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Unlike neonates, hyperbilirubinemia itself requires no treatment in adults. Instead, treatment varies by underlying diseases. As mentioned, cholelithiasis is the most common cause of hyperbilirubinemia. Gallstones can be removed using acid or shock waves in litholytic therapy and lithotripsy, respectively.
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [3] [6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. [7]
Urobilinogen is a yellow by-product of bilirubin reduction. It is formed in the intestines by the bacterial enzyme bilirubin reductase. [1] About half of the urobilinogen formed is reabsorbed and taken up via the portal vein to the liver, enters circulation and is excreted by the kidney.
Treatment of the condition is specific to the cause of hemolysis, but intense phototherapy and exchange transfusion can be used to help the patient excrete accumulated bilirubin. [11] Complications related to hemolytic jaundice include hyperbilirubinemia and chronic bilirubin encephalopathy, which may be deadly without proper treatment. [12] [13]
Jaundice may be noticeable in the sclera of the eyes at levels of about 2 to 3 mg/dl (34 to 51 μmol/L), [27] and in the skin at higher levels. [note 1] Jaundice is classified, depending upon whether the bilirubin is free or conjugated to glucuronic acid, into conjugated jaundice or unconjugated jaundice. [citation needed]
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Rotor syndrome is a benign disease requiring no treatment. [2] Jaundice is a lifelong finding, but the disease is not associated with morbidity or mortality, and life expectancy is not affected. [2] Most individuals with Rotor syndrome are born to consanguineous couples and its diagnosis may coincidently identify consanguinity. [2]
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