may be ordered based on the initial results. A urinalysis will likely also be ordered.

Depending on the results of initial blood tests, further studies may be needed to help diagnose the underlying disease process. In certain cases, imaging studies will need to be obtained in order to evaluate for any abnormalities of the liver, gallbladder, and pancreas. These imaging studies may include:

• Abdominal ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Cholescintigraphy (HIDA scan)

Occasionally, people will need further invasive testing to determine the cause of jaundice. Procedures that may be ordered include endoscopic retrograde cholangiopancreatography (ERCP) or a liver biopsy.

Adult Jaundice Treatment

Jaundice usually does not require treatment in adults (it is a more severe problem in infants). The causes and complications of jaundice can be treated. For instance, if itching is bothersome, it may be eased by cholestyramine (Questran).