What all causes scleral icterus

[Rockhouse]

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I am posting this here because I have a sneaking suspicion that I will find more broad knowledge from the EP's than any other crowd. So let's just hypothetically say an 8 y/o african american boy comes in with a lack of appetite for three days and sceral icterus. My question is, does anything cause scleral icterus besides jaundice (I don't need anything far fetched like phenol poisoning)? Or do african americans have "scleral icterus" in a benign, not caused by anything but melanin, kind of way? Thanks in advance

 

[BKN]

I am posting this here because I have a sneaking suspicion that I will find more broad knowledge from the EP's than any other crowd. So let's just hypothetically say an 8 y/o african american boy comes in with a lack of appetite for three days and sceral icterus. My question is, does anything cause scleral icterus besides jaundice (I don't need anything far fetched like phenol poisoning)? Or do african americans have "scleral icterus" in a benign, not caused by anything but melanin, kind of way? Thanks in advance

Many if not most A.A.s and some hispanics are described as having "muddy sclerae". Not really icteric, more of a cream color, but often confusing to newbie docs.

 

[AF Freddie]

Another cause of the Scleral Icterus would be Sickle Cell Anemia. Bilirubin is a biproduct of heme (which is released as RBCs are broken down @ higher levels in SCA) and the cuase for the Icterus.

 

[HIJay]

marijuana use can also cause "yellowing"

 

[RxnMan]

AA can have beta thal, SS, and G6PD, all of which can increase bili turnover.

Maybe also Hep A (icterus + loss of appetite + kids).

 

[deleted109597]

Not carotenemia.

 

[Apollyon]

Not carotenemia.

Give that man an A (vitamin)!

 

[spyderdoc]

I had a nice case of rifampin poisoning during residency. VERY impressive in that the guy's eyes were pretty much orange, as well as his skin (from orange sweat/secretions), his urine, and his vomit. In fact, the janitor had to use special chemicals to remove the orange stains from the floor when the guy vomited....