Jaundice

All looks yellow to a jaundiced eye - Alexander Pope

Jaundice

image by: Mark Smith

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Medical mystery: Common symptom, uncommon cause

As I went through my patient notes one night in the ER, I thought about how strangely quiet the last few hours had been. Just then, I heard the doors slam as the police rushed in with a man in his late 20s. He was delusional and psychotic.

His mother arrived and told me that she had to call 911 when her son started waving a knife, threatening to kill her. She said that he had stopped bathing in recent days, and then she noticed that he was extremely paranoid. He had hardly any appetite - and, she recalled, the whites of his eyes had looked yellow for the last few weeks.

His behavior reminded her of how he acted the previous year, when he was diagnosed with schizophrenia.…

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Resources

 Medical mystery: Common symptom, uncommon cause

The next day, he appeared calm and oriented, talking to his mother sitting by his bedside. His mood and behavior had remarkably improved. But his skin looked yellow.

ScienceDirect

Jaundice (icterus) is the accumulation of, and colouring of the skin and mucous membranes by, bilirubin, if it appears in excessive amounts or is not conjugated or excreted.

eMedicineHealth

Jaundice may be caused by several different disease processes. It is helpful to understand the different causes of jaundice by identifying the problems that disrupt the normal bilirubin metabolism and/or excretion.

NHS

The most common signs of jaundice are: •yellowing of the skin, eyes and the lining of the inside of parts of the body, such as the mouth and nose (mucus membrane) •pale-coloured stools •dark-coloured urine

Patient

Jaundice results from interference in the normal metabolism of bilirubin (including uptake, transport, conjugation and excretion). This may result from: •Pre-hepatic causes (unconjugated hyperbilirubinaemia), eg haemolytic anaemia. •Hepatocellular disease. •Cholestasis: intrahepatic or extrahepatic cholestasis.

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