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==Overview==
If left untreated, neonatal jaundice may lead to brain damage. Common complications of neonatal jaundice include acute bilirubin encephalopathy and kernicterus. Prognosis of neonatal jaundice is excellent with the proper treatment.
 
==Natural history, complications and prognosis==
===Natural history===
* If left untreated, neonatal jaundice may develop bilirubin related brain damage.


==Overview==
==Natural history== == Prognosis==
===Complications===
===Complications===
With high doses of bilirubin (severe hyperbilirubinemia) there can be a complication known as [[kernicterus]].  This is the chief condition that treatment of jaundice is aimed at preventing. The effects of kernicterus range from fever, seizures, and a high-pitched crying to mental retardation. This is due to a staining effect on the [[basal ganglia]] leading to neuronal damage. With aggressive treatment such as exchange transfusion to lower very high bilirubin levels, the neurological effects are almost always transient.
*Common complications of neonatal jaundice include the following:
**Acute bilirubin encephalopathy:<ref name="pmid9027422">{{cite journal| author=Chuniaud L, Dessante M, Chantoux F, Blondeau JP, Francon J, Trivin F| title=Cytotoxicity of bilirubin for human fibroblasts and rat astrocytes in culture. Effect of the ratio of bilirubin to serum albumin. | journal=Clin Chim Acta | year= 1996 | volume= 256 | issue= 2 | pages= 103-14 | pmid=9027422 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9027422  }}</ref><ref name="pmid2196140">{{cite journal| author=Bratlid D| title=How bilirubin gets into the brain. | journal=Clin Perinatol | year= 1990 | volume= 17 | issue= 2 | pages= 449-65 | pmid=2196140 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2196140  }}</ref><ref name="pmid8947954">{{cite journal| author=Hoffman DJ, Zanelli SA, Kubin J, Mishra OP, Delivoria-Papadopoulos M| title=The in vivo effect of bilirubin on the N-methyl-D-aspartate receptor/ion channel complex in the brains of newborn piglets. | journal=Pediatr Res | year= 1996 | volume= 40 | issue= 6 | pages= 804-8 | pmid=8947954 | doi=10.1203/00006450-199612000-00005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8947954  }}</ref>
***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]]:<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 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.  


===Prognosis===
*Prognosis of neonatal jaundice is excellent with receiving the proper treatment.


==Prognosis==
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 22:57, 29 July 2020

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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

If left untreated, neonatal jaundice may lead to brain damage. Common complications of neonatal jaundice include acute bilirubin encephalopathy and kernicterus. Prognosis of neonatal jaundice is excellent with the proper treatment.

Natural history, complications and prognosis

Natural history

  • If left untreated, neonatal jaundice may develop bilirubin related brain damage.

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.

Prognosis

  • Prognosis of neonatal jaundice is excellent with receiving the proper treatment.

References

  1. ↑ 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.
  2. ↑ Bratlid D (1990). "How bilirubin gets into the brain". Clin Perinatol. 17 (2): 449–65. PMID 2196140.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.

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