What is Jaundice?
Jaundice is the yellowing of your skin and the whites of your eyes caused by too much yellow pigment called bilirubin, produced when haemoglobin, the main component of red blood cells, is broken down. When it is released from red blood cells into the bloodstream, bilirubin is taken to the liver, where it is further modified and passed to the small intestines via bile ducts. From there, it’s excreted from the body through urine or stool. However, if the flow out of the system is disrupted, bilirubin can accumulate in the body [1].
What Are The Causes of Jaundice?
Jaundice can result from a variety of conditions, several of which involve the liver. A common factor is the overproduction of bilirubin or the liver's inability to handle it. For instance, when there’s a block in the bile ducts through which it usually leaves the body, the bilirubin has nowhere to go and instead builds up in the blood [2].
Other conditions that can result in jaundice include alcohol abuse, liver cancer, thalassaemia, cirrhosis (scarred liver, often due to alcohol), gallstones, hepatitis A, B, C, D and E, pancreatic cancer, G6PD deficiency, biliary (bile duct) obstruction, sickle cell anaemia, acute pancreatitis and other blood disorders such as haemolytic anaemia. An adverse reaction to, or overdose of, drugs such as acetaminophen (Tylenol) can cause jaundice too [2].
Among newborns, jaundice is common, especially for those born premature, because the liver hasn’t had a chance to develop fully and can produce more bilirubin than the body can eliminate, a phenomenon called breast milk jaundice [2].
Risk Factors of Jaundice
Jaundice, a condition characterized by yellowing skin and eyes, can be caused by various factors.
The main risk factor is liver disease, including cirrhosis, viral hepatitis, primary biliary cirrhosis, alcoholic hepatitis and liver cancer. This disease can damage the liver and blunt its ability to filter blood and remove bilirubin, a yellow compound that causes jaundice if it builds up in the blood [1].
Some of these genetic diseases also raise the chance of jaundice. G6PD deficiency is when red blood cells break down prematurely, causing bilirubin to accumulate. This condition is exceedingly common in some populations, including roughly one in 10 African American males in the United States [3].
Maternal factors that can increase the risk of neonatal jaundice include white blood cell count, haemoglobin levels, platelet count and gestational age of the mother, as well as thyroid-stimulating hormone (TSH), level of T4 in neonate and G6PD deficiency [4]. Other maternal risk factors include hypertension, diabetes, type of delivery, vaginal bleeding, premature rupture of membranes (PROM), maternal age and incorrect technique of breastfeeding [5].
Lifestyle factors that can add to these risk factors for jaundice are excessive alcohol consumption and certain medications such as acetaminophen, certain cardiac medications, antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), statins, dietary supplements and anabolic steroids [1, 3].
Additionally, jaundice can be caused by conditions such as nonalcoholic fatty liver disease (NAFLD), hepatitis, sickle cell anaemia and gallstones, which disproportionately affect certain groups of people due to genetic, social and environmental factors. For example, African Americans have higher rates of jaundice caused by these conditions [3].
Does Jaundice Affect Different Races?
Although jaundice, or yellow skin and eyes because of high bilirubin, occurs in all racial groups, the risk factors and incidence for jaundice can differ among racial and ethnic groups depending on genetic influences, environmental factors and social backgrounds.
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