Date:   1/25/2009 11:36:53 AM ( 15 y ago)
Hits:   7,665
URL:   https://www.curezone.org/forums/fm.asp?i=1342605

This fits right in with that, and makes more sense to me now with the Babesia/malaria connection (and flukes and bacterias)

//www.curezone.org/forums/fm.asp?i=1242597


Causes (of Jaundice)

When a pathological process interferes with the normal functioning of the metabolism and excretion of bilirubin just described, jaundice may be the result. Jaundice is classified into three categories, depending on which part of the physiological mechanism the pathology affects. The three categories are:

Pre-hepatic: The pathology is occurring prior the liver

Hepatic: The pathology is located within the liver

Post-Hepatic: The pathology is located after the conjugation of bilirubin in the liver


Pre-hepatic

Pre-hepatic jaundice is caused by anything which causes an increased rate of hemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as sickle cell anemia, spherocytosis and glucose 6-phosphate dehydrogenase deficiency can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as hemolytic uremic syndrome, can also lead to coloration. Defects in bilirubin metabolism also present as jaundice. Jaundice usually comes with high fevers.


Laboratory findings include:

Urine: no bilirubin present, urobilirubin > 2 units (except in infants where gut flora has not developed).

Serum: increased unconjugated bilirubin.


Hepatic

Hepatic jaundice causes include acute hepatitis, hepatotoxicity and alcoholic liver disease, whereby cell necrosis reduces the liver's ability to metabolize and excrete bilirubin leading to a buildup in the blood. Less common causes include primary biliary cirrhosis, Gilbert's syndrome (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population) and metastatic carcinoma. Jaundice seen in the newborn, known as neonatal jaundice, is common, occurring in almost every newborn as hepatic machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age.


Laboratory Findings include:

Urine: Conjugated bilirubin present, Urobilirubin > 2 units but variable (Except in children)


Post-hepatic

Post-hepatic jaundice, also called obstructive jaundice, is caused by an interruption to the drainage of bile in the biliary system. The most common causes are Gallstones in the common bile duct, and pancreatic cancer in the head of the pancreas. Also, a group of parasites known as "liver flukes" live in the common bile duct, causing obstructive jaundice. Other causes include strictures of the common bile duct, biliary atresia, ductal carcinoma, pancreatitis and pancreatic pseudocysts. A rare cause of obstructive jaundice is Mirizzi's syndrome.


The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from bile pigments. Patients also can present with elevated serum cholesterol, and often complain of severe itching or "pruritus."



 

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