Jaundice - yellow skin

Hepatitis B virus	Jaundice infant	Bili lights

A yellow discoloring of the skin, mucous membranes, and eyes, caused by too much bilirubin in the blood.

Jaundice is a condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat (the layer of fat just beneath the skin), causing a yellowish appearance of the skin and the whites of the eyes. With the exception of physiologic jaundice in the newborn (normal newborn jaundice in the first week of life), all other jaundice indicates overload or damage to the liver, or inability to move bilirubin from the liver through the biliary tract to the gut.

JAUNDICE IN AN INFANT, CHILD, OR ADULT SHOULD ALWAYS BE MEDICALLY EVALUATED.

Newborn jaundice is common and unless associated with an abnormal condition will clear without treatment. Another condition called Gilbert’s syndrome is a hereditary condition in which mild jaundice develops during times of stress. This condition, once recognized, requires no further treatment or evaluation. There are also other more rare hereditary causes of elevated bilirubin levels.  All other jaundice is the result of an underlying disease, condition, or toxicity.

A yellow-to-orange color may be imparted to the skin by excessive intake of beta carotene, the orange pigment seen in carrots. People who consume large quantities of carrots or carrot juice or take beta carotene tablets may develop a distinctly yellow-orange cast to their skin. This condition is called hypercarotenemia or just carotenemia. Hypercarotenemia is easily distinguished from jaundice in that the whites of the eye (sclera) remain white, while people with true jaundice have a yellow sclera.

• newborn jaundice (physiologic jaundice)
• breastfeeding jaundice
• viral hepatitis (hepatitis A, , hepatitis C, hepatitis D, and hepatitis E)
• hemolytic anemia
• congenital disorders of bilirubin metabolism (Gilbert’s syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes)
• biliary atresia 
• autoimmune hepatitis
• malaria

• obstruction of the bile ducts (by infection, tumor or gallstones)
• viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E)
• drug-induced cholestasis (bile pools in the gallbladder because of the effects of drugs)
• drug-induced hepatitis (hepatitis triggered by medications, including erythromycin sulfa drugs, antidepressants, anti-cancer drugs, Aldomet, rifampin, steroids, chlorpropamide, tolbutamide, oral contraceptives, testosterone, propylthiouracil)
• biliary stricture
• alcoholic liver disease (alcoholic cirrhosis)
• pancreatic carcinoma (cancer of the pancreas)
• primary biliary cirrhosis
• ischemic hepatocellular jaundice (jaundice caused by inadequate oxygen or inadequate blood flow to the liver)
• intrahepatic cholestasis of pregnancy (bile pools in the gallbladder because of the pressure in the abdomen with pregnancy)
• hemolytic anemia
• congenital disorders of bilirubin metabolism (Gilbert’s syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes)
• chronic active hepatitis
• autoimmune hepatitis
• malaria

The cause of jaundice must be determined before treatment can be given. Follow prescribed therapy to treat the underlying cause.