Jaundice

Jaundice
Other names	Icterus[1]
Jaundice of the skin caused by pancreatic cancer
Pronunciation	/ˈdʒɔːndɪs/ JAWN-diss
Specialty	Gastroenterology, hepatology, general surgery
Symptoms	Yellowish coloration of skin and sclera, itchiness[2][3]
Causes	High bilirubin levels[3]
Risk factors	Pancreatic cancer, pancreatitis, liver disease, certain infections
Diagnostic method	Blood bilirubin, liver panel[3]
Differential diagnosis	Carotenemia, taking rifampin[4]
Treatment	Based on the underlying cause[5]

Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels.^[3][6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction.^[7] The prevalence of jaundice in adults is rare, while jaundice in babies is common, with an estimated 80% affected during their first week of life.^[8] The most commonly associated symptoms of jaundice are itchiness,^[2] pale feces, and dark urine.^[4]

Normal levels of bilirubin in blood are below 1.0 mg/dl (17 μmol/L), while levels over 2–3 mg/dl (34–51 μmol/L) typically result in jaundice.^[4][9] High blood bilirubin is divided into two types – unconjugated and conjugated bilirubin.^[10]

Causes of jaundice vary from relatively benign to potentially fatal.^[10] High unconjugated bilirubin may be due to excess red blood cell breakdown, large bruises, genetic conditions such as Gilbert's syndrome, not eating for a prolonged period of time, newborn jaundice, or thyroid problems.^[4][10] High conjugated bilirubin may be due to liver diseases such as cirrhosis or hepatitis, infections, medications, or blockage of the bile duct,^[4] due to factors including gallstones, cancer, or pancreatitis.^[4] Other conditions can also cause yellowish skin, but are not jaundice, including carotenemia, which can develop from eating large amounts of foods containing carotene — or medications such as rifampin.^[4]

Treatment of jaundice is typically determined by the underlying cause.^[5] If a bile duct blockage is present, surgery is typically required; otherwise, management is medical.^[5] Medical management may involve treating infectious causes and stopping medication that could be contributing to the jaundice.^[5] Jaundice in newborns may be treated with phototherapy or exchanged transfusion depending on age and prematurity when the bilirubin is greater than 4–21 mg/dl (68–365 μmol/L).^[9] The itchiness may be helped by draining the gallbladder, ursodeoxycholic acid, or opioid antagonists such as naltrexone.^[2] The word jaundice is from the French jaunisse, meaning 'yellow disease'.^[11][12]