Is yellowing of the whites of the eyes jaundice? Why does jaundice occur

People's eyes should be composed of white and black, but we will also find that many people's whites of the eyes turn yellow. The yellowing of the whites of the eyes can be considered to be caused by jaundice, because jaundice destroys the body's hemolysis, causing thalassemia, hemoglobin disease, and genetic problems will cause our eyeballs to turn yellow, the skin will also turn yellow, and multiple parts of the body may be accompanied by a light yellow color. It is very likely to cause a variety of complications, and the harm is also quite large. As long as the cause of jaundice can be found, active treatment is carried out, and the appropriate method is selected to control it, the white of the eye will slowly return to being no longer yellow, and will no longer affect the appearance of the person.

What causes jaundice?

1. Causes of disease

1. Hemolytic jaundice Any disease that can cause massive destruction of red blood cells and produce hemolysis can cause hemolytic jaundice. Common diseases fall into two categories.

(1) Congenital hemolytic anemia: such as thalassemia (hemoglobinopathy) and hereditary spherocytosis.

(2) Acquired hemolytic anemia: such as autoimmune hemolytic anemia, hereditary glucose-6-phosphate dehydrogenase deficiency (favism), hemolytic anemia after heterotypic blood transfusion, neonatal hemolytic anemia, malignant malaria, primaquine and other drugs, snake venom, mushroom poisoning, paroxysmal nocturnal hemoglobinuria, etc.

2. Hepatocellular jaundice Various liver diseases, such as viral hepatitis, toxic hepatitis, drug-induced liver disease, various types of cirrhosis, primary and secondary liver cancer, sepsis and leptospirosis, can cause jaundice due to diffuse damage to liver cells.

3. Obstructive jaundice (cholestatic jaundice) can be divided into two categories according to the site of obstruction: extrahepatic bile duct obstruction and intrahepatic bile duct obstruction.

(1) Common diseases that cause extrahepatic bile duct obstruction include common bile duct stones, stenosis, inflammatory edema, ascariasis, tumors, and congenital biliary atresia. Common diseases or causes that cause extrahepatic compression and lead to common bile duct obstruction include pancreatic head cancer, chronic pancreatitis with enlarged pancreatic head, ampulla of Vater cancer, common bile duct cancer, liver cancer, and enlarged lymph nodes in the porta hepatis or around the common bile duct (cancer metastasis).

(2) Intrahepatic bile duct obstruction can be divided into intrahepatic obstructive cholestasis and intrahepatic cholestasis. The former is common in intrahepatic bile duct sludge stones, cancer thrombi (mostly liver cancer), Clonorchiasis, etc.; the latter is common in capillary cholangiocarcinoma viral hepatitis, drug-induced cholestasis (such as chlorpromazine, methyltestosterone, oral contraceptives, etc.), bacterial sepsis, recurrent jaundice during pregnancy, primary biliary cirrhosis and a few cases after heart or abdominal surgery.

4. Congenital non-hemolytic jaundice refers to a congenital defect in the metabolism of bilirubin. It is more common in infants, young children and young people, and often has a family history. If a patient survives infancy or childhood, jaundice may recur, often triggered by a cold, exercise, infection, or fatigue, but the patient is generally in good health. This type of jaundice is rare in clinical practice and is sometimes easily misdiagnosed as hepatobiliary disease. The following are some common diseases that cause this type of jaundice.

(1) Gilbert syndrome: The mechanism of jaundice is the disorder of hepatocyte uptake of unconjugated bilirubin (mild form, the most common type of familial jaundice in clinical practice) and the deficiency of glucuronyl transferase in hepatocyte microsomes (severe form, poor prognosis). The characteristics of this disease are that except for jaundice, other liver function tests are normal, the concentration of unconjugated bilirubin in serum is increased, and the fragility of red blood cells is increased; after oral cholecystography, the gallbladder is well visualized and there are no abnormalities in liver biopsy.

(2) Dabin-Johnson syndrome: The cause of jaundice is that after unconjugated bilirubin is converted into conjugated bilirubin in liver cells, the transport and secretion of conjugated bilirubin into the bile duct capillaries are impaired. The disease is characterized by increased serum conjugated bilirubin; the gallbladder does not appear after oral cholecystography; the liver appears green and black (observed under laparoscopy), and liver biopsy shows diffuse brown pigment granule deposition in the hepatocytes. The prognosis of this disease is good.

(3) Rotor syndrome: Jaundice occurs due to a partial obstruction in the uptake of unconjugated bilirubin by hepatocytes and the secretion of conjugated bilirubin into the bile duct capillaries. The characteristics of this disease are increased serum unconjugated and conjugated bilirubin; impaired (decreased) indigo green (ICG) excretion test; cholecystography is mostly well developed, with only a few not developed; there is no pigment granule deposition in the liver, and liver biopsy is normal. The prognosis of this disease is generally good.

(4) Crigler-Najjar syndrome: The cause of jaundice is the lack of glucuronyl transferase in the hepatocyte microsomes, which prevents the conversion of unconjugated bilirubin into conjugated bilirubin. This syndrome can be divided into severe or mild types. The former is prone to bilirubin encephalopathy (kernicterus) because of the high concentration of unconjugated bilirubin in the blood, which has a strong affinity with the fat tissue in the brain. It is more common in newborns and has a very poor prognosis, with most dying within one year after birth. The latter is caused by a partial lack of glucuronyl transferase in the hepatocyte microsomes, so the symptoms are milder and the prognosis is slightly better than the severe type.