Neonatal jaundice natural history, complications and prognosis
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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.