Classification of jaundice
PRE-HEPATIC
POST-HEPATIC
HEPATOCELLULAR (Intrahepatic)
There is excessive red cell breakdown which overwhelms the liver’s ability to conjugate bilirubin. This causes an unconjugated hyperbilirubinaemia.
Causes
There is dysfunction of the hepatic cells. This means the liver loses the ability to conjugate bilirubin. This leads to both unconjugated and conjugated bilirubin in the blood or a ‘mixed picture’.
Causes
This refers to obstruction of biliary drainage. The bilirubin that is not excreted will have been conjugated by the liver, hence is a conjugated hyperbilirubinemia.
Causes
Haemolytic anaemia
Gilbert’s syndrome
Criggler-Najjar syndrome
Alcoholic liver disease
Viral hepatitis
Iatrogenic, e.g. medication
Hereditary haemochromatosis
Autoimmune hepatitis
Primary biliary cirrhosis or primary sclerosing cholangitis
Hepatocellular carcinoma
Intra-luminal causes
Mural causes
Extra-mural causes
Cholangiocarcinoma, strictures, or drug-induced cholestasis
Gallstones
Pancreatic cancer or abdominal masses (e.g. lymphomas)
Ana Maria Romero y Julieth Puentes