Physical jaundiceIt is a chronic jaundice caused by ingestion, binding or excretion of bilirubin by congenital hepatocytes, mainly characterized by long-term persistent or fluctuating jaundice, mild or asymptomatic and normal liver function. Physical jaundice is also known as constitutional hyperbilirubinemia and hereditary hyperbilirubinemia. It is rare in clinical practice.
Disease introduction
Clinically, according to the nature of serum bilirubin, it can be divided into two categories, namely, jaundice with high unconjugated bilirubin (high non-binding bilirubinemia).UCHBAnd jaundice with high conjugated bilirubin (high binding bilirubinemia)CHB).
Physical jaundice is often misdiagnosed as chronic hepatitis or chronic biliary tract disease due to long-lasting persistent or fluctuating jaundice, and even unnecessary surgery is mistaken. Clinical identification with other types of jaundice is important, which is related to treatment and prognosis. The key to the diagnosis of this type of jaundice is to have a basic concept for it. Any clinically encountered long-term jaundice with mild clinical symptoms, the course of the disease is different from viral hepatitis, hemolytic jaundice and biliary tract disease.
The general rule, in addition to abnormal bilirubin metabolism, other liver function tests are normal, especially when there is a family history, such rare jaundice should always be considered. General constitutional jaundice has four characteristics:1.Most have a family history or have a genetic predisposition;
2.The clinical symptoms are mild or asymptomatic, mainly characterized by chronic volcanic jaundice;
3.In addition to elevated serum bilirubin, liver function is normal;
4.crigler najjarIn addition, most do not require treatment and have a good prognosis.
Physical jaundice, the name of the disease. Also known as constitutional liver dysfunction jaundice, is a more common hereditary unconjugated bilirubinemia.
GilbertSyndromeAlso known as constitutional liver dysfunction jaundice, is a more common hereditary unconjugated bilirubinemia,1901yearGilbertFirst report.GilbertThe clinical manifestations of the syndrome are characterized by long-term intermittent mild jaundice with no obvious symptoms. GilbertThe syndrome is an autosomal dominant hereditary disease, and the patients are mainly adolescents, and men are more common. The incidence rate is approximately5%about.
Symptoms
1.No obvious symptoms;
2.Long-term intermittent mild jaundice;
3.Some cases have fatigue, indigestion, and discomfort in the liver area;
4.Liver and spleen are not swollen.
Diagnose based on
1.Adolescent onset, with increasing age, jaundice gradually declines, often with a family history;
2.Chronic recurrent jaundice, fatigue, alcohol, infection or menstrual period jaundice.
3.PhenobarbitalOr guided sleep can reduce or eliminate jaundice.
4.Serum unconjugated bilirubin increased, urinary bilirubin was negative, and urinary bilirubin content was normal. No dominant or latent hemolytic jaundice;
5.Liver function test, bromosulfate sodium test, liver biopsy normal.
Treatment principles
GilbertThe syndrome requires no special treatment;
2.If necessary, taking phenobarbital has the effect of lowering blood bilirubin.
Efficacy evaluation
1.Cure: jaundice subsides and symptoms disappear;
2.Better: jaundice relieved, symptoms improved;
3.Unhealed: Symptoms did not improve.
Expert tips
GilbertThe cause of the syndrome is a decrease in the ability to clear bilirubin, which may be a decrease in the ability of hepatocytes to take up bilirubin and a decrease in the activity of intrahepatic bilirubin glucuronide. In diagnosisGilbertIn the case of syndrome, attention should be paid to hemolytic jaundice, obstructive jaundice, fatty liver, alcoholism, viral hepatitis, cirrhosis, Dubin-JohnsonSyndrome and other phase identification. GilbertThe prognosis of the syndrome is good and generally does not require special treatment. However, the cause of the increase in jaundice should be avoided.
Diet therapy
Oyster meat corn soup
Fresh oyster meat 100Gram ,Corn must 150Gram. Wash the corn first ,Cut into small pieces ,Put in a gauze bag ,Tightening the mouth ,spare. Wash the fresh oyster meat ,Obliquely cut into pieces with a sharp knife ,Put it in the casserole with the corn must bag ,Add appropriate amount of water ,Quick boil ,Then use a small fire to cook. After the oyster meat is cooked, ,Take out the medicine bag ,Filter out the juice ,Add chopped green onion, ginger, salt, and MSG. ,Mix well ,Cook until boiled. This soup is taken twice ,It has the effect of clearing heat and removing yellow.
简体中文