Eng / JAUNDICE

Parenchymal (hepatic)

impaired excretion and capture of bilirubin, bilirubin regurgitation (acute and chronic hepatitis, acute and chronic hepatosis, liver cirrhosis)

impaired excretion of bilirubin, its regurgitation, the formation of biliary thrombi (cholestatic jaundice, cholestatic hepatitis, primary biliary cirrhosis of the liver, idiopathic benign recurrent cholestasis

violation of conjugation and capture of bilirubin (enzymopathic jaundice in the syndrome of Gilbert, Crigler-Najjar, etc.)

impaired excretion of bilirubin (Dubin-Johnson and Rotor syndrome)

Subhepatic (mechanical)

the result of impaired excretion and regurgitation of bilirubin

intracanal (blockage, bile duct stones, tumor, parasites, inflammatory exudate)

extracanal (compression of the ducts from the outside by a tumor, echinococcus, narrowed by scars)

suprahepatic (hemolytic)

:

corpuscular hemolytic jaundice - based on biochemical defects - enzymopathies erythrocytes (Minkowski-Choffard anemia) hemoglobinopathies (thalassemia) defects of erythrocyte membranes

extracorpuscular hemolytic anemias (transfusion of incompatible blood, malaria, | leptospirosis, sepsis, hemolytic poisons - arsenic

increased production of bilirubin as a result of the breakdown of erythrocytes in extensive hematomas, heart attacks, hemorrhages in the abdominal or pleural cavity

suprahepatic (hemolytic)

clinical and laboratory symptom complex

hyperbilirubinemia due to free (indirect bilirubin)

absence of acholia

dark urine color due to increased content of urobilinogens

anemia, reticulocytosis

hepatosplenomegaly

no significant liver dysfunction

suprahepatic (hemolytic)

hereditary microspherocytosis - Minkowski-Choffard disease (jaundice) anemia, splenomegaly, formation of gallstones, hemolytic crises. The diameter of erythrocytes is reduced, and the thickness is increased.

hereditary stomacytosis (anemia, hemolytic crises). Jaundice, enlarged spleen. The peculiar form of erythrocytes - their non-staining part in the center is limited by two curved lines and resembles a mouth.

suprahepatic (hemolytic)

G6 PD deficiency - acute hemolytic crises in response to the use of certain drugs with the release of brown urine and fever:

- sulfonamides

antimalarials (quinine, primaquine, quinine)

- nitrofurans

- 5-NOK, non-grammon

- derivatives of isonicotinic acid)

suprahepatic (hemolytic)

thalassemia - impaired synthesis of globin

autoimmune ndiopathic hemolytic

symptomatic autoimmune hemolytic anemia (multiple myeloma, lymphocytic leukemia, sarcoma, systemic lupus erythematosus, rheumatoid arthritis), the possibility of provoking them by many infectious diseases (measles, rubella, mumps, viral hepatitis).

suprahepatic (hemolytic)

autoimmune hemolytic anemia with incomplete heat agglutinins

paroxysmal nocturnal hemoglobinuria - Marchiafava-Mikeli disease

(abdominal pain due to thrombosis, hepatosplenomegaly, dark urine, proteinuria, hemosiderin excretion in the urine, anemia, leukopenia, thrombocytopenia, decreased glucose.

Hepatic jaundice

general clinical and laboratory symptom complex:

hyperbilirubinemia with a predominance of the direct fraction

acholia feces

choluria

hepatosplenomegaly

signs of liver dysfunction