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Hyperbilirubinemia

  1. Reasons
  2. Symptoms
  3. Diagnosis
  4. Treatment


Hyperbilirubinemia

it’s the human condition, which is accompanied by elevated levels of bilirubin or decay products of red blood cells.

Distinguish free bilirubin, which is constantly circulating in the blood only after the breakdown of red blood cells. It is very toxic, poisons the body, so its accumulation in the human body leads to certain symptoms. Also is direct hyperbilirubinemia, with bilirubin which has passed through the conversion in the liver to subsequently display it via urine or faeces from the body. Call it a concept even conjugational hyperbilirubinemia.

Reasons

In different forms of hyperbilirubinemia the causes vary depending on the diagnosis.

  • when the suprarenal hyperbilirubinemia occurs
    • anemia
      • hemolytic when erythrocytes are destroyed
      • pernicious, when there is a lack of vitamin B12, leading to anemia
      • hemoglobinopathies, when the structure of hemoglobin is disrupted.
  • hereditary, that is, those that are transmitted to children from parents, violations of building blood cells, for example, it may be a defect of the cell wall of the erythrocyte
    • intoxication or poisoning medsedziai, alcohol
  • infection
    • sepsis, or General inflammation of the body that occurs mostly when you transfer bacteria in the blood
    • viruses
  • wrong blood transfusion
  • autoimmune disease when the body’s immune system does not perceive its own cells and takes them over others and begins to attack them
    • autoimmune hemolytic anemia
    • systemic lupus erythematosus, is a chronic disease of the connective tissue, which takes part in the protective and supporting functions of blood vessels of medium caliber. A characteristic rash and joint pain also affects the kidneys
    • autoimmune hepatitis or inflammation of the liver
  • or blood cancer
  • volume of hemorrhage, perhaps, they are directed into the abdominal cavity due to abdominal trauma
  • hepatic giperbilirubinemia
    • Hepatitis
      • the virus, which are caused by hepatitis viruses A, b, C, D and E
      • drug, that is triggered by steroids or some antibacterial drugs may even antipyretic agents
    • tumors and abscesses of the liver
  • giperbilirubinemia Gilbert, which is characterized by periodically appearing yellowing of skin and whites of the eyes without any other complaints. It is also possible intermittent pain in the right hypochondrium. This giperbilirubinemia flows in the quiescent state, is not particularly affect the way of human life
  • syndrome giperbilirubinemii Dabina-Johnson characteristic yellowing of the eye protein and skin, possible skin itching. In the syndrome there is weakness, fatigue, decreases the desire to eat, there’s a hint of bitterness in the mouth, sometimes there is pain in the right hypochondrium
  • benign hyperbilirubinemia (Rotor syndrome) characterized by periodic yellowness of skin, whites of the eyes, itching of the skin. In the event of jaundice is weakness and fatigue, decreased appetite, there is a bitter taste in the mouth, sometimes pain in the upper quadrant, and dark urine
  • when obstructive hyperbilirubinemia occurs
    • blockage of a bile duct stone, and inflammation
    • the narrowing of duct due to damage
    • cancer of the pancreas or bile duct
    • functional hyperbilirubinemia in pregnant women may be on the diseases present in women before pregnancy it could be chronic hepatitis or liver tumors, or anemia can develop in the light of newly emerged diseases.

Symptoms

The majority of sick patients without any symptoms with increased decay product of blood cells. When the disease Hyperbilirubinemia symptoms are sufficient in order to understand the presence of the disease.

  • the development of the suprarenal hyperbilirubinemia occurs when the amount of bilirubin in the blood increases
    • white of the eye, sheath of mouth, throat, and skin becomes lemon-yellow color. This only happens if the bilirubin is increased two times or more, and the norm is 8,520,5 mkmoll)
    • the person feels a weakness and a kind of lethargy
    • the stool is painted in dark brown color
    • apathy occurs, the person is observed in a bad mood
    • on the background of the skin, in comparison, visible paleness of the mucosa of the mouth and throat
    • dark urine
    • there are loss of consciousness or neurological impairment sometimes found decreased vision, drowsiness, or even slurred speech
  • hepatic hyperbilirubinemia is directly related to damage of the liver tissue
    • the skin, the mucous membrane of the oral cavity, pharynx, and the white of the eye is dyed saffron-yellow if the color of the skin more red hue red is called jaundice, which occurs only at elevated bilirubin in two and more times
    • as in the above variant of the disease, the weakness, lethargy
    • there is a bitter taste in your mouth
    • felt minor itching on the body
    • traced the pain in his right side and General discomfort
    • occurs vomiting, often repeated, rather than disposable
    • sometimes there is heartburn
    • the color of the urine turns into dark
    • over time, the skin acquires a greenish tint
  • obstructive hyperbilirubinemia detected when blockage of the passage of bile or of its difficult passage in the intestines
    • also as in the first described case, the white of the eye, sheath of mouth, throat, and skin becomes lemon-yellow color. This only occurs if bilirubin increases two times or more
    • itchy skin on body
    • discomfort and pain in the right upper quadrant
    • the stool become lighter and can be white
    • there is an increased amount of fat in the stool
    • there Horikita mouth
    • decreases body weight
    • is hypovitaminosis.

Diagnosis

For diagnosis, they analyze the medical history and complaints, the time of onset of pain in the right side, yellowness of the skin and whites of the eyes, darkening of urine. Also the issues that relate to linking the patient’s symptoms with the disease. Also questions are asked about nutrition, medications and use of alcoholic beverages.

Is the study of life anamnesis past diseases of the gastrointestinal tract and blood, hepatitis, gallstone disease or surgery.

Family history questions about the illness of relatives hyperbilirubinemia, alcoholism.

The inspection of the skin, presence of yellowing, a sign of tenderness on palpation of the liver, spleen and pancreas.

Be sure tests are performed. This clinical analysis of blood and biochemical, coagulation of the blood system. Also conduct a urine test for the presence of elevated bilirubin and blood tests for viral hepatitis A, b, C, D. Hold and the coprogram, the so-called feces analysis and analysis on helminth eggs (Ascaris or pinworms are parasites intestinal protozoa and amoebae or Giardia).

Mandatory tests. Is ultrasound examination of the abdominal organs to assess the condition of the kidneys, gallbladder, intestines, biliary tract, pancreas and liver. Such a study would help to find possible pockets of scar tissue in the liver, the possible compression of bile ducts by a tumor or stone.

Performed CT of the abdomen for clear and accurate assessment of the liver, trudnostyami detect tumors, damage, nodes in the liver tissue.

Esophagogastroduodenoscopy, in which the diagnosed state of the inner surface of the esophagus in order to detect pathology of the vein, damage to the mucosal 12 duodenal ulcer and stomach through the endoscope.

A liver biopsy is also needed for microscopic examination of the liver tissue obtained with a thin needle under ultrasound control, which will help to establish the accurate diagnosis, thus eliminating the tumor process.

Elastography or the study of the liver tissue is performed for diagnosis using special apparatus to determine the degree of liver fibrosis, which is a process that is curable.

Hyperbilirubinemia in newborns is diagnosed in the same way as in adults.

Treatment

Hyperbilirubinemia in children and adults is treatable in identifying the reasons that caused this disease.

Prescribe antibacterial and also antiviral drugs, which destroy bacterial or viral causes of the disease. Also hepatoprotectors, i.e. drugs that retain the activity of the liver cells. Prescribed cholagogue, which increase delchevalerie. Immunomodulatory drugs that stimulate the immune system to combat hyperbilirubinemia. Anti-inflammatory drugs, which removed the inflammation of the liver. Antioxidants drugs that reduce and remove the damaging effects of toxic substances in the body. Preparations of barbiturates is also prescribed as a means of influencing the decrease in the level of bilirubin in the blood. Chelators for better stimulation of excretion of bilirubin from the intestines. Perhaps the use of phototherapy. This is done by the action of light blue lamps for destruction accumulated in the tissues of bilirubin.

Shown diet 5 meals 5 to 6 times a day, while excluded from the diet spicy and fatty, fried and smoked foods, and salt, limit protein intake to 40 grams per day during the development of hepatic encephalopathy.

Taking vitamin complexes courses lasting from one to two months. Enzyme preparations that do not contain bile, also shown in the diagnosis of hyperbilirubinemia. Limited physical activity, and decreases psycho-emotional stress.

Any treatment of pregnant women with the use of drug therapies due to the risk of development of complications in mother and fetus, the treatment should be monitored by a doctor. Treatment of hyperbilirubinemia in newborns should be carried out under the supervision of a physician.

Complications

Maybe after this disease, vitamin deficiency or shortage of vitamins and minerals in the body, you may experience liver failure, inflammation of the gallbladder, the occurrence of gallstones.

Prevention

  • prevention of hyperbilirubinemia in pregnant women is a timely registration in the antenatal clinic, timely visits to the doctor, examination
  • to prevent any person required proper diagnosis and early treatment of the disease or other related hyperbilirubinemia diseases that led to the development of the disease
  • anaemia the destruction of red blood cells, poor intake of vitamin B12 in the body associated with disease of the stomach and lead to anemia, impaired the structure of the protein-carrier of oxygen
  • poisoning by drugs or alcohol
  • infection severe inflammation of the body caused by proliferation of bacteria in the blood and viruses
  • tumors and ulcers in the liver
  • blockage of the bile duct stone
  • inflammation of the bile duct
  • rational and balanced diet by eating foods rich in fiber, refusal fried, smoked, hot or spicy foods
  • quitting Smoking and alcoholic beverages
  • strict control of intake of medications with different courses of treatment, the shelf life of drugs, dosage.