LAUSR

Background: Jaundice is a common clinical finding in clinical practice of hepatologists and general practitioners. It occurs when serum bilirubin levels exceed 3 mg/dL. Summary: In this review, we summarize the pathophysiological mechanism of jaundice, clinical approach to the patient with jaundice, and laboratory and imaging techniques. Clinical presentation of jaundice manifests through yellow skin and sclera coloration. Evaluation of every patient includes detailed medical history and examination. In the laboratory, evaluation of enzymes of hepatic inflammation as well as cholestatic enzymes with serum bilirubin must be included. Additional laboratory analysis and imaging modalities are needed in order to differentiate jaundice etiology. Moreover, imaging is available and needed in further evaluation, and treatment is dependent on the underlying cause. Key Messages: In this review, we will outline the pathophysiological mechanism of jaundice, clinical approach to the patient with jaundice, and diagnostic and treatment approach to these patients. © 2021 S. Karger AG, Basel Introduction Jaundice is a clinical manifestation of elevated serum bilirubin. Accumulation of elevated serum bilirubin leads to yellow discoloration of the skin, sclera, and other mucous membranes known as jaundice or icterus. When serum bilirubin level exceeds 3 mg per dL, jaundice becomes clinically apparent. From general practitioners’ (GPs’) point of view, timely and adequate assessment of the patient with jaundice is of great importance [1]. A general approach to the patient with jaundice should include detailed medical history, careful clinical examination, and appropriate laboratory and imaging techniques (Fig. 1) [2]. Epidemiology data suggest that incidence of jaundice varies depending on the underlying cause, and it is more common in certain age groups. Namely, jaundice affects approximately 6 out of 10 otherwise healthy newborns, mainly due to immature hepatic conjugation and uptake [3]. Jaundice due to alcoholic liver disease, as well as nonalcoholic liver disease, is more common in men, while primary biliary cholangitis as an underlying cause of jaundice is dominantly seen in women [4]. In this review article, we aim to provide a systematic approach to the patient with jaundice, especially in terms of diagnosis and therapy.