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| Also known as: '''''Jaundice | | Also known as: '''''Jaundice |
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| ==Introduction== | | ==Introduction== |
| [[File:Jaundiced cat.jpg|thumb|right|Image of a jaundiced cat, note the discoloured pinnae<br><small>(Image source Sabar 2007, Wikimedia Commons)</small>]] | | [[File:Jaundiced cat.jpg|thumb|right|Image of a jaundiced cat, note the discoloured pinnae<br><small>(Image source Sabar 2007, Wikimedia Commons)</small>]] |
− | Icterus refers to the staining of tissues by [[Bilirubin|bilirubin]] pigment or bilirubin complexes. Bile pigments such as bilirubin have particular affinity for elastic tissues and the typical yellow/orange colour of icterus is therefore evident in the slcera and mucous membranes in life and in the tunica intima of the aorta at post mortem examination. | + | Icterus refers to the staining of tissues by [[Bilirubin|bilirubin]] pigment or bilirubin complexes. Bile pigments such as bilirubin have particular affinity for elastic tissues and the typical yellow/orange colour of icterus is therefore evident in the sclera and mucous membranes in life and in the tunica intima of the aorta at post-mortem examination. |
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| The serum bilirubin concentration of an animal indicates the degree of icterus and the condition only becomes clinically evident at levels above 2 mg/100 ml (normal range below 0.5 mg/100 ml). Bilirubin should be measured by a technique which measures the large proportion which is bound to plasma albumin. | | The serum bilirubin concentration of an animal indicates the degree of icterus and the condition only becomes clinically evident at levels above 2 mg/100 ml (normal range below 0.5 mg/100 ml). Bilirubin should be measured by a technique which measures the large proportion which is bound to plasma albumin. |
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| Animals suffering from extra-hepatic biliary obstruction (EHBO) are often profoundly unwell. The reduced flow of bile salts into the gastro-intestinal (GI) tract allows GI bacteria to proliferate and eventually translocate across the intestinal wall. In addition, biliary stasis reduces the function of Kupffer cells within the liver, reducing their ability to remove and neutralise translocated bacteria from the portal blood. These animals should be stabilised adequately before any surgical repair is attempted. | | Animals suffering from extra-hepatic biliary obstruction (EHBO) are often profoundly unwell. The reduced flow of bile salts into the gastro-intestinal (GI) tract allows GI bacteria to proliferate and eventually translocate across the intestinal wall. In addition, biliary stasis reduces the function of Kupffer cells within the liver, reducing their ability to remove and neutralise translocated bacteria from the portal blood. These animals should be stabilised adequately before any surgical repair is attempted. |
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| + | ==Histopathology== |
| + | Bilirubin stains brown with H&E, like both [[Pigmentation - Pathology#Haemosiderin|haemosiderin]] and [[Pigmentaion - Pathology#Lipofuscin|lipofuscin]]. They must be distinguished from each other by special stains. Bilirubin stains bright green with a Fouchet stain. |
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− | ====Jaundice====
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− | * Jaundice is also known as icterus.
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− | * Jaundice is a yellowish discoloration due to excessive levels of bilirubin in plasma.
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− | ** Seen in tissues that are normally white, e.g.
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− | *** Fat
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− | *** Intima of blood vessels
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− | *** Sclera
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− | * Bilirubin stains brown with H&E, like both haemosiderin and lipofuscin.
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− | ** Must be distinguished from each other by special stains.
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− | *** Bilirubin stains bright green with a Fouchet stain.
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− | =====Production of Bilirubin=====
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− | * Red blood cells either undergo:
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− | ** Phagocytosis, in the case of ageing cells.
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− | ** Haemolysis, in haemolytic crises.
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− | * Haemoglobin is freed from the red cells and is further broken down in the reticulo-endothelial system to haeme and globulin.
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− | ** Haeme is a mixture of iron and porphyrin.
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− | ** Both the iron and globulin are recycled for further use in erythropoiesis.
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− | * The porphyrin from haemoglobin breakdown is converted to biliverdin.
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− | ** A green pigment
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− | *** May contribute to the greenish appearance seen in local bruising.
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− | * Biliverdin is subsequently changed into bilirubin.
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− | * The bilirubin is then bound to albumin, and transported in the blood to the [[Liver - Anatomy & Physiology|liver]].
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− | ** In the hepatocyte, bilirubin is released from the albumin and conjugated with glucuronic acid.
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− | *** Forms conjugated bilirubin.
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− | **** Excreted into the intestine via the bile ducts.
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| ===== Prehepatic (Haemolytic) Icterus===== | | ===== Prehepatic (Haemolytic) Icterus===== |
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| + | {{review}} |
| [[Category:Liver_-_General_Pathology]] | | [[Category:Liver_-_General_Pathology]] |
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