Difference – Jaundice vs Icterus
Jaundice is a common clinical scenario which manifests as a yellowish tinge of the skin and white part of the eye (sclera), resulting from increased bilirubin (a waste product of hemoglobin degradation) levels in the blood (hyperbilirubinemia). This mainly occurs due to an increased risk of several causes such as gallstone obstructions, structural anomalies in the bile duct, hepatitis, liver cirrhosis, poor breastfeeding, etc. Icterus is another name for jaundice. Thus, there is no difference between jaundice and icterus. However, some suggest that jaundice is a complication arising due to various underlying diseases whereas icterus is a sign which can be elicited by examining a patient with jaundice.
What is Jaundice
Bilirubin, a substance formed after the degradation of hemoglobin in red blood cells is in an unconjugated form which does not dissolve in water; therefore, it cannot get excreted via urine like other waste materials. The liver is the organ which combines this Bilirubin with some other chemicals and converts it into a conjugated-water soluble material, which will then be secreted via the bile duct into urine and feces. Bilirubin is what gives feces its characteristic yellow color.
However, due to increased degradation of red blood cells through a process called Hemolysis, various pathological conditions in the liver and the bile duct can give rise to increased levels of Bilirubin in the blood. This excess Bilirubin will get diffused through the skin and mucous membranes, resulting in a yellowish discoloration, known as Jaundice.
There are 3 major types of jaundice, based on their underlying pathophysiology.
- Hepatocellular jaundice – occurs as a result of liver disease or injury
- Hemolytic jaundice – occurs as a result of increased hemolysis
- Obstructive jaundice – occurs as a result of an obstruction in the bile duct, preventing bilirubin from exiting the liver.
Other rare causes of jaundice include,
Crigler-Najjar syndrome – an inherited disorder which causes a mutation in the specific enzyme which is responsible for forming unconjugated bilirubin to conjugated form, resulting in excess amounts of bilirubin.
Dubin-Johnson syndrome – an inherited condition which prevents conjugated bilirubin leaving the liver cells.
Signs and symptoms of Jaundice mainly depend on the underlying cause and generally include a yellow tinge of the skin and the whites of the eyes, pruritus (itchiness), fatigue, abdominal pain. If there is blockage of the bile duct, symptoms can include loss of weight, vomiting, fever, pale stools and dark urine.
Taking a complete history from the patient will help to get an idea about the cause and severity of the underlying condition; a thorough physical examination will elicit abdominal signs like tenderness and masses.
Furthermore, investigations such as Bilirubin levels, Full blood count (FBC), Hepatitis A, B, and C tests, Ultrasound scan, MRI, CT scan and Endoscopic retrograde cholangiopancreatography (ERCP) can be carried out to reveal possible etiological conditions giving rise to jaundice.
A liver biopsy may be required for some patients in order to look for inflammation, cirrhosis, malignancies and fatty liver.
Once the underlying diagnosis is established, the treatment will be decided accordingly. Hepatitis induced jaundice can be treated with steroids or antiviral drugs whereas obstructions or narrowing of the bile duct (stones) can be treated by surgical interventions depending on the severity and location.
What is Icterus
Icterus has been derived from the Greek term ‘icteric’ which is used to describe a yellowish discoloration of the skin and mucous membranes in the body such as sclera.
Difference Between Jaundice and Icterus
According to most of the experts in the field, there is no such difference between Jaundice and Icterus; both refer to the same condition. However, some suggest that jaundice is a complication arising due to various underlying diseases whereas icterus is a sign which can be elicited by examining a patient with jaundice.
“Jaundice eye new” By Jaundice_eye.jpg: * Photo Credit:Content Providers(s): CDC/Dr. Thomas F. Sellers/Emory University derivative work (Public Domain) via (Commons Wikimedia)
“Jaundice-types” (GFDL) via Commons Wikipedia