Icterus

Front 1

Icterus vs. Jaundice

Back 1

Patients with icterus have yellow sclera, and patients with jaundice have yellow skin.

Front 2

At what level of bilirubin does jaundice occur?

Back 2

Jaundice occurs when systemic retention of bilirubin leads to serum levels above 2.0-2.5mg/dl

Front 3

Kenicterus

Back 3

severe neurologic damage in newborn, caused by accumulation of unconjugated bilirubin in brain

Front 4

• Crigler-Najjar syndrome type I

Back 4

• Crigler-Najjar syndrome type I
o Autosomal recessive
o Lack of the enzyme responsible for the conjugation of glucuronic acid to bilirubin
o Fatal  death within 18 months of birth secondary to brain damage (kernicterus)

Front 5

• Crigler-Najjar syndrome type II

Back 5

• Crigler-Najjar syndrome type II
o Autosomal recessive
o Less severe, nonfatal
o Partial defect in the conjugating enzyme – consequence is extraordinarily yellow skin

Front 6

• Gilbert syndrome

Back 6

• Gilbert syndrome
o Common, benign, heterogenous inherited
o Mild, fluctating unconjugated hyperbilirubinemia
o Primary cause: decreased hepatic levels of glucuronosyl-transferase
o Affecting up to 7% of the population

Front 7

• Dubin-Johnson syndrome

Back 7

• Dubin-Johnson syndrome
o Autosomal recessive defect in the transport protein responsible for hepatocellular excretion of bilirubin glucuronides across the canalicular membrane
o Conjugated hyperbilrubinemia
o Darkly pigmented liver from polymerized epinephrine metabolites
o hepatomegaly

Front 8

• Rotor syndrome

Back 8

o Variant of Dubin-Johnson syndrome in which the liver is not pigmented