Today there are many different diseases that people do not encounter too often. However, you still need to know about them at least a little. After all, in this way, for example, it is possible to prevent the occurrence of such problems. That is why now I want to talk in great detail about such a pathology as parenchymal jaundice.
Terminology
Before dealing with the disease itself, it is necessary to define the concepts that will be actively used in this article. So, parenchymal jaundice is a disease, or rather, a special symptom complex, which is characterized by staining in icteric color not only of the skin, but also of the mucous membranes (sclera of the eyes). All this happens due to the fact that bilirubin (a bile pigment) gradually begins to accumulate in the patient's body. It is also important to note that this symptom complex indicates that the patient has liver problems that need to be resolved as soon as possible.
It is interesting that in medicine there is also the concept of false jaundice. ATIn this case, it is not bilirubin that accumulates in the human body, but carotene, a natural substance due to which skin coloring occurs. So, this can happen if you eat carrots, pumpkins, oranges, and beets too often and in large quantities. A similar problem can occur if you eat picric acid for a long time, as well as some other medications.
Clinical picture
How does such a pathology as parenchymal jaundice proceed? The pathogenesis of the disease is as follows. So, initially it should be noted that during normal operation, bilirubin, a bile pigment, is excreted from the body naturally. If there are certain problems in the liver, it begins to gradually accumulate in the body, signaling this by yellowing of the skin, as well as mucous membranes. Looking through the information about what parenchymal jaundice is, it is also important to say that this problem has three main stages of development.
- The first stage. In this case, there is a decrease in enzyme activity, hepatocyte membranes are damaged, direct bilirubin ceases to be produced normally.
- At the second stage of the disease, patients have such a problem as hyperfermentation, the permeability of hepatocyte membranes increases. Pain in the side appears due to squeezing of the capillaries.
- At the third stage, there is a violation of the process of bilirubin glucuronization, liver failure occurs. Also, the urine becomes very light, pains are constantly felt in the side.
It is worth noting that it is very important to start fighting parenchymal jaundice at the very first stages of the onset of the disease. After all, in this case, dealing with the problem can be much easier and faster. If you "drag" the beginning of the recovery process to the third stage, then it will be very difficult to recover from this disease.
Causes of the problem
Why can parenchymal jaundice appear, what are the main causes of its occurrence?
- First of all, it should be noted that the main problem in this case are infectious agents: these are viruses, bacteria, toxins. Most often, in this case, we are talking about diseases such as malaria, syphilis, toxoplasmosis, etc.
- The defeat of hepatocides with poisons, both organic and inorganic. Toxic poisoning of the body can occur due to the use of poisonous mushrooms, low-quality alcohol, after taking arsenic or a snake bite.
- The use of certain medications that have a hepatotoxic effect can also lead to this problem. In this case, most often we are talking about a drug such as Paracetamol or antibiotics.
Heredity
Considering the causes of parenchymal jaundice, it must also be said that this disease also has a hereditary factor. That is, it can be transmitted by gender from one family member to another.
- There may be a lack of special ligandin proteins that are located onsurface of the liver.
- The reason may be a hereditary deficiency of a special enzyme called UDP-glucuronyltransferase.
- Wilson-Konovalov's disease is also hereditary, when copper accumulates in hepatocytes, due to this genetic defect, the functionality of this organ is disrupted.
Main symptoms
Considering such a disease as parenchymal jaundice, the symptoms - that's what also needs to be told. So, what are the manifestations of this disease?
- First of all, this problem is evidenced by yellowing of the skin, as well as mucous membranes, mainly the sclera of the eyes.
- The patient may also have mild itching.
- There is a headache, fever, migraine.
- Patients often complain of loss of appetite resulting in weight loss.
- There are also muscle pains and general weakness.
Analysis rates are also changing.
- Feces becomes light, slightly colored. This is due to the loss of stercobilin, another bile pigment.
- Urine also changes color. Can be either too light or too dark.
- In the blood of patients, the content of direct and indirect bilirubin increases.
Diagnosis
How can you understand that a person has parenchymal jaundice? Diagnostics - that's what will tell you about the existencethis disease. For this you need:
- Perform a general analysis of urine, feces, and blood.
- Assessment of the overall clinical picture.
- Biochemical blood test.
- Certain instrumental examinations may be ordered.
Clinical tests
If the patient was tested for feces and urine, then in this case, with this disease, the levels of bilirubin and urobilin increase significantly, and the amount of stercobilin falls, which causes a weak coloration of human excrement.
You will also need blood tests. In this case, leukocytosis and anemia may occur. If the patient has parenchymal jaundice, blood biochemistry is also important. Here, the indicators of bound and unbound bilirubin and urobilin will be increased.
In some cases, the patient will be assigned other additional studies. It could be:
- Determining the level of folic acid and vitamin B12 in the blood.
- Determination of tumor markers.
- Coprogram: analysis for parasites and helminths.
Instrumental studies
An experienced specialist can easily distinguish parenchymal jaundice syndrome from a full-fledged disease without any problems. However, in some cases, even the most eminent luminaries of medicine need additional instrumental studies to confirm the diagnosis. In this case, the patient may be assigned:
- X-ray. To identify problems with the stomach, esophagus and intestines.
- Cholecystography. This is necessary to understand if there are stones in the gallbladder.
- Ultrasound can provide information about the state of the liver and other important organs.
- CT or MRI.
It is very rare for patients to also have a liver biopsy.
Treatment
It should be noted that this pathology has several ways to get rid of it. It all depends on the degree of neglect of the underlying disease. Most often, doctors prescribe drugs that remove excess bilirubin from the body. However, medication does not always help. In this case, doctors may prescribe a procedure such as phototherapy. And all because ultraviolet light is able to quickly break down bilirubin molecules and help them to be removed as soon as possible. With this disease, it is also important to take a complex of vitamins, and especially B and C, lipoic acid and amino acids.
Prevention and complications
Since parenchymal jaundice is a symptom complex that occurs against the background of other diseases (viral hepatitis B and C, bladder stones, etc.), it is very important to start getting rid of these diseases in time. After all, we must remember that if the patient is not helped in time, this can result in certain complications. Namely: the patient may irrevocably disrupt the work of the liver and gallbladder. At the same time, an increased concentration of bilirubin causes intoxication of the body, which has an extremely negative effect on the work of all its organs and systems.
