IcterusR17

Last updated on: 18.12.2020

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Synonym(s)

Icterus; jaundice

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DefinitionThis section has been translated automatically.

Icterus (from Greek ícterus = jaundice), generally refers to the discoloration(dyschromia) of visible tissues due to the accumulation of bilirubin in the skin, sclerae and internal organs (perceptible discoloration of the skin in the case of bilirubin > 3 mg/dl, perceptible discoloration of the sclerae in the case of bilirubin > 2 mg/dl). The sclerae are affected at an early stage, as bilirubin preferentially stains the elastic fibres. The scleral icterus is therefore an early and important diagnostic leading symptom for clarification of the symptom.

Pseudo-octerus is a deposit of dye on the skin and/or sclerae, e.g. through repeated, excessive carotene consumption(carotene jaundice, e.g. in infants through fed carrot pulp) at normal bilirubin levels.

Xanthoderma is a yellowing of the skin caused by medication (e.g. Qinacrin).

ClassificationThis section has been translated automatically.

According to the site of the causative disorder:

  • Prehepatic
  • Intrahepatic
  • Posthepatic.

In prehepatic icterus, there is an increase in bilirubin, the cause of which lies "before the liver" (e.g., due to hemolysis).

In intra- and posthepatic icterus, there is a bilirubin increase in the liver or behind the liver, respectively. This is always obstructive or non-obstructive cholestasis.

According to the cause of jaundice:

Idiopathic functional cholestasis (rare)

  • Gestational cholestasis

  • Summerskill-Tygstrup syndrome

  • Idiopathic postoperative jaundice

  • Cholestasis due to lack of transporters in the canalicular membrane
  • Bile acid synthesis disorders
    • Zellweger syndrome (damage to peroxisomes)
  • Extrahepatic cholestasis (bile flow disturbance in the extrahepatic large bile ducts)
  • Intracanalicular obstruction (choledochal stones, Mirizzi syndrome, papillary stenosis, cholangitis, tumor, stricture, parasites, ascarides, schistosomiasis, Fasciola hepatica, Clonorchis sinensis)
  • Etracanalicular duct compression (pericholecystitis, pancreatitis, tumors like pancreatic carcinoma, cholangiocellular carcinoma, gallbladder carcinoma, pancreatic pseudocysts, liver echinococcus, liver abscess)
  • Familial hyperbilirubinemia syndromes
  • With elevated direct bilirubin (very rare)

Clinical featuresThis section has been translated automatically.

Clinically, in addition to the different yellowing of the skin and the sclerae, there is typically severe itching and, in the case of cholestatic (congestion-related) causes, often discoloration of the stool with darkening of the urine.

LiteratureThis section has been translated automatically.

  1. Ebrahimi A et al (2018) Crigler-Najjar Syndrome: Current Perspectives and the Application of Clinical Genetics. Endocr Metab Immune Disord Drug Targets 18:201-211.
  2. Maruo Y et al (2016) Genotype of UGT1A1 and phenotype correlation between Crigler-Najjar syndrome type II and Gilbert syndrome. J Gastroenterol Hepatol 31:403-408.
  3. Rowland A et al (2013) The UDP-glucuronosyltransferases: their role in drug metabolism and detoxification. Int J Biochem Cell Biol 45:1121-1132.

Last updated on: 18.12.2020