Some Causes and Features of Jaundice
Cause | Common Features* | Tests† |
|---|---|---|
Liver and gallbladder disorders | ||
Jaundice that develops slowly A history of heavy alcohol consumption In men, development of feminine characteristics, including loss of muscle tissue, smooth skin, enlarged breasts, shrunken testes, and growth of pubic hair in a female pattern Sometimes swelling of the abdomen due to accumulation of fluid (ascites) | A doctor's examination Blood tests Sometimes liver biopsy | |
Blockage of a bile duct by a gallstone or, less commonly, by a tumor of the pancreas or bile ducts | Dark urine and light-colored, soft, bulky, oily-looking, and unusually foul-smelling stool Usually pain in the upper right part or middle of the abdomen If the cause is a tumor, weight loss and sometimes chronic abdominal pain | Imaging such as
Biopsy if imaging results suggest cancer |
Severe itching Later, jaundice and dark urine Usually develops during late pregnancy | Blood tests Usually ultrasonography | |
Symptoms that occur before jaundice develops:
Often in people with risk factors, such as recreational use of injected drugs or participation in anal sex | Blood tests for hepatitis viruses Sometimes liver biopsy if hepatitis is chronic | |
Primary biliary cholangitis (an autoimmune disorder causing destruction of the small bile ducts in the liver) | Symptoms that often occur before jaundice develops:
Sometimes discomfort in the upper right part of the abdomen, darkening of the skin, and small yellow deposits of fat in the skin (xanthomas) or eyelids (xanthelasmas) | Blood tests to check for the antibodies that occur in most people with this disorder Ultrasonography and often MRI of the abdomen |
Primary sclerosing cholangitis (scarring and destruction of small and large bile ducts) | Symptoms that occur before jaundice develops:
Pain in the upper right part of the abdomen Sometimes light-colored, soft, bulky, oily-looking, and unusually foul-smelling stool Often in people with inflammatory bowel disease | MRI of the abdomen |
Other disorders | ||
Breakdown of red blood cells (hemolysis), which may be caused by
| Symptoms of anemia (paleness, weakness, and fatigue) Sometimes use of a drug that causes hemolysis or presence of a red blood cell disorder in a family member | Blood tests |
Tremors, difficulty speaking and swallowing, involuntary movements, loss of coordination, and personality changes Gold or greenish gold rings in the cornea of the eyes (Kayser-Fleischer rings) | Slit-lamp examination of the eyes to check for Kayser-Fleischer rings If the diagnosis is still unclear, liver biopsy | |
Surgical complications such as
| Develops soon after surgery, particularly major surgery | A doctor’s examination Sometimes other tests, depending on the likely causes |
Drugs and toxins | ||
(in high doses or as an overdose) Certain medicinal herbs such as germander, kava, extracts, or pyrrolizidine Iron when taken in large amounts Mushroom toxin (from Amanita phalloides) | Use of a substance that can cause jaundice | A doctor's examination |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Doctors typically measure bilirubin levels in the blood and do blood tests to determine how well the liver is functioning and whether it is damaged (tests of liver function) and to assess the blood’s ability to clot. | ||
CT = computed tomography; ERCP = endoscopic retrograde cholangiopancreatography; G6PD = glucose-6-phosphate dehydrogenase; MRCP = magnetic resonance cholangiopancreatography; MRI = magnetic resonance imaging. | ||