How common is jaundice in sickle cell disease?

Jaundice makes the whites of the eyes or skin look yellow because bilirubin has built up in the body. In sickle cell disease, red blood cells can break down more quickly than usual, producing bilirubin faster than the liver can clear it. Yellowing may become more noticeable during a pain episode, an infection, dehydration or another period of physical stress.

Jaundice can occur with dark urine, tiredness or pale stools, but these changes do not identify the cause by themselves. A clinician may assess your symptoms, examine you and arrange blood or urine tests to distinguish a sickle-cell-related change from liver, gallbladder or viral illness.

Keep a record of when the yellowing started, whether it is changing, and any accompanying pain, fever, vomiting, itching, abdominal discomfort or change in urine or stool colour. Follow your personalised sickle cell plan, drink fluids as advised, and take prescribed medicines as directed. Do not start supplements or pain medicines for jaundice without checking that they are suitable for you.

Arrange a clinical review if jaundice is new, stronger than usual or accompanied by symptoms that are not part of your usual pattern. Bring your medicines and note recent infections, travel, fasting or missed treatment, since these details can help guide the assessment.

Seek urgent medical help for jaundice with a high temperature, severe or worsening abdominal pain, repeated vomiting, confusion, unusual sleepiness, breathing difficulty, chest pain, fainting or inability to drink. Prompt assessment is also needed if yellowing appears suddenly or you feel markedly weaker than usual.

Could this jaundice fit my usual sickle cell pattern, or do I need tests for a liver or gallbladder problem? Which symptoms should make me contact the sickle cell team immediately? Should any of my current medicines be changed while the yellowing is being assessed?