icterus kuliah.ppt
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ICTERUS
Erwin Taher
FK-UISU
2012
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Prehepatic (hemolytic) jaundice
• Results from excess production ofbilirubin (beyond the livers abilityto conjugate it) following hemolysis
• Excess RBC lysis is commonly theresult of autoimmune disease
hemolytic disease of the newborn(Rh! or "B#! incompatibility)structurally abnormal RBCs ($ic%lecell disease) or brea%down ofextravasated blood
• &igh plasma concentrations ofunconjugated bilirubin (normalconcentration '* mg+d,)
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Intrahepatic jaundice
• -mpaired upta%e.
conjugation. or secretion ofbilirubin
• Reflects a generali/ed liver
(hepatocyte) dysfunction
• -n this case.hyperbilirubinemia isusually accompanied by
other abnormalities inbiochemical mar%ers ofliver function
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Posthepatic jaundice
• Caused by an obstruction of thebiliary tree
• 0lasma bilirubin is conjugated.and other biliary metabolites.such as bile acids accumulate in
the plasma
• Characteri/ed by pale coloredstools (absence of fecal bilirubinor urobilin). and dar% urine
(increased conjugated bilirubin)
• -n a complete obstruction.urobilin is absent from the urine
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