Liver Disease | Why Does Harvey Have Yellow Skin and Eyes?

Harvey is jaundiced. Jaundice is a yellowish discoloration of the skin and of the whites of the eyes caused by abnormally high levels of the pigment bilirubin in the bloodstream. Old or damaged red blood cells are constantly being removed from the circulation, mainly by the spleen. During this process, hemoglobin, the part of red blood cells that carries oxygen, is broken down into a dark greenish yellow pigment called bilirubin.

Bilirubin is then carried in the bloodstream to the liver and is excreted into the intestine as a component of bile (the digestive fluid produced by the liver). If bilirubin cannot be excreted into bile quickly enough, it builds up in the blood. The excess bilirubin is deposited in the skin, resulting in the yellowish discoloration called jaundice.

High levels of bilirubin in the blood is due, in Harvey's case, to damage to the liver, such as that due to inflammation or scarring, can impair its ability to excrete bilirubin into bile. When Harvey was diagnosed with Biliary Atresia, his jaundice was caused by the blockage of his bile ducts,which carry bile from the liver to the small intestine.

The skin of people who eat large amounts of food rich in beta-carotene (such as carrots, squash, and some melons) may develop a mild yellow tint, but their eyes do not turn yellow. This condition is not jaundice and is unrelated to liver disease.

In jaundice, the skin and whites of the eyes appear yellow. Urine is often dark because excess bilirubin is excreted through the kidneys. People may have itching, light-coloured stools, or other symptoms, depending on the cause of jaundice. In Harveys case, the most irratating symptom is the itching, which occurs mainly at night. He has been known to scratch himself so agressively to try to relieve the itch, that he draws blood.

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