What is the main pathological process involved in hemolytic jaundice?

Hemolytic jaundice primarily arises from the breakdown of red blood cells (RBCs), a process known as hemolysis. In this condition, the rapid destruction of RBCs leads to an increase in bilirubin levels, particularly unconjugated bilirubin, in the bloodstream. Bilirubin is a breakdown product of heme from hemoglobin, and when RBCs are hemolyzed at an accelerated rate, the liver may not be able to conjugate and excrete this excess bilirubin promptly. This accumulation of unconjugated bilirubin results in the yellowing of the skin and sclera, characteristic of jaundice.

In hemolytic jaundice, the liver itself is typically functioning normally regarding its ability to conjugate and excrete bilirubin, and thus, hepatic necrosis, impaired bile flow, or inflammation are not the primary processes at play in this specific type of jaundice. Instead, the focus remains on the excessive RBC breakdown as the central pathological mechanism leading to the elevated bilirubin levels.