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Three Causes of Jaundice Plus Haemolysis

OP Kapoor
 
The following are the three causes, where a patient having jaundice develops haemolysis, which increases the depth of jaundice:-
  1. Viral Hepatitis: The virus of this illness is the most common cause of producing haemolysis in a patient having G6PD deficiency. If a patient having G6PD deficiency develops viral hepatitis, he may also develop very high levels of bilirubin due to additional haemolysis.
  2. Falciparum Malaria: In this condition, the patient can develop Malarial Hepatitis. In addition, unconjugated bilirubin may add to the level of jaundice due to haemolysis produced by the malarial parasite.
  3. Zieves Syndrome has been described years back, where a patient having mild jaundice due to alcoholic liver disease develops severe jaundice over the weekend following an alcoholic binge, which may produce haemolysis.
Finally, in practice if a patient having liver disease also shows evidence of mild haemolysis in the blood, it favours the diagnosis of Wilson’s disease.

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

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