Hemolytic jaundice

Introduction to hemolytic jaundice Hemolytic jaundice is mainly caused by the intrinsic defects of red blood cells or the damage of red blood cells by exogenous factors, which causes the red blood cells to be destroyed a lot, releasing a large amount of hemoglobin, resulting in an increase in the content of non-lipid bilirubin in plasma, exceeding the processing capacity of hepatocytes. Then there is jaundice. Hemolytic jaundice can occur in all diseases that cause hemolysis, including congenital hemolytic anemia and acquired acquired hemolytic anemia. The former has maritime anemia (thalassemia), hereditary spherocytosis, etc., the latter has autoimmune hemolytic anemia, neonatal hemolytic disease, hemolysis after blood transfusion of different blood types and faba bean disease, primaquine, snake venom, Poisonous, paroxysmal nocturnal hemoglobinuria. Generally, jaundice is mild and light lemon color. When acute hemolysis, there may be fever, chills, headache, vomiting, low back pain, and varying degrees of anemia and hemoglobinuria (urine is soy sauce or brown). In severe cases, there may be acute kidney. Functional failure. Chronic hemolysis is mostly congenital, in addition to anemia, there are splenomegaly. basic knowledge The proportion of the disease: the incidence rate of young children is about 12% Susceptible people: good for infants and young children Mode of infection: non-infectious Complications: hemolytic anemia

Hemolytic jaundice

Cause

Hemolytic jaundice can occur in diseases that cause massive destruction of red blood cells and cause hemolysis:

1. Congenital hemolytic anemia.

2. Acquired hemolytic anemia.

Pathogenesis

When the red blood cells are destroyed in a large amount, excessive indirect bilirubin is produced, which is far beyond the limit of hepatocyte uptake, binding and excretion. At the same time, hypoxia caused by hemolytic anemia, toxic substances released by red blood cell destruction can weaken the biliary red blood cells. Metabolic function, which causes indirect bilirubin to remain in the blood and cause jaundice.

Hemolytic jaundice prevention

Prevention should be carried out according to the cause. Patients with these diseases should be actively treated. For autoimmune hemolytic anemia, the spleen can be cut off to reduce recurrence. For jaundice caused by hemolysis caused by the lack of glucose hexaphosphate dehydrogenase, avoid eating broad beans and avoid contact with camphor balls.

Hemolytic jaundice complications Complications hemolytic anemia

When the spleen function is hyperactive, the red blood cells are destroyed. Due to the destruction of a large number of red blood cells, a large amount of unbound bilirubin is formed, which exceeds the uptake, binding and excretion ability of hepatocytes, anemia caused by hemolytic, hypoxia and red blood cell destruction products. The toxic effect weakens the metabolic function of hepatocytes on bilirubin and causes unbound bilirubin to remain in the blood.

Symptoms of hemolytic jaundice Common symptoms Skin yellow-green or green-brown hemoglobinuria low back pain Caroteneemia Scleral yellow stain

1, the sclera is more common with mild yellow staining, there is fever in the acute attack, back pain, the skin and mucous membranes are often pale.

2, the skin is not itchy.

3, there is a spleen.

4, there is a strong performance of bone marrow hyperplasia.

5, serum total bilirubin increased, generally not more than 85mol / L, mainly indirect bilirubin increased.

6, urinary urinary biliary tract increased without bilirubin, hemoglobinuria in acute attack, soy sauce color, increased hemosiderin in the urine during chronic hemolysis, 24 hours of urinary biliary excretion increased.

7. When the hereditary spheroid cells increase, the erythrocyte fragility increases, and the fragility decreases during thalassemia.

Hemolytic jaundice examination

The diagnosis of hemolytic jaundice mainly depends on the following laboratory tests:

1. The content of jejunal and urobilinogen increases.

2, serum bilirubin increased Vanden's test showed an indirect response.

3. Increased reticulocytes in the blood.

4. Increased serum iron content.

5, the bone marrow red system hyperplasia.

Diagnosis and diagnosis of hemolytic jaundice

diagnosis

Diagnosis can be performed based on clinical performance and laboratory tests.

Differential diagnosis

1, liver fever, liver sputum, liver cancer, etc.: history and disease of liver parenchymal damage, skin light yellow or golden yellow, mild itching, dark urine, yellowish stool color, serum non-binding and bilirubin binding Moderately increased, the whitening test showed direct or biphasic accelerated response, abnormal liver function, B-ultrasound and other tests can be identified.

2, timid: often have gallstones, sputum, biliary sputum, abdominal cancer, biliary surgery and other medical history, there is evidence of biliary excretion blocked. Dark complexion, yellowish green or greenish brown skin, itchy skin is obvious, urine such as strong tea, feces are light gray or clay, often accompanied by anorexia greasy, diarrhea, right flank or upper abdominal pain. The binding of bilirubin in serum is significantly increased, urinary bilirubin is strongly positive, but urinary biliary tract is reduced or absent. The urinary biliary tract in the feces is reduced or absent.

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