Jaundice
A sign of high bilirubin indicating underlying disease.
Wikipedia / Wikimedia Commons
Jaundice, also called icterus, turns the skin and the whites of the eyes a yellow or, less often, greenish color. This happens because of too much bilirubin in the blood. In adults, jaundice is uncommon and usually points to an underlying problem with how the body processes heme, how the liver works, or a blockage in the bile ducts. In newborns, however, it is very common—about 80% of babies develop it during their first week of life. Common symptoms that go along with jaundice include itching, pale stools, and dark urine.
Normal bilirubin levels in the blood are below 1.0 mg/dL (17 μmol/L). Jaundice typically becomes noticeable when levels rise above 2–3 mg/dL (34–51 μmol/L). High bilirubin comes in two types: unconjugated and conjugated. Causes range from mild to life-threatening. High unconjugated bilirubin can result from excessive red blood cell breakdown, large bruises, genetic conditions like Gilbert’s syndrome, not eating for a long time, newborn jaundice, or thyroid problems. High conjugated bilirubin can be due to liver diseases such as cirrhosis or hepatitis, infections, certain medications, or a blocked bile duct from gallstones, cancer, or pancreatitis. Other conditions can turn the skin yellow without being jaundice, such as carotenemia from eating lots of carotene-rich foods, or the medication rifampin.
Treatment depends on the underlying cause. If a bile duct is blocked, surgery is usually needed; otherwise, medical management is used. This may involve treating infections or stopping medications that contribute to the jaundice. For newborns, phototherapy or exchange transfusion may be used when bilirubin levels are between 4 and 21 mg/dL (68–365 μmol/L), depending on age and prematurity. Itching can be relieved by draining the gallbladder, taking ursodeoxycholic acid, or using opioid antagonists like naltrexone. The word "jaundice" comes from the French *jaunisse*, meaning "yellow disease."
**Signs and symptoms**
The most common sign in adults is a yellow tint to the white part of the eye (sclera) and the skin. Yellowing of the sclera usually means the serum bilirubin is at least 3 mg/dL. Other common signs are dark urine (bilirubinuria) and pale, fatty stools (steatorrhea). Because bilirubin irritates the skin, jaundice often comes with severe itching. The conjunctiva of the eye has a high amount of elastin, which binds bilirubin strongl
- field
- Medicine
- known_for
- Yellowish pigmentation of skin and sclera due to high bilirubin
- prevalence_in_adults
- Rare
- prevalence_in_newborns
- Common (80% in first week of life)
- normal_bilirubin_level
- Below 1.0 mg/dl (17 μmol/L)
- threshold_for_jaundice
- Over 2–3 mg/dl (34–51 μmol/L)
Lore & Background
Jaundice is classified into three categories based on the part of the physiological mechanism affected: prehepatic, hepatic, and posthepatic. Prehepatic jaundice is most commonly caused by increased red blood cell hemolysis, as seen in sickle-cell anemia, spherocytosis, thalassemia, and infections such as malaria. Hepatic jaundice results from abnormal liver metabolism due to conditions like hepatitis, cirrhosis, drug-induced liver injury, or genetic disorders such as Gilbert's syndrome. Posthepatic jaundice, or obstructive jaundice, is caused by blockage of bile ducts, most often from gallstones, but also from pancreatic cancer, biliary strictures, or parasites.
Reader's Guide
Jaundice serves as a critical clinical indicator for a range of conditions from benign to potentially fatal. Its presence in adults typically prompts investigation into liver function, bile duct patency, and red blood cell turnover. The distinction between unconjugated and conjugated hyperbilirubinemia guides diagnostic workup and treatment. Treatment is determined by the underlying cause: surgery for bile duct blockage, medical management for infections or medication-induced cases, and phototherapy or exchange transfusion for newborns when bilirubin exceeds 4–21 mg/dl depending on age and prematurity. The word 'jaundice' derives from the French 'jaunisse', meaning 'yellow disease'. Accurate assessment requires attention to scleral icterus, especially in individuals with darker skin tones, where skin discoloration may be less apparent.
Did You Know?
- Scleral icterus is technically a misnomer; the yellowing occurs in the conjunctival membranes overlying the sclera.
- In developing children, hyperbilirubinemia can cause yellowish or greenish tooth discoloration due to bilirubin deposits during tooth calcification.
- Carotenemia from eating large amounts of carotene-rich foods can cause yellowish skin but is not jaundice.
- The itchiness associated with jaundice may be helped by draining the gallbladder, ursodeoxycholic acid, or opioid antagonists such as naltrexone.
Frequently Asked Questions
What is Jaundice?
Jaundice (also called icterus) is a visible yellowing of the skin and the whites of the eyes that appears when bilirubin accumulates in the bloodstream past its normal ceiling. It is not a standalone disease but a visible marker that something else in the body is malfunctioning.
What symptoms does Jaundice bring along with the color change?
Beyond the characteristic yellow or, less frequently, greenish tint, affected individuals often report persistent itching, stools that look unusually pale, and urine that turns a noticeably dark color. These accompanying signs help clinicians narrow down what is driving the bilirubin spike.
How common is Jaundice in adults versus newborns?
In adults it is relatively rare and usually flags a liver-processing issue, a heme-breakdown problem, or a blockage in the bile ducts. In newborns, by contrast, roughly four out of five babies develop some degree of it during their first week of life, making it one of the most routine findings in neonatal care.
What bilirubin level triggers the visible yellowing?
Normal blood bilirubin stays below 1.0 mg/dL (about 17 μmol/L), and the skin-and-sclera discoloration generally becomes apparent once levels climb past roughly 2–3 mg/dL (34–51 μmol/L). That gap between 'normal' and 'visible' is why mild elevations can go unnoticed until the tint shows up.
Why is Jaundice considered important in medicine?
It acts as a visible red flag pointing toward an underlying disorder, whether that involves the liver's processing capacity, a biliary obstruction, or abnormal red-blood-cell breakdown. Because it is uncommon in adults, its appearance usually prompts a full diagnostic workup to identify the root cause.
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