Sarılık
Özet
Sarılık, serum bilirübin düzeyinin 2,5-3 mg/dL üzerine çıkmasıyla cilt ve mukoza zarlarının sarı renk alması durumudur ve prehepatik, intrahepatik veya posthepatik nedenlerle ortaya çıkabilir. Tanı sürecinde detaylı anamnez ve fizik muayene ile birlikte bilirübinin direkt veya indirekt baskınlığının tespiti, altta yatan enfeksiyon, malignite veya metabolik bozuklukların ayırt edilmesinde kritik rol oynar. Tedavi genellikle altta yatan hastalığa yönelik planlanırken, aile hekimleri özellikle ciddi durumlarda hastayı uzman merkezlere sevk etmekle yükümlüdür.
Jaundice is the yellowing of the skin and mucous membranes when serum bilirubin levels exceed 2.5-3 mg/dL, and it can arise from prehepatic, intrahepatic, or posthepatic causes. In the diagnostic process, a detailed medical history and physical examination, along with determining direct or indirect bilirubin dominance, play a critical role in differentiating underlying infections, malignancies, or metabolic disorders. Treatment is generally planned according to the underlying disease, and family physicians are responsible for referring patients to specialized centers, especially in severe cases.
Referanslar
Winger J, Michelfelder A. Diagnostic approach to the patient with jaundice. Primary Care. 2011;38(3):469-82; viii. doi: 10.1016/j.pop.2011.05.004
Roche SP, Kobos R. Jaundice in the adult patient. American Family Physician. 2004;69(2):299-304.
American International Medical University. Jaundice : symptoms, causes, diagnosis, management and prevention [Online] https://www.aimu.us/2018/01/24/jaundice-symptoms-causes-diagnosis-management-and-prevention [Accessed: 31th December 2021]
Contreras-Omana R, Velarde-Ruiz Velasco JA, Castro-Narro GE, et al. Approach to the patient with cholestasis and jaundice syndrome. Joint AMH, AMG, and AMEG scientific position statement. Revista de gastroenterología de México (English). 2022;87(1):80-88. doi: 10.1016/j.rgmxen.2021.04.003
Pavlovic Markovic A, Stojkovic Lalosevic M, Mijac DD, et al. Jaundice as a diagnostic and therapeutic problem: a general practitioner's approach. Digestive diseases (Basel, Switzerland). 2021. doi: 10.1159/000517301. Online ahead of print.
Taylor A, Stapley S, Hamilton W. Jaundice in primary care: a cohort study of adults aged >45 years using electronic medical records. Family Practice. 2012;29(4):416-420. doi: 10.1093/fampra/cmr118
Hao SR, Geng SC, Fan LX, et al. Intelligent diagnosis of jaundice with dynamic uncertain causality graph model. Journal of Zhejiang University. Science. B. 2017;18(5):393-401. doi: 10.1631/jzus.B1600273
Fevery J. Bilirubin in clinical practice: a review. Liver International. 2008;28(5):592-605. doi: 10.1111/j.1478-3231.2008.01716.x
Pashankar D, Schreiber RA. Jaundice in older children and adolescents. Pediatrics in Review. 2001;22(7):219-226. doi: 10.1542/pir.22-7-219
Molina EG, Reddy KR. Postoperative jaundice. Clinics in Liver Disease. 1999;3(3):477-488. doi: 10.1016/s1089-3261(05)70081-7
Sackey K. Hemolytic anemia: part 1. Pediatrics in Review. 1999;20(5):152-158. doi: 10.1542/pir.20-5-152
Pasha TM, Lindor KD. Diagnosis and therapy of cholestatic liver disease. The Medical Clinics of North America. 1996;80(5):995-1019. doi: 10.1016/s0025-7125(05)70477-6
Tung BY, Carithers Jr RL. Cholestasis and alcoholic liver disease. Clinics in Liver Disease. 1999;3(3):585-601. doi: 10.1016/s1089-3261(05)70086-6
Schramm C, Kanzler S, zum Büschenfelde KH, et al. Autoimmune hepatitis in the elderly. The American Journal of Gastroenterology. 2001;96(5):1587-1591. doi: 10.1111/j.1572-0241.2001.03782.x
UpToDate. Drug-induced liver injury. [Online] https://www.uptodate.com/contents/drug-induced-liver-injury#H1 [Accessed: 2nd February 2022]
Lewis JH. Drug-induced liver disease. The Medical Clinics of North America. 2000;84(5):1275-1311, x. doi: 10.1016/s0025-7125(05)70287-x
Cleveland Clinic. Adult jaundice. [Online] https://my.clevelandclinic.org/health/diseases/15367-adult-jaundice [Accessed: 31 December 2021]
Shiha G. Hepatocellular jaundice. In: Mamun Al Mahtab SR (ed). Liver: A complete book on hepato-pancreato-biliary diseases. Chennai, India: Elsevier; 2009. p. 173-91.
Kalloo AN, Kantsevoy SV. Gallstones and biliary disease. Primary Care. 2001;28(3):591-606, vii. doi: 10.1016/s0095-4543(05)70055-5
Gadia CLB, Manirakiza A, Tekpa G, et al. Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: a retrospective assessment, 2008-2010. BMC Infectious Diseases. 2017;17(1):735. doi: 10.1186/s12879-017-2840-8
Singh N, Gayowski T, Wagener MM, et al. Vulnerability to psychologic distress and depression in patients with end-stage liver disease due to hepatitis C virus. Clinical Transplantation. 1997;11(5 Pt 1):406-411.
Modolell I, Guarner L, Malagelada JR. Vagaries of clinical presentation of pancreatic and biliary tract cancer. Annals of Oncology 1999;10 Suppl 4:82-4.
Blitz NM, Rudikoff D. Pyoderma gangrenosum. The Mount Sinai Journal of Medicine, New York. 2001;68(4-5):287-297.
Pyrsopoulos NT, Reddy KR. Extrahepatic manifestations of chronic viral hepatitis. Current Gastroenterology Reports. 2001;3(1):71-78. doi: 10.1007/s11894-001-0044-1
Seifert B, Rubin G, de Wit N, et al. The management of common gastrointestinal disorders in general practice A survey by the European Society for Primary Care Gastroenterology (ESPCG) in six European countries. Digestive and Liver Disease. 2008;40(8):659-666. doi: 10.1016/j.dld.2008.02.020
Bassari R, Koea JB. Jaundice associated pruritis: a review of pathophysiology and treatment. World Journal of Gastroenterology. 2015;21(5):1404-1413. doi: 10.3748/wjg.v21.i5.1404
Chen HL, Wu SH, Hsu SH, et al. Jaundice revisited: recent advances in the diagnosis and treatment of inherited cholestatic liver diseases. Journal of Biomedical Science. 2018;25(1):75. doi: 10.1186/s12929-018-0475-8
Johnston DE. Special considerations in interpreting liver function tests. American Family Physician. 1999;59(8):2223-2230.
Cohen JA, Kaplan MM. The SGOT/SGPT ratio--an indicator of alcoholic liver disease. Digestive Diseases and Sciences. 1979;24(11):835-838. doi: 10.1007/BF01324898
Pasanen PA, Partanen K, Pikkarainen P, et al. A prospective study on the value of ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the diagnosis of unjaundiced cholestasis. In Vivo (Athens, Greece). 1994;8(2):227-230.
Alempijevic TM, Lalosevic MS, Dumic I, et al. Diagnostic accuracy of platelet count and platelet indices in noninvasive assessment of fibrosis in nonalcoholic fatty liver disease patients. Canadian Journal of Gastroenterology & Hepatology. 2017;2017:6070135. doi: 10.1155/2017/6070135
United States Preventive Services Task Force. Hepatitis B virus infection in adolescents and adults: screening. [Online] https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-b-virus-infection-screening [Accessed: 1st February 2022]
United States Preventive Services Task Force. Hepatitis C virus infection in adolescents and adults: screening. [Online] https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening [Accessed: 1st February 2022]
United States Preventive Services Task Force. Unhealthy alcohol use in adolescents and adults: screening and behavioral counseling interventions. [Online] https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions [Accessed: 3rd February 2022]
United States Preventive Services Task Force. Unhealthy drug use: screening. [Online] https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/drug-use-illicit-screening [Accessed: 3rd February 2022]
T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Aile hekimliği uygulamasında önerilen periyodik sağlık muayeneleri ve tarama testleri. [Online] https://hsgm.saglik.gov.tr/depo/birimler/Toplum_Sagligi_Hizmetleri_ve_Egitim_Db/Dokumanlar/rehberler/psm_2019.pdf [Accessed: 4th February 2022]
