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Jaundice

Jaundice is a condition in which there is yellowing of skin, nails, eyes and mucous membranes due to the increased amounts of bilirubin in the bloodstream. Bilirubin is a yellow colour substance that is formed due to the breakdown of red blood cells. Normally the liver metabolizes bilirubin and excretes it in the form of bile. When there is a liver dysfunction, the bilirubin gets accumulated in the blood and causes jaundice.


Most of the newborn babies may have mild jaundice within first 5 days of their birth. Infant jaundice can occur due to lack of certain proteins, sickle cell anemia, high levels of RBC, infections or Rh incompatibility.

Signs and symptoms

Yellow discoloration of skin and sclera of eye is the hallmark sign of jaundice. However, if there is a progressive increase of bilirubin in your blood, you may experience the following symptoms:

Nausea and vomiting

Itching of the skin

Pale-coloured stools

Fever and chills

Dark-coloured urine

Loss of appetite

Abdominal pain

Swelling of legs and abdomen

Fatigue for prolonged periods

How to find out whether I have Jaundice?

If you notice yellowing of skin and eyes along with flu like symptoms, consult your doctor. You doctor would recommend you some tests to determine the underlying cause of jaundice.

Blood test

Bilirubin test: This test assesses the levels of total bilirubin, direct bilirubin and indirect bilirubin.

Indirect bilirubin refers to the bilirubin formed by the breakdown of red blood cells which travels from the blood to the liver.

Direct bilirubin refers to the bilirubin which undergoes chemical change in the liver. This bilirubin moves to the intestine and is then removed through stools.

For understanding your results, it is important to know the reference values of bilirubin in your blood. Refer the following table to interpret your test results:

Bilirubin type

Normal Range

Direct bilirubin

0.0 – 0.3 mg/dL

Total bilirubin

0.3 – 1.9 mg/dL


Indirect bilirubin = Total bilirubin – direct bilirubin


If the total bilirubin level exceeds more than 2.5 mg/dL(hyperbilirubinemia), it indicates the presence of jaundice.

Coombs test – Jaundice is also caused due to excessive breakdown of red blood cells. Coombs test determines the presence of antibodies that attacks red blood cells and destroys them. This test is usually done to detect Rh incompatibility in the newborn which also causes severe jaundice.

Urine test

Your urine sample is collected and assessed for the presence of bilirubin. Normally, bilirubin is not found in urine. Presence of bilirubin in your urine sample is an indication of liver dysfunction.

Liver function tests

If elevated levels of bilirubin are found in your blood sample, your doctor would recommend you liver function tests to evaluate the liver function. The following liver parameters are assessed to determine the underlying cause of jaundice:

Alanine Transaminase (ALT) test

Aspartate aminotransferase (AST) test

Alkaline phosphatase (ALP) test

Albumin and total protein test

Parameter

Normal ranges

Interpretation

Alanine Transaminase (ALT)

7 to 55 units per liter (U/L)

Increase indicates liver dysfunction

Aspartate aminotransferase (AST)/ serum glutamic-oxaloacetic transaminase (SGOT)

Males -10 to 40 units/L


Females- 9 to 32 units/L

Increase in the levels indicate liver dysfunction

Alkaline phosphatase (ALP)

44 to 147 IU/L

Increase in levels may indicate liver failure

Serum Albumin

3.4 to 5.4 g/ dL

Decreased levels indicate liver dysfunction


Other tests

Ultrasound –An ultrasound scan is usually done to observe for the signs of obstruction in liver and bile ducts.

CT (computed tomography) scan - CT scan gives a detailed image of the liver and helps in detection of liver obstruction or injuries.

Management of Jaundice

Self-care to treat jaundice

Take ample amounts of water and fluids.

Follow the dietary restrictions as recommended by your doctor.

Avoid alcohol consumption as it can aggravate liver dysfunction.

Take prescribed medications regularly as instructed by your doctor.

Medical intervention

Early detection of jaundice helps in decreasing the progression of liver diseases. Jaundice caused due to acute viral hepatitis disappears gradually without any treatment. Symptoms like itching get faded away once the liver function improves.

Medications – Steroids may be used to treat certain conditions that lead to jaundice. Diuretics and lactulose may be used to treat the patients having liver cirrhosis. Antibiotics may be prescribed to treat liver infections that can cause jaundice.

Surgery - If jaundice is caused due to the obstruction of your bile ducts, your doctor would remove the bile ducts or the gall bladder with surgery.

Why choose Apollo Diagnostics?

We have the expertise of 34 + years in healthcare. Our labs are equipped with EQUAS (External Quality Assurance System) and loaded with full automated machines to ensure error free reports, with a quick turnaround time, and at an affordable price. For your convenience, we offer free home collection of samples.

For appointments, please call 9205478479.

References

What is jaundice? https://www.emedicinehealth.com/jaundice/article_em.htm. Accessed on 09-10-2017

Infant jaundice. https://www.healthline.com/health/bilirubin-blood#infant-jaundice8. Accessed on 09-10-2017

What are the symptoms and signs of jaundice? https://www.emedicinehealth.com/jaundice/page2_em.htm#what_are_symptoms_and_signs_of_jaundice. Accessed on 09-10-2017

Bilirubin blood test. https://medlineplus.gov/ency/article/003479.htm. Accessed in 09-10-2017

Bilirubin – urine. https://medlineplus.gov/ency/article/003595.htm Accessed on 09-10-2017

Self-care at home for jaundice. https://www.emedicinehealth.com/jaundice/page3_em.htm#what_are_jaundice_treatments. Accessed on 09-10-2017

What is the treatment for jaundice in adults? https://www.medicinenet.com/jaundice_in_adults/article.htm#what_is_the_treatment_for_jaundice_in_adults. Accessed on 09-10-2017

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