Parenchymal jaundice causes and treatment

The causes of the appearance of the parenchymal form of hepatic dysfunction are associated with various infectious diseases, as a result of which liver cells are damaged. Due to their partial or complete dysfunction, bilirubin ceases to be converted from free to its direct form and returns to the blood vessels. Therefore, the skin and eye sclera acquire a characteristic yellow color.

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Etiology

Parenchymal jaundice, which is also called hepatic jaundice, has a characteristic feature of the course, during which the epidermis, mucous membranes of the patient and even the eyeballs acquire a characteristic yellow tint. This is explained by the fact that the diseased organ stops converting the free bile enzyme in the blood into its simple form with the intensity that is characteristic of its healthy state. As a result, even that small amount of direct bilirubin does not enter the bile ducts, but returns back to the blood vessels. Those, in turn, spread it throughout the body, as a result of which the patient’s skin acquires a characteristic yellow tint, which gives it the bile pigment bilirubin.

During normal liver function, complete elimination of the bile enzyme from the human body is characteristic. When parenchymal jaundice begins to develop, bilirubin accumulates in the body, especially a lot of it is deposited in the skin when pathological anatomy begins to appear, and biochemistry corresponds to indications of ICD 1, in which:

  • severe parenchymal dystrophies,
  • liver necrosis,
  • acute intoxication with alcohol decomposition products or infectious microorganisms.

Yellow skin and mucous membranes of the same color indicate that the function of removing the bile enzyme from the blood and delivering it to the biliary tract has completely failed in the blood-forming organ. The international qualification of liver diseases identifies different types of hepatic dysfunctions and the mechanisms of their development.

Causes

Parenchymal jaundice appears as a result of acute viral infections, oncology, or as a result of acute intoxication with alcohol decomposition products or other poisons. Hepatic dysfunction results from:

  • leptospirosis,
  • infectious mononucleosis,
  • cirrhosis,
  • infectious viral or chronic hepatitis,
  • hepatocellular cancer.

Hepatic jaundice is also called true, since, unlike its false analogue, the skin and mucous membranes in this case are colored yellow with bile pigment, and not carotene.

For the hepatic form, in addition to yellow skin, eye sclera and tongue, unbearable itching on the skin is characteristic, which indicates that the cells of the epidermis intensively absorb the bile enzyme, experiencing acute intoxication, and the liver is not able to clear the blood from bilirubin.

This hepatic pathology can manifest itself in different forms:

  • parenchymal (hepatic),
  • suprahepatic
  • subhepatic.

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If hepatic jaundice is characterized by a violation of the entire movement of bilirubin in the body of an adult or infant, then suprahepatic jaundice is associated with a dysfunction of the secretion of bile enzyme in the biliary tract. In this form of the disease, bilirubin can be excreted in excess. Subhepatic jaundice manifests itself in the compression of the biliary tract, which leads to swelling. When making a diagnosis, the doctor must accurately establish the type of disease in order to prescribe the correct treatment for the patient. This is very important, as newborns often suffer from this disease associated with liver dysfunction. Their treatment plays an important role in the further development of babies.

In contrast to true jaundice, adhepatic jaundice is characterized by a failure of the biliary tract and an intense breakdown of erythrocytes. The pathological anatomy of this liver disease is manifested in the development of hemolytic anemias. The skin color in the suprahepatic form becomes a characteristic lemon-yellow hue, and at the same time it does not itch, as in the hepatic form of the disease. The easiest way to make a diagnosis is if the patient has suprahepatic jaundice, the pathological anatomy of which has characteristic signs that are clearly manifested at the first stage of the development of the disease.

In the biochemical analysis of the patient, the indicators inherent in a healthy body deteriorate, the urine becomes light, pain is constantly present in the side due to squeezing of the capillaries, the permeability of the cell membranes deteriorates or becomes too loose, the feces acquire a characteristic whitish hue. During the examination of the patient, the doctor can distinguish two main types of the hepatic form of the disease: postcellular or hepatocellular. The latter can be:

  • microsomal,
  • premicrosomal.

Symptoms and stages

In addition to the characteristic color of the epidermis and mucous membranes, such a patient may experience vomiting, diarrhea, nausea, headache, indigestion and high fever. An experienced doctor will always be able to accurately determine the problems with the removal of the bile enzyme from the body by such signs and send the patient to a hospital for treatment.

Symptoms of different types of diseases can be intertwined and lead to an erroneous diagnosis and incorrect treatment of the patient.

For each type of pathology, the doctor prescribes a special treatment. The disease itself goes through three stages of development, during which:

  • the production of enzymes decreases and deformation of the membranes of hepatocytes develops, as a result of which bilirubin is not produced normally,
  • hyperfermentation develops,
  • the process of permeability of the cell membrane increases, characterized by the active penetration of bilirubin into them, which is in an excess state in the blood.
  • hepatic pain in the side increases. To avoid painful seizures in a patient, the doctor should start treatment as early as possible.

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Only then parenchymal jaundice, the symptoms of which are clearly manifested at the last stages of its development, will be completely cured if it is possible to make a diagnosis at the very beginning of the course of the disease.

With parenchymal jaundice, the patient may experience acute pain in the side and liver failure. With hepatic colic, the patient should be put to bed and provided with the necessary assistance. All patients diagnosed with hepatocellular jaundice should be hospitalized. The viral etiology and pathogenesis of this disease require hospitalization and the creation of a quarantine regime to prevent the development of an epidemic.

Diagnostics

Diagnosis of the disease sees the reason for its appearance in the ingestion of viruses and microbes, toxins and pathogenic bacteria, which trigger pathogenesis in the liver. Jaundice is the result of a powerful liver intoxication, which can be completely or partially damaged. In acute hepatic colic, the patient cannot tolerate pain and requires special medical attention.

Diagnosis of liver diseases, including the true form, confirms that the cause of liver failure can be:

  • infections and pathogenic bacteria that cause diseases such as toxoplasmosis, syphilis, malaria,
  • highly toxic substances such as arsenic, snake venom, overdose of poor quality alcohol, poison contained in inedible mushrooms,
  • uncontrolled intake of medications with hepatotoxic effects. It can be “Paracetamol” antibiotics, aspirin.

One of the reasons for parenchyma may be a hereditary predisposition to such a pathology. Diagnostics of a large number of patients made it possible to establish that the propensity to the disease can be transmitted from parents to children, as well as congenital insufficiency of ligandin proteins that the liver produces. They are on its surface. Also, a lack of a special enzyme is inherited, which determines the pathomorphology of jaundice. The inherited Wilson-Konovalov disease, which manifests itself in the accumulation of copper in hepatocytes, can also disrupt the liver. Any lecture notes of a medical student contain such information. Patients with a hereditary tendency should also know it.

The more effective and timely the course of therapy is prescribed, the faster it is possible to restore the functions of the diseased organ, to turn free bilirubin into a simple one and direct it to the choleretic ducts.

Complications

In adults, this pathology leads to the destruction of the cells of the blood-forming organ. Against the background of such a disease, cholecystitis, cirrhosis or oncology may develop. Hepatic dysfunction, which is the most important complication of the disease, can lead to disability or death.

In newborns, the complication occurs in the form of anemia, which entails pathologies in the general development of the child, including the development of the brain and nervous system. To prevent the destruction of liver cells, strict adherence to a therapeutic diet and a full course of drug treatment will be required. Complications in children and adults occur as a result of incorrect diagnoses, erroneous therapy, or complete absence of treatment.

It is especially important to timely deal with the liver of newborns who have been diagnosed with jaundice. Even if they have the development of extrahepatic diseases, children under one and a half years old should be treated in special hospitals, which have all the necessary equipment that allows them to carry out timely diagnostics, take tests and prescribe the most suitable treatment for children. The condition of the liver is very important for the subsequent development of the child. It is a hematopoietic organ that is responsible for the work of the entire human body. Therefore, experienced doctors with extensive clinical practice should deal with liver disease in both children and adults.

Treatment

Treatment of jaundice in adults and newborns should always be carried out in a hospital setting. Here it is easier to take tests and conduct a biochemical blood test at any time required by the attending physician.

In a hospital setting, the doctor prescribes all the necessary medical procedures for subhepatic, hepatic and suprahepatic jaundice. Having at hand all the necessary medical equipment, the physician will be able to quickly see the signs of pathology even at the first stage of its development.

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As a treatment for an excess of bile enzyme, doctors prescribe special medications that help remove it from the body. If this is not enough, then a special photo procedure is carried out. Before choosing the appropriate type of therapy for such patients, the doctor prescribes tests to find out the degree of bilirubin concentration in the blood. The method of treatment directly depends on the level of its concentration in the body.

In the anatomical theater, the liver is often shown affected by various toxins. It is an important organism of the human body, which has a unique ability to recover from intoxication and infectious diseases. But this requires a long course of therapy in a hospital setting.

Prevention of the disease among children and adults

For the occurrence of parenchymal, subhepatic and suprahepatic forms of the disease, a whole complex of causes and symptoms characteristic of viral and bacterial diseases is required. Therefore, in order to prevent such diseases that affect the liver itself and the organs adjacent to it, you should regularly observe sanitary and hygienic rules, do not abuse alcohol and do not take dangerous foods containing toxins.

Many symptoms of liver failure in adults and children indicate that the cause of the failure in the liver, which must intensively purify the blood, was due to its powerful poisoning with toxins of various origins. During the examination, the doctor should always identify the causes of the liver disease. Hepatic jaundice is the result of microbial infectious, chemical or other intoxication. The sooner the treatment is prescribed by the doctor, the more chances to recover faster. With an advanced form of parenchymal pathology and chronic inflammation, a person runs the risk of severely undermining his health. Already at the first symptoms indicating a malfunction in the work of this organ, you should consult a doctor. This is especially important if the disease has affected children attending preschool and school childcare facilities.

Prevention is effective against jaundice and hepatitis of various types, which parents should instill in their children from an early age. Jaundice, which has arisen on the basis of viral and microbial infections, can significantly undermine the health of any person. To protect your liver from such a disease, you need to regularly wash your hands before eating, do not eat large amounts of spicy and salty foods, and give up alcohol and smoking. You should minimize the intake of any toxins and regularly cleanse the liver from the accumulated toxins and toxins.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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