a condition that can indicate problems with the liver or biliary tract, but which is sometimes also caused by some forms of anemia or taking medications
Jaundice, or jaundice, or the yellowish discoloration of the skin and of the sclera (whites of the eyes) is a fairly frequent phenomenon that can cause concern. Usually the thought immediately goes to the liver, but in addition to being a warning of liver disease, jaundice can be the wake-up call for other conditions as well. The first step is always to understand its origin and then take the right measures. This condition very common in newborns. The so-called neonatal jaundice in fact, it affects about 60 per cent of term births and 80 per cent of premature babies. In most cases a physiological manifestation destined to disappear in a few days and it probably has a positive function as bilirubin can act as an efficient antioxidant.
Why do you turn yellow?
The yellowish discoloration of the skin and mucous membranes caused by a increase of bilirubin in the blood. Normally the levels of this reddish-yellow pigment, which derives from the destruction of hemoglobin contained in red blood cells, are less than one milligram per deciliter of blood, while the appearance of jaundice occurs when its concentration exceeds 2.5-3 mg / dl – pressed the professor Pietro Lampertico, director of the Gastroenterology and Hepatology Division of the Irccs Policlinico and University of Milan Foundation -. In our body, bilirubin can be found in two forms: that not conjugated, called indirect bilirubin, or conjugated, called direct bilirubin. The first is produced by destruction of red blood cells in the spleen. This form of bilirubin is transformed into bilirubin directed into the liver by an enzyme that combines it with another substance, glucuronic acid. Direct bilirubin then comes poured into the bile and from there into the intestine. In the case of jaundice, identifying which of the two forms of bilirubin is predominant can provide valuable information to understand its origin.
What are the main causes of jaundice?
Jaundice with a prevalent increase in indirect bilirubin in general consequence of pre-hepatic conditions. These include, for example, haemolytic diseases characterized by an accelerated destruction of red blood cells and the intake of special drugs that prevent the entry of indirect bilirubin into the liver cells. Also there Gilbert’s syndrome, characterized by the fact that the enzyme that must conjugate indirect bilirubin within the defective hepatocyte, a common cause of jaundice predominantly to indirect bilirubin, although it is a hepatic form. When to exceed the threshold values especially direct bilirubin, at the origin there may be two major conditions: liver disease and diseases related to obstruction of the biliary tract. The first group includes, to name a few, all acute hepatitis (viral, autoimmune, toxic, drug-induced, etc.), liver failure, hereditary pathologies of bilirubin-carrying enzymes to bile and cholestatic syndromes (such as cholestasis of pregnancy). The group of biliary obstructive diseases includes benign conditions, such as wedged gallstones, or malicious, for example tumors of the pancreas or biliary tract. Cholestasis gravidarum is a frequent condition that it occurs in 1 percent of pregnancies. It typically occurs in the third month of pregnancy with itching and increased liver function index values (transaminase, bilirubin, alkaline phosphatase, etc.), jaundice occurs more rarely – explains Pietro Lampertico -. Cholestasis of pregnancy not considered a serious problem for the future mother, but an element of important fetal suffering. Basically
childbirth therapy, which interrupts this mechanism whose pathogenesis is uncertain. Predisposing factors are represented by South American ethnicity, familiarity (genetic predisposition) as well as hepatitis C, which increases the risk of developing it.
How can it be cured?
Alone discovering the cause correct therapy can be set. In some cases, such as in the Gilbert’s syndrome, no treatment is required: the person concerned should primarily be reassured about the benign nature of this condition. Other times, however, it may be necessary to intervene surgically, for example in the case of tumors or to remove stones that obstruct the biliary tract.
November 9, 2021 (change November 9, 2021 | 18:06)
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