Pathophysiology of Jaundice

The causes of jaundice can be divided into pre-hepatic, hepatic, and post hepatic aetiologies.

Pre-hepatic:

Any process that causes an increased rate of RBC breakdown (haemolysis) and saturation of enzymes can cause jaundice.

• Malaria
• Sickle cell anaemia
• Spherocytosis
• Glucose-6-PD deficiency
• Haemolytic uraemic syndrome
• Transfusion reaction

Hepatic:

Any process which effects liver function can cause jaundice.

• Drugs/toxins: Alcohol, paracetamol, anabolic steroids, Isoniazid, amanita toxin, chlorpromazine, flucloxacillin, halothane
• Infections: Viral hepatitis, infectious mononucleosis, leptospirosis
• Metabolic: Wilsons disease, Reyes disease, haemochromatosis
• Granulomatous: Wegners granulomatosis, lymphoma, Sarcoidosis, mycobacterial
• Genetic: Gilberts syndrome, Crigler-Najjar syndrome, Dubin-Johnson Syndrome
• Other: Fatty liver of pregnancy, primary biliary cirrhosis, amyloidosis, metastatic carcinoma, neonatal jaundice

Post-hepatic:

Any process which causes post-hepatic obstruction can cause jaundice.

• Drugs amitriptyline, prochlorperazine, verapamil, co-amoxiclav
• Gallstones
• Pancreatic carcinoma
• Primary sclerosing cholangitis
• Biliary atresia
• Bile duct strictures
• Cholangiocarcinoma
• Pancreatitis
• Pancreatic pseudocyst