Jaundice and Pruritus: A Diagnostic Approach

Andrea A. Gossard, Keith D. Lindor

Research output: Chapter in Book/Report/Conference proceedingChapter


Jaundice is probably one of the most commonly recognized cutaneous markers of liver dysfunction and can occur with all types of liver disease. Typically, the bilirubin level exceeds 2.5 mg/dL before jaundice is evident clinically. The color changes may range from light yellow to dark green, and will affect the skin and the mucosal surfaces. The degree of jaundice will vary in relationship to the level of bilirubin elevation. Generalized pruritus can develop from a variety of conditions, but when present in conjunction with jaundice, requires consideration of a hepatobiliary source. A thorough and timely diagnostic approach must be undertaken starting with a comprehensive history, blood work, and radiologic evaluation. Differential considerations must include hematologic conditions, biliary obstruction, hepatic failure, and renal disease. Appropriate management of jaundice and pruritus may include cholangiography and /or surgery. Although the mechanism for pruritus is poorly understood, there are a variety of management options, including several medications, which can be employed to afford the patient relief particularly in the setting of advanced stage liver disease.

Original languageEnglish (US)
Title of host publicationPractical Gastroenterology and Hepatology
Subtitle of host publicationLiver and Biliary Disease
Number of pages8
ISBN (Print)9781405182751
StatePublished - Aug 31 2010
Externally publishedYes


  • Bile duct obstruction
  • Cholangiography
  • Cholestasis
  • Hyperbilirubinemia
  • Jaundice
  • Pruritus

ASJC Scopus subject areas

  • Medicine(all)


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