Neonatal jaundice natural history, complications and prognosis: Difference between revisions
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***If the encephalopathy not diagnosed early, more complications will develop as lethargy, seizures, inability to feed, and apnea in severe cases. | ***If the encephalopathy not diagnosed early, more complications will develop as lethargy, seizures, inability to feed, and apnea in severe cases. | ||
***It is better to diagnose it early in order not to develop severe cases of encephalopathy. | ***It is better to diagnose it early in order not to develop severe cases of encephalopathy. | ||
**[[Kernicterus]]:<ref name="pmid27591005">{{cite journal| author=van Toorn R, Brink P, Smith J, Ackermann C, Solomons R| title=Bilirubin-Induced Neurological Dysfunction: A Clinico-Radiological-Neurophysiological Correlation in 30 Consecutive Children. | journal=J Child Neurol | year= 2016 | volume= 31 | issue= 14 | pages= 1579-1583 | pmid=27591005 | doi=10.1177/0883073816666473 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27591005 }}</ref> | **[[Kernicterus]]:<ref name="pmid27591005">{{cite journal| author=van Toorn R, Brink P, Smith J, Ackermann C, Solomons R| title=Bilirubin-Induced Neurological Dysfunction: A Clinico-Radiological-Neurophysiological Correlation in 30 Consecutive Children. | journal=J Child Neurol | year= 2016 | volume= 31 | issue= 14 | pages= 1579-1583 | pmid=27591005 | doi=10.1177/0883073816666473 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27591005 }}</ref><ref name="pmid26283777">{{cite journal| author=Wickremasinghe AC, Risley RJ, Kuzniewicz MW, Wu YW, Walsh EM, Wi S et al.| title=Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds. | journal=Pediatrics | year= 2015 | volume= 136 | issue= 3 | pages= 505-12 | pmid=26283777 | doi=10.1542/peds.2014-3357 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26283777 }}</ref> | ||
***Kernicterus is the chronic neurologic dysfunction that results from high levels of bilirubin. | ***Kernicterus is the chronic neurologic dysfunction that results from high levels of bilirubin. | ||
***Kernicterus occurs due to damage of the basal ganglia with the precipitating bilirubin. | ***Kernicterus occurs due to damage of the basal ganglia with the precipitating bilirubin. | ||
*** | ***Kernicterus can present with the following features: | ||
****Hearing impairement | |||
****Gaze abnormality | |||
****Cerebral palsy like features | |||
***The neurological manifestations of Kernicterus are reversible with exchange transfusion and decreasing the high bilirubin levels. | ***The neurological manifestations of Kernicterus are reversible with exchange transfusion and decreasing the high bilirubin levels. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Naturla history, complicaions and prognosis
Natural history
- If left untreated, neonatal jaundice may develop bilirubin related encephalopathy.
Complications
- Common complications of neonatal jaundice include the following:
- Acute bilirubin encephalopathy:[1][2][3]
- Bilirubin is toxic to the brain and high levels may cause acute bilirubin encephalopathy.
- In the beginning, it may be asymptomatic or the infant is sleepy and hypotonic.
- If the encephalopathy not diagnosed early, more complications will develop as lethargy, seizures, inability to feed, and apnea in severe cases.
- It is better to diagnose it early in order not to develop severe cases of encephalopathy.
- Kernicterus:[4][5]
- Kernicterus is the chronic neurologic dysfunction that results from high levels of bilirubin.
- Kernicterus occurs due to damage of the basal ganglia with the precipitating bilirubin.
- Kernicterus can present with the following features:
- Hearing impairement
- Gaze abnormality
- Cerebral palsy like features
- The neurological manifestations of Kernicterus are reversible with exchange transfusion and decreasing the high bilirubin levels.
- Acute bilirubin encephalopathy:[1][2][3]
Prognosis
- Prognosis of neonatal jaundice is excellent with receiving the proper treatment.
References
- ↑ Chuniaud L, Dessante M, Chantoux F, Blondeau JP, Francon J, Trivin F (1996). "Cytotoxicity of bilirubin for human fibroblasts and rat astrocytes in culture. Effect of the ratio of bilirubin to serum albumin". Clin Chim Acta. 256 (2): 103–14. PMID 9027422.
- ↑ Bratlid D (1990). "How bilirubin gets into the brain". Clin Perinatol. 17 (2): 449–65. PMID 2196140.
- ↑ Hoffman DJ, Zanelli SA, Kubin J, Mishra OP, Delivoria-Papadopoulos M (1996). "The in vivo effect of bilirubin on the N-methyl-D-aspartate receptor/ion channel complex in the brains of newborn piglets". Pediatr Res. 40 (6): 804–8. doi:10.1203/00006450-199612000-00005. PMID 8947954.
- ↑ van Toorn R, Brink P, Smith J, Ackermann C, Solomons R (2016). "Bilirubin-Induced Neurological Dysfunction: A Clinico-Radiological-Neurophysiological Correlation in 30 Consecutive Children". J Child Neurol. 31 (14): 1579–1583. doi:10.1177/0883073816666473. PMID 27591005.
- ↑ Wickremasinghe AC, Risley RJ, Kuzniewicz MW, Wu YW, Walsh EM, Wi S; et al. (2015). "Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds". Pediatrics. 136 (3): 505–12. doi:10.1542/peds.2014-3357. PMID 26283777.