Jaundice Causes

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Jaundice may be caused by several different disease processes. It is helpful to understand the
different causes of jaundice by identifying the problems that disrupt the normal bilirubin
metabolism and/or excretion.
Pre-hepatic (before bile is made in the liver)

Excessive bilirubin formation by overwhelming destruction of RBC

Jaundice in these cases is caused by rapid increase in the breakdown and destruction of the red
blood cells (hemolysis), overwhelming the liver's ability to adequately remove the increased
levels of bilirubin from the blood.

Bilirubin uptake disruption

To enter the liver bilirubin must attach with albumin, because unconjugated bilirubin is so
difficult to be soluble in plasm.
Examples of conditions with increased breakdown of red blood cells include:

malaria

sickle cell crisis,

spherocytosis,

thalassemia,

glucose-6-phosphate dehydrogenase deficiency (G6PD),

drugs or other toxins, and

autoimmune disorders.
Hepatic (the problem arises within the liver)
Jaundice in these cases is caused by the liver's inability to properly metabolize and excrete
bilirubin. Examples include:

hepatitis (commonly viral or alcohol related),

cirrhosis,

drugs or other toxins,

Crigler-Najjar syndrome,

Gilbert's syndrome, and

cancer.

Post-hepatic (after bile has been made in the liver)

Jaundice in these cases, also termed obstructive jaundice, is caused by conditions which interrupt
the normal drainage of conjugated bilirubin in the form of bile from the liver into the intestines.
Causes of obstructive jaundice include:

gallstones in the bile ducts,

cancer (pancreatic and gallbladder/bile duct carcinoma),

strictures of the bile ducts,

cholangitis,

congenital malformations,

pancreatitis,

parasites,

pregnancy, and

newborn jaundice.
Source : Sylvia A, Price. 2007. Pathophysiology for clinical concept of disease. Vol 1. Ed 6;
Jakarta. EGC