Conjugation jaundice in newborns: causes, symptoms, treatment and effects
Often, while still in the maternity hospital, looking at the baby, we notice that the color of his skin has changed - she has acquired a yellowish tint. This phenomenon is called jaundice of newborns. The whites of the eyes and the visible mucous membrane may become yellowish. Experts identify 2 types of neonatal jaundice:
- Physiological (conjugation).
- Pathological (nuclear, hemolytic).
Who can get newborn jaundice?
There is a certain risk group of babies who may experience neonatal jaundice:
- premature babies
- children of mothers who have diabetes
Neonatal jaundice: causes
Conducting research, modern experts have shown that the manifestation of yellowness on the skin of the baby also affects:
- maternal nutrition during pregnancy
- deterioration in the health of the pregnant woman,
- bad habits of the future mother,
- iodine deficiency in a pregnant woman,
- adverse environmental conditions,
- management of drugs in the body of a pregnant woman during childbirth or during breastfeeding.
All of the above factors affect the underdevelopment of the fetus in the womb and preterm labor, when the baby’s organs are not yet fully formed to function well. And the underdevelopment of the fetus adversely affects the body's ability to transport the bilirubin accumulated after birth in the baby’s blood to the liver for removal from the body. And now, when the body can not completely remove the bilirubin, then there is an icteric color of the skin and mucous membranes of the child.
Physiological or conjugation jaundice: causes
Any yellowness of the skin is associated with an increased level of bilirubin in the blood of a person, even just born. Bilirubin is a substance that is formed after the breakdown of red blood cells. In the womb, a child has a large number of red blood cells that carry hemoglobin. After birth, a small person does not need such a number of them, and therefore they are destroyed. Bilirubin, formed after their breakdown, must be supplied with blood to the liver and excreted through the urine and the first feces of the newborn.
While bilirubin "gets" to the liver, it can partially be absorbed into the baby’s blood and stain its skin and mucous membranes. Yellowiness is manifested due to the underdevelopment of the systems in babies, which are responsible for the exchange of bilirubin in the blood.
Physiological jaundice of newborns appears 2-4 days after birth. Such jaundice takes place within a maximum of 2-3 weeks after birth in full-term babies (3-4 weeks in prematurity), without medical intervention and disruption of the child’s general condition. But the extinction, that is, the lesser yellowness, should begin at the end of the first week of life.
Physiological (conjugation) jaundice: effects
Physiological jaundice, which takes place within 2-3 weeks after birth without any complications, has no consequences for the functioning of the organs of the child. If at the maternity hospital you are told that the child has a jaundice, but at the same time no analysis is done, and you do not observe moodiness or rejection of the breast, then you have physiological jaundice.
Physiological (conjugation) jaundice: treatment
Such jaundice does not need medical intervention if there are no violations in the general condition of the baby. In the maternity hospital, pediatricians monitor the course of this disease daily, who evaluate the degree of the child’s yellowness each day and decide whether there is a need for a blood test for the amount of bilirubin in the blood.
After discharge, the parents watch the baby at home, fixing every day, whether the jaundice has become stronger. If it fades away, then you should not go to the doctor. If you notice that the baby's integuments have become more yellow than before, then you should consult a doctor for advice.
Sometimes after discharge, a 5% glucose solution is prescribed for jaundice, which after 1–1.5 should help relieve jaundice when there is a non-pathological course.
The sun's rays are a beneficial effect on the mood of the mother and baby, and a good cure for physiological jaundice.
Pathological jaundice of newborns
As mentioned earlier, jaundice of newborns can be of two types. One of them is analyzed above (physiological), the second type - pathological jaundice of newborns - is not as harmless as the first type.
If jaundice lasts more than a month, then you should start worrying. Most likely, you are faced with the pathology of the flow of jaundice. Without a blood test and consultation of an experienced doctor you can not do.
Types of pathological jaundice:
Nuclear pathological jaundice of newborns: causes
Pathological jaundice of newborns occurs due to the excess of bilirubin in the blood of a child. The main cause of an excessive amount of bilirubin in an infant’s blood is the lack of enzymes in the body that supply bilirubin to the liver. The absence of such enzymes is associated with:
- massive hemorrhages on the baby’s skin and head,
- very pronounced jaundice in previous children, if they were in the family.
Most of all, of course, the likelihood of the development of such a course of jaundice in a newborn is in premature babies, since their organs are not ready for independent living without the participation of the maternal organism.
Nuclear pathological jaundice: consequences
Nuclear jaundice received this name, because, penetrating into the blood of the infant, it reaches the brain and infects the nucleus of its cells. Nuclear jaundice of newborns in the absence of timely and correct treatment can lead to mental retardation and physical development, cerebral palsy, deafness, reduced vision and even blindness. The activity of the entire nervous system is disrupted, and a very serious neurological defect arises. In some cases, nuclear jaundice leads to paralysis of the child.
Nuclear pathological jaundice: treatment
Excessive amount of bilirubin in the blood should be determined even in the hospital. Experienced doctors should eliminate the main reasons for the increase in the concentration of this substance in the baby’s blood.
The most common ways to eliminate excess bilirubin from the baby’s blood is phototherapy. In phototherapy, quartz lamps are usually used, which are able to break down the bilirubin accumulated in the skin of the newborn. As long as there are indications, phototherapy sessions should be repeated regularly. The optimal scheme of phototherapy for most newborns is the sequential alternation of phototherapy sessions with feeding interruptions.
There is also the possibility, in case of not very severe nuclear jaundice, to use droppers with special preparations that help remove excess bilirubin from the child’s body. Droppers with 5% glucose solution are used.
In severe cases, replace with blood transfusions in order to completely clean the small body of excess bilirubin cells negatively affecting its vital activity.
Hemolytic pathological jaundice: causes
Not for nothing in women who are registered in the antenatal clinic for pregnancy, they immediately take a whole group of tests. One of these tests is a blood test to determine the group and Rh factor. If a woman turns out to be with 1 group or with a negative Rh factor, then they will definitely require that the future father also pass the analysis for the group and Rh.
This is done in order to exclude the appearance of a “conflict” between the blood of the mother and the fetus. Such conflicts can lead either to developmental pathologies of the fetus or to miscarriages.
Thus, another reason for the accumulation of bilirubin in the child’s blood may be a mismatch between the blood groups of the mother and the child, or a mismatch of the blood rhesus (the mother is negative and the child is positive).
Hemolytic pathological jaundice: consequences
Like the symptoms, the effects of this jaundice are the same as with nuclear jaundice, since both of them prevent the removal of bilirubin from the body, lead to its absorption into the blood and affect all vital organs.
All children who have had hemolytic jaundice are observed by a neurologist, ophthalmologist, orthopedist every month for a year. These children are given a withdrawal from vaccinations for 1 year.
Hemolytic pathological jaundice: treatment
As with pathological nuclear jaundice, phototherapy and an IV can be used. But the most effective way is to replace blood transfusion, which instantly saves the baby from excess bilirubin.
If a doctor considers surgery to be impractical, then most often they are given a course of droppers, since the lamp in this case can be a waste of time.
How to determine how serious jaundice of a newborn?
If the baby’s yellowness of the baby’s skin and other symptoms of the pathological course of this disease appear in the maternity hospital, it is considered necessary to take blood from the infant for analysis. The analysis is taken from a vein on an empty stomach. According to the results of tests that show the level of concentration of bilirubin in the blood, the doctor prescribes a treatment or says that everything will pass by itself soon.
There is a norm of concentration of bilirubin in the blood of a newborn - 255 µmol / l. If this rate is exceeded, conservative or operative treatment is prescribed (depending on the degree of excess of the norm). But even if the norm is observed, but your baby has a low weight, then the pediatrician may consider it necessary, to conduct a conservative treatment with phototherapy or droppers.
Prevention of neonatal jaundice
The best way to prevent jaundice in newborns is early and frequent breastfeeding. Colostrum is a natural laxative, causing a faster release of meconium in an infant, with which extra bilirubin is released.
Since children with elevated bilirubin are very drowsy, they should even be awakened for feeding: when the time is right and the baby does not wake up. There are times when breastfeeding is the cause of jaundice (mom's diabetes), but even in this case, the rejection of breastfeeding is not welcome.
Thus, jaundice of the newborn is the acquisition of a yellowish tinge of the skin and visible mucous membranes of the infant due to the excess of the bilirubin content in the baby’s blood. May occur on the first day or in 2-3 days.
There are two types of jaundice: physiological - practically harmless and self-transposing in 2-3 weeks after birth, and pathological - a serious excess of the amount of bilirubin in the blood, which without medical intervention can lead to serious consequences: paralysis, deafness, blindness and mental and physical retardation. With manifestations of jaundice, the main thing is daily observation of the general condition of the baby and the degree of yellowness of the surfaces.
What is conjugation jaundice?
Pathology arises due to hereditary factors when the liver does not produce the necessary bilirubin-binding enzymes. It appears in the blood after the natural death of red blood cells. Up to 1% of red blood cells are updated daily, they contain indirect bilirubin. It is a toxic pigment that carries oxygen and carbon dioxide. In healthy people, it interacts with proteins, forms a complex organic compound. Its destruction occurs in the liver under the influence of enzymes (enzymes), this process is called conjugation. The converted pigment becomes water soluble, it enters the bile for disposal.
When conjugation jaundice of newborns, the liver does not produce enzymes in full, the processing of toxic bilirubin is disturbed, its concentration in the blood gradually increases. If no measures are taken, the condition of the infant will worsen, and intoxication of the brain nuclei develops.
Causes of disease
In case of violation of the conjugation process, jaundice of newborns occurs in the first days of life or in utero. The disease occurs in the following forms:
- Due to prematurity, an immature liver is not ready to produce enzymes. In this case, conjugation jaundice is protracted, dangerous by complications, delayed up to 4 weeks.
- Gilbert's syndrome is a chromosomal disorder of a congenital nature, when enzymes are synthesized incorrectly. It is more common in newborn boys, characterized by a moderate increase in the concentration of toxic pigment.
- Crigler-Nayar syndrome is a severe form of jaundice that occurs due to conjugation reason. Associated with the genetic pathology of the liver when enzyme production does not occur. Fermentation of toxic bilirubin is disturbed, this leads to damage to the central nervous system, conjugation jaundice is transformed into nuclear.
- Lyceum-Driscol syndrome is characterized by the presence of specific hormones in a child’s blood that prevent the conversion of bilirubin. This is a very rare pathology, its nature is not fully understood. If the body of the baby in the first weeks of life alone does not suppress the action of foreign hormones, irreversible brain damage and death are possible due to conjugation disorders.
- Breast feeding syndrome, is extremely rare with rhesus incompatibility of the mother and child. With this form of conjugation jaundice with mother's milk, substances that cause the death of red blood cells enter the body of the baby. In this case, the baby is transferred to artificial feeding or give him breast milk from another mother.
- Hyperbilirubinemic form occurs during heavy labor, oxygen starvation of the fetus. The nature of conjugation disorders is associated with an increased level of toxic pigment in the blood of a newborn. In some cases, prematurity leads to the defeat of the gray matter of the brain.
- The endocrine form of conjugation jaundice is associated with impaired hormone production by the thyroid gland.
- Intrauterine lesion of the baby’s liver with drugs contraindicated during pregnancy. Reception of quinine, some types of antibiotics leads to conjugation disorders. Requires immediate treatment, baby support the function of the parenchyma until it is restored.
Symptoms of conjugation jaundice in newborns
The disease is often manifested by a change in the color of the mucous membranes and the skin on the second or third day of life, they become yellow. Pathology is not accompanied by an increase in the parenchyma and spleen, sometimes accompanied by a change in the behavior of the baby: his appetite decreases, crying becomes long and monotonous.
Physiological jaundice from pathological is distinguished by the color of feces: with conjugation disorders, they change color, urine darkens, feces become colorless. Pathological disorders of the brain signal some symptoms:
- mucous membranes, skin and eyeballs of the baby become bright orange,
- he often throws back his head, rolls his eyes,
- there are cramps
- the temperature rises
- spits up masses of yellowish color.
Conjugation Jaundice Treatment
The tactics of therapeutic interventions depends on the concentration of bilirubin in the blood of the infant. If it does not exceed 120 µmol / l, phototreatment is prescribed: under the influence of light of a certain wave, the toxic pigment in the skin is destroyed, and the process of its connection with albumin is activated. Frequent breastfeeding is recommended for detoxification, up to 7 times a day.
With a lack of protein, the donor plasma and albumin preparations are injected into the baby. If there is a threat of brain damage, the blood is replaced completely. Intravenous administration of glucose, salts of potassium, magnesium, calcium support metabolic processes in the body of the baby, reduce the concentration of toxins in the blood.
Barbiturates are prescribed to activate the conjugation processes in the liver, they normalize the production of bilirubin-binding enzymes.
When does jaundice pass?
Conjugation disorders are rarely protracted, after 7–10 days the production of enzymes normalizes, the concentration of bilirubin decreases to normal levels. Premature babies have longer yellowness, up to 21 days. If the skin color remains yellow, the concentration of the toxic pigment does not decrease — complications of conjugation jaundice are possible. They are treated for up to 4 months.
Timely removal of intoxication avoids complications. Much depends on the nursing mother: the more often she puts the baby to the breast, the faster he will recover. With rare genetic pathologies of conjugation jaundice, relapses are possible, failure of enzyme production can occur at any age with infectious lesions of the parenchyma.
Yellowness by conjugation type is detected extremely rarely, the cases of fatal outcomes are rare, their statistics are not kept. The child is in hospital for six months. Периодически проводится биохимическое исследование крови, выявляется содержание непрямого и прямого билирубина.
When complications arise as a result of conjugation jaundice, central nervous system disorders are eliminated due to toxic damage. In this case, the child develops mental retardation, possible speech delays. Sometimes reduced vision, hearing.
Causes and features of the manifestation of pathology
Conjugation jaundice in newborns does not pass on its own within two weeks. During the entire course of the disease, the baby has an increase in the amount of bilirubin in the blood. Additionally, it should be noted that in full-term newborns the risk of developing this disease decreases several times. Pathological manifestation may develop under the direct influence of the following external and internal causes:
- the child was diagnosed with a hemolytic disease of a hemolytic nature,
- excessive content of vitamin K in the body,
- the functioning of the internal systems and organs of the fetus was disrupted due to the presence of diabetes mellitus,
- use of drugs without a prescription,
- liver diseases that have arisen on the background of a hereditary predisposition to them.
The risk of conjugation jaundice occurs when the mother and fetus do not match the blood group. Against this background, Rh-conflict can develop. In the body, the active decomposition of red blood cells is recorded, which in medical practice is called hemolysis. The disease leads to an active increase in the content of certain components.
In medical practice, there are the following liver diseases that are considered hereditary and can cause jaundice in a newborn:
- Gilbert's syndrome is chronic and leads to the periodic appearance of excessive amounts of bilirubin in the blood. If the disease was detected in time, then it has a favorable prognosis for treatment.
- Against the background of pathology in the liver, Crigler-Nayar syndrome is also observed. The disease develops due to an insufficient number or low activity of the glucuronyl transferase process. This component is necessary for the processing of bilirubin in the liver. As a result, the usual rate can be increased from 20 to 40 times. The disease has characteristic symptoms that appear from the first day of a child’s life. At the same time, the intensity of staining of the skin is quite high. If the little patient does not receive the necessary medical care in time, the situation can be fatal.
The main types of disease
The attending physician carefully analyzes the condition of the young patient and takes the necessary material for analysis. Conjugation jaundice can be of several types.
Physiological jaundice is usually manifested within 24 hours after the baby is born. The reason lies in the immaturity of liver enzymes. Against this background, bilirubin begins to actively accumulate in the body. The skin becomes yellow, but there is no need for further treatment. Adaptation occurs within a week. The baby adapts to the changed environmental conditions.
For premature babies, the likelihood of jaundice increases to 90%. Significantly increases the risk of transition of the physiological state in the pathological form. In this case, the decrease in bilirubin is slow. Against this background, there is intoxication in the body, which leads to nuclear jaundice.
Nuclear yellowness is very dangerous for infants. It can lead to serious damage to the internal organs and main parts of the brain. This situation threatens deafness and blindness. If bilirubin grows too fast, then the child needs emergency medical care.
Hereditary jaundice can be one of three types. Most often, infants are diagnosed with Gilbert's syndrome. The defect develops as a result of a genetic disorder in the formation of enzymes in the liver. Positive dynamics in the treatment can be detected only with a strict diet. Crigler-Najar syndrome is diagnosed in the case of a small activity in the production of the liver enzyme. Bilirubin is almost always at a high level, and pathology leads to nuclear jaundice. The pathology of Lucey-Driskol develops against the background of a lack of an enzyme, which is temporary. Only with full compensation can you avoid serious brain damage.
The diagnosis is confirmed after a detailed study of the history of each family member. These syndromes are always hereditary.
Aries syndrome is characteristic of 3% of newborns. In this case, the concentration of bilirubin is increased due to ingestion of the mother's milk. It is possible to fully confirm the diagnosis if the crumb is weaned for a while. Symptoms of pathology disappear completely in this case after 48 hours.
The consequences of injury during childbirth can lead to the development of jaundice of this nature. Pathology develops on the background of oxygen starvation. If this period was large, then the brain nuclei can be affected in the infant.
Conjugations also develop when a woman or a child takes a certain group of drugs. For example, levomycetin, menthol, vitamin K and chitin have a negative effect. On their background, the principle of erythrocyte hemolysis noticeably changes. In this case, the level of bilirubin in the body increases dramatically. If the situation is not stopped on time, nuclear jaundice develops.
Pathological jaundice develops on the background of various disorders in the functioning of the endocrine system. Today, in the neonatal age, the following types of these diseases are distinguished:
- Pathology develops on the background of mechanical stress. Bilirubin is increased in the event that the correct transfer of bile is impossible. The situation arises against the background of damage to the paths. As a rule, the pathology manifests itself in the first few days of life.
- Pathology of hemolytic nature occurs when the red blood cells in the child's body are destroyed very quickly. In this case, a rapid breakdown also awaits the components of hemoglobin. The disease develops on the background of poisoning with toxic substances. The situation may be exacerbated by genetic abnormalities in the structure of red blood cells.
- Parenchymal jaundice is diagnosed in the event of irreversible changes in the structure of the liver. This situation is observed in the case of infection of the child with the hepatitis B and C virus. The method of infection can be intrauterine and transmitted directly from the mother during the gestation period.
Danger of illness
Symptoms of jaundice consist in staining the skin and eyes in yellow. Most often, the condition is physiological in nature and passes without additional medical treatment. In this case, the crumb retains its activity, eats well and sleeps. Only in rare cases, you can fix the periodic occurrence of nausea and vomiting. When regurgitating, the milk has the usual white color, that is, it is not stained during the stay in the body. There are no convulsions, and feces have a normal color and texture.
The reasons for even a slight change in the color of the sclera must be established without fail. Parents put it on the account in the city hospital. The doctor periodically asks to provide the results of blood tests for the presence of bilirubin.
Conjugation jaundice is dangerous if a child has a dark urine and a dramatic lightening of the feces.
Immediate treatment is required in the following cases:
- The skin and eyes of a child have a pronounced yellow color:
- the crumb is constantly in a sluggish and sleepy state,
- significant increase in body temperature
- the child is constantly crying loudly, with obvious bending of his back and head,
- periodic manifestation of seizures,
- vomiting occurs in breast milk of a yellow color.
Correct diagnosis can only doctor. Additionally, you will need to know the opinion of the infectious diseases specialist. A group of specialists decides whether to continue further treatment in a hospital.
To determine the correct diagnosis, you will need to provide the following data:
- analysis of the amount of bilirubin in the child’s blood,
- parents tell the doctor about changes in the child’s behavior lately,
- Is there a hereditary predisposition in this family to this pathology?
If there is a suspicion, it is advisable to continue the study of the general condition of the small patient.
If the bilirubin is too much in the blood, then an abdominal ultrasound examination will help determine the true cause of the pathological situation. It focuses on the condition of the liver, spleen and gall. Confirm or deny the diagnosis can be due to a thorough examination of the urine.
Parents should know that the most important indicators of the content of bilirubin in the blood appear in the child’s body on the fifth day. If the child was born prematurely, the situation will need to be further monitored on the seventh day.
Features of the treatment of pathology
Therapy is not prescribed if the baby has only a temporary increase in the volume of bilirubin in the blood. To help the body in reducing it, it is advisable to use light therapy. The procedure involves exposure to the skin of the baby with a special ultraviolet lamp. Thanks to her, she manages to translate bilirubin into lumirubin in a short time. This component can be easily released from the skin along with urine.
For splitting the component, it is advisable to use breast milk. It contains special enzymes that significantly speed up the process.
If the nature of the disease is pathological, then you will also need to take special medication. Improve the condition of the skin also helps regular exposure to sunlight. Intravenous administration of salt and glucose helps to get rid of symptoms quickly and effectively.
Any disease is much easier to prevent than to deal with its consequences. Conjugation jaundice is a serious disease that can lead to serious consequences for a child’s health. Before pregnancy, a couple is recommended to visit a special planning center. Here it is possible to prevent the development of serious genetic diseases. Mom should get advice and a gynecologist, who pre-examines the fetus and mother for the presence of Rh-conflict. During pregnancy and carrying a fetus, junk food should be additionally excluded from the diet. Due to this, it will be possible to minimize the probability of damage to the child’s liver.
Jaundice in adults: symptoms, classification and characteristics
Many people think that jaundice is the common name for hepatitis or Botkin's disease, but this is not all. So called a number of many pathological ailments that apply not only to the human liver, but also to other organs. Jaundice appears in violation of the exchange of bilirubin, which can be triggered by various factors.
- General characteristics of jaundice
- What diseases are called jaundice?
- The causes of jaundice
- Jaundice: symptoms of the disease in adults
- Classification of jaundice in adults
- Signs and features of conjugation jaundice
- Hemolytic jaundice and its causes
- Parenchymal form of the disease and its symptoms
- Hepatic form: description and symptoms
- Mechanical jaundice and its causes
- Diagnosis and therapy for jaundice in adults
- Treatment of group A virus
Today's material is about describing jaundice and what jaundice symptoms are in adults. You will also learn how to recognize the disease, and what methods of its treatment exist today.
General characteristics of jaundice
Jaundice appears due to excessive accumulation of bilirubin in the human body and it is characterized by symptoms such as staining of the skin and mucous membranes in a yellow tint.
As a rule, bilirubins are released when red blood cells break down in the spleen, then they pass into the liver and, after participating in metabolic processes, are removed from our body. However, if any of the listed steps occurs incorrectly, the bilirubin is not eliminated, but accumulates in the blood, as a result of which the mucous membranes and scleras become yellow.
This happens because in the breakdown of hemoglobin, the body produces a yellow pigment, which in a healthy person comes out through defecation. However, in the presence of jaundice, which is also caused by liver failure and impaired patency of the biliary tract, bilirubin can remain in the blood in large quantities and only in small amounts is excreted through the kidneys or skin.
People with a warm climate and poor sanitary living conditions are especially prone to jaundice.
What diseases are called jaundice?
As already mentioned, most often jaundice is understood to mean Botkin's disease or group A hepatitis. In addition, diseases such as are called jaundice:
- viral hepatitis group C and B,
- autoimmune forms of hepatitis,
Regardless of the type of disease, the incubation period of jaundice lasts several months, the disease itself has three forms:
The causes of jaundice
In adults, the most common causes of jaundice are:
- benign or malignant liver formations,
- congenital pathological phenomena in the biliary tract,
- parasite infection
- pathology of the gallbladder or liver,
- complications after surgery
- the use of certain drugs.
The following categories of people are most susceptible to infection with group A viral hepatitis:
- close relatives of the infected,
- people who have sex with infected people,
- people visiting the country where the virus is very widespread
- drug addicts.
Jaundice: symptoms of the disease in adults
The main symptoms of jaundice in adults are as follows:
- yellow skin,
- enlarged spleen and liver,
- increased red blood cell levels
- appearance of the venous network in the abdomen,
- severe itching of the skin
- changes in feces or urine. As a rule, the feces become gray and the urine becomes darker,
- loss of appetite,
- distinct pain in right hypochondrium of spasmodic or pulling character.
Signs and features of conjugation jaundice
This form of the disease is associated with a violation in the processing of indirect bilirubin, and as a result - its content in the blood increases sharply. Basically, this form is typical for newborns, since their exchange system is still imperfect. But in adults, signs of this form are less common, and the reason for their appearance may be the intake of certain drugs or congenital abnormalities.
Hemolytic jaundice and its causes
This form of the disease is a consequence of the pathological destruction of red blood cells and the difficulty in removing bilirubin from the body. Its causes may be:
- lymphocytic leukemia,
- toxic effects of certain drugs.
Parenchymal form of the disease and its symptoms
Parenchymal form is the most common, it appears due to disruption of the structure of liver cells due to cirrhosis or viral hepatitis. Her symptoms are:
- enlarged liver
- yellowed skin with a red tint,
- appearance on the body of vascular "stars".
Hepatic form: description and symptoms
This form of jaundice occurs when the normal functioning of the liver cells is disrupted due to the high content of direct bilirubin in the blood. Syndromes such as:
- toxic lesions of the body with drugs,
- viral and alcoholic hepatitis,
- malignant tumor.
- yellowness of the skin,
- loss of appetite,
- pain in the right hypochondrium,
- color change urine and feces.
Therapeutic measures depend on the cause of the disease.
Diagnosis and therapy for jaundice in adults
If you notice at least the slightest signs or symptoms of jaundice, you should immediately consult a doctor. At the initial stage, it is possible to cure and restore the body, regardless of the form of the disease. However, to make a diagnosis, you need to go through the following diagnostic measures:
- to pass a general and biochemical blood test,
- test for bilirubin level in your blood,
- go through liver screening activities
- do a liver biopsy, if previous activities could not allow the doctor to make the correct diagnosis.
Treatment of jaundice in adults depends on the form, symptoms and stage of the disease. In order to get the most effective treatment regimen, it is necessary to establish the cause of the disease. Treatment may be either conservative (except for the mechanical form) or suggest surgery if the case is already running.
Conservative treatment of the disease includes the following components:
- taking antihistamines and steroids,
- plasma exchange
- strict dieting.
The ultimate goal of treatment is the complete ridding of the human body of the virus, preventive measures and reducing the risk of infecting other people.
Если же у человека развивается аутоиммунный гепатит в хронической форме, ему назначают лечение в виде приема кортикостероидов.
Диета при желтухе у взрослого человека базируется на обильном приеме белков и витаминов группы В. They contain such products:
You also need to eat dried apricots and grain bread. However, a detailed diet is signed solely by the attending physician after the patient has completed all diagnostic activities.
Treatment of group A virus
If group A viral hepatitis develops, then the patient recovers over time without special treatment. Doctors do not prescribe any special antiviral drugs, but prescribe medicines that help reduce the concentration of harmful substances in the body that have accumulated when the normal functioning of the human liver is disturbed.
Therapy consists of activities such as:
- the introduction of detoxification solutions, for example, vitamins and glucose,
- taking hepatoprotectors, these are drugs that protect liver cells, for example, syrepar, silibinin or silibor,
- additionally, antispasmodics may be prescribed, such as no-shpa, remidon or papaverine.
If the cases are more complex, the principle of treatment remains the same, except that more attention is paid to symptomatic treatment. In most cases, liver function is completely restored over time.
Folic acid is required to restore bleeding processes. It is contained in products such as:
- green vegetables
Also, the body needs fiber in the recovery period, which is in oatmeal. In addition, the diet should contain products such as:
- fruits in large quantities
- freshly squeezed juices.
Regardless of what type of disease is being treated, one should completely refrain from products that exert an extra load on an already weak liver, in particular, from such:
It can be summarized that jaundice in adults is a common phenomenon, which is associated with a large number of diseases, they are characterized by different symptoms and causes.
For symptoms such as the appearance of yellow lesions on the skin and pain in the right hypochondrium, you should immediately consult a doctor, as in most cases they indicate the presence of one or another form of the disease. The sooner you apply, the faster you will get rid of the disease and you will be able to avoid more serious consequences for your body.
Features of the disease
Accurately diagnosing conjugation jaundice is difficult; it can only be done in a general hospital. It is important to distinguish this pathology from mechanical, hemolytic jaundice.
After birth, jaundice is diagnosed for all babies who have bilirubin-stained skin, sclera, and in severe cases, the internal biological fluid of the body.
How is bilirubin formed? The substance is in the body during the breakdown of red blood cells. Allocate direct and indirect bilirubin. The latter refers to unconjugated - it is a dangerous toxic substance that adversely affects the cells and is formed from red blood cells. Indirect bilirubin binds to albumin in the blood, then enters the liver, there undergoes a process of detoxification.
A straight line appears in the liver due to the conjugation process, in which sugar derivatives are added to the indirect bilirubin. After this connection is in the bile, begins to stand with feces or in small quantities enters the urine.
Types of jaundice in newborns
The disease can manifest itself in different forms, it all depends on the mechanism of damage:
- Mechanical jaundice appears in the case of an increased amount of direct bilirubin, as a result of this process, problems with biliary excretion arise. Most often, the disease develops a few days after birth, if the child has a congenital blockage or underdeveloped biliary tract.
- Hemolytic jaundice develops in the case of enhanced decomposition of red blood cells, as well as hemoglobin. Pathology is associated with hemolytic disease of the newborn, and also appears in the hereditary pathology of erythrocytes, in case of poisoning with toxins.
- Parenchymal jaundice indicates hepatic pathology. Most often occurs in utero if the fetus was infected with the hepatitis C virus, B, cytomegalovirus.
It is worth noting all of the above types are pathological jaundice, which requires treatment. But conjugation jaundice does not apply to the disease.
Causes of pathology
Conjugation jaundice is diagnosed when the type of hemoglobin in the erythrocytes of the fetus disintegrates. Compared to other forms, the child's condition improves on the 10th day of life, while no complications are observed.
Conjugate jaundice is very rarely diagnosed:
- Premature babies the disease develops subsequently liver immaturity. The child's condition improves only after a month with timely treatment. What is dangerous jaundice in this situation? Over time, it affects the structure of the brain, leads to neurological disorders and even the death of a baby.
- With congenital pathology Gilbertwhich is a serious genetic defect in liver enzymes. This type of jaundice proceeds favorably, does not lead to brain damage. Re-yellowing of the skin of a child may in violation of the diet.
- With congenital disease Kriegler-Nayar there is a low activity of the enzyme responsible for the entry of bilirubin in the liver. Pathology is dangerous because brain damage can end.
- With the congenital form of Lyceum-Driskoland jaundice makes itself felt in the early days, often reflected on the state of the nervous system. The lack of enzymes is transient but pronounced. As a rule, the pathology is not further complicated and passes quickly.
Nuclear jaundice, which occurs after the administration of drugs such as Quinine, Levomitsetin, vitamin K to a newborn, is especially dangerous. Rarely conjugation jaundice accompanies endocrine diseases, such as congenital hypothyroidism.
Attention! All types of jaundice are dangerous for the newborn, because the child has an immature structure of the brain that can be seriously damaged.
The course of therapy depends on the type of jaundice. The main methods include:
- Dieting. The newborn should be fed breast milk at least 8 times a day. Thus, bilirubin will be eliminated from the intestines.
- Phototherapy. The UV lamp turns bilirubin into another enzyme.
- Infusion therapyduring which glucose, saline solutions are injected into a vein. Due to these substances, the conjugation of bilirubin is improved.
To summarize, conjugation jaundice in a newborn is a group of diseases in which the concentration of bilirubin in the blood rises sharply. Pathology is associated with various congenital liver enzyme disorders. Some forms of jaundice are not at all dangerous, and some lead to nuclear jaundice. It is important that the doctor promptly paid attention to the condition of the baby and did not miss the severe form of jaundice, otherwise everything could end in death. Pregnant women for preventive purposes should monitor their health, especially if they have problems with the gall bladder, liver. Also in no case during pregnancy should you take drugs that have a toxic effect. Be attentive to the health of your baby!