Jaundice
Yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment bilirubin. The yellowing extends to other tissues and body fluids. Jaundice was once called the “morbus regius” (the regal disease) in the belief that only the touch of a king could cure it.
When red blood cells are removed from the bloodstream, hemoglobin, the molecule in red cells that carries oxygen, is broken down into bilirubin. The bilirubin is carried to the liver and excreted into the intestine as a component of bile.
Jaundice can indicate liver or gallbladder disease. When the excretion of bilirubin is hindered, excess bilirubin passes into the blood, resulting in jaundice. Inflammation or other abnormalities of liver cells hinder the excretion of bilirubin into bile. Or the bile ducts outside the liver may be blocked by a gallstone or a tumor. Jaundice can also result from the excessive breakdown of red blood cells (a process called hemolysis) and too much bilirubin is released into the bloodstream. This occurs typically in the hemolytic anemias (as opposed to the aplastic anemias in which not enough red cells are produced). Jaundice is common in newborns because there is some hemolysis during labor and delivery and the newborn’s liver is immature and may not be fully up to the task of handling the bilirubin for a few days. In Gilbert syndrome, the blood bilirubin levels are slightly increased, enough to cause mild jaundice. This genetic condition is usually discovered serendipitously during routine screening tests of liver function. It causes no symptoms and no problems.
The figurative use of “jaundice” in “to view things with a jaundiced eye” refers to an attitude of distaste. This may reflect the distaste with which a jaundiced person views food, since severe jaundice typically brings loss of appetite and feelings nausea. “Jaundice” is often said to have come from the French “jaune” for yellow. This is incorrect. The word “jaundice” stemmed from the Latin “galbinus” which described a light greenish-yellow color. In Old French this became “jaunisse” and, in crossing the English Channel, it became “jaundice.” In French “jaundice” is still “jaunisse.”
The term icterus is synonymous with jaundice. A person who is icteric is jaundiced. Abnormally high blood bilirubin is termed hyperbilirubinemia.
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