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Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [ 3 ] [ 6 ] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism , liver dysfunction , or biliary-tract obstruction. [ 7 ]
Physiologic jaundice can be a benign condition that presents in newborns until two weeks of life. [2] However, jaundice that continues after two weeks requires follow up with measurement of total and conjugated bilirubin. [3] Elevated levels of conjugated bilirubin are never benign and require further evaluation for neonatal cholestasis. [3]
Neonatal jaundice is a yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. [1] Other symptoms may include excess sleepiness or poor feeding. [ 1 ]
Conjunctival icterus can be quantified by the Jaundice Eye Colour Index (JECI) through digital photography of the sclera, where a JECI of 0 indicates a white colour, and a JECI of 0.1 indicates an intense yellow colour, which is a sign of hemolytic jaundice. [31]
Physical examination reviews clinical symptoms like degree of jaundice, vital signs and sensations of pain, further followed by urine tests, blood analysis and imaging. [3] [4] The degree of yellowish staining of the conjunctiva and skin in jaundice is proportional to hyperbilirubinemia to some extent. [6]
Jaundice may be noticeable in the sclera of the eyes at levels of about 2 to 3 mg/dl (34 to 51 μmol/L), [27] and in the skin at higher levels. [note 1] Jaundice is classified, depending upon whether the bilirubin is free or conjugated to glucuronic acid, into conjugated jaundice or unconjugated jaundice. [citation needed]
The Latin name icterus is from Greek ἴκτερος (íkteros, "jaundice"); the icterus was a bird the sight of which was believed to cure jaundice, perhaps the Eurasian golden oriole. [3] It also had the more general meaning "yellow bird", which is why the name was later given to this South American bird. [4]
Mild jaundice may appear under conditions of exertion, stress, fasting, and infections, but the condition is otherwise usually asymptomatic. [7] [8] Severe cases are seen by yellowing of the skin tone and yellowing of the conjunctiva in the eye. [9] Gilbert syndrome has been reported to contribute to an accelerated onset of neonatal jaundice.