Neonatal jaundice causes

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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

Neonatal jaundice is caused by hemolysis of the RBCs mainly due to either intravascular causes or extravascular causes. Other causes include non-hemolytic causes such as cephalosporin induced jaundice, genetic mutations of the UGT enzyme, and hepatic causes.

Causes

Common causes

• Common causes of neonatal jaundice include the following:
  • Increase bilirubin production due to hemolysis. Hemolytic causes include:
    • Intrinsic causes of hemolysis
      • Spherocytosis
      • Hereditary elliptocytosis
    • Systemic contitions
      • Splenomegaly
      • Sepsis
      • Arteriovenous malformation
    • Enzyme conditions
      • Glucose-6-phosphate dehydrogenase deficiency (also called G6PD deficiency)
      • Pyruvate kinase deficiency
    • Globin synthesis defect
      • Alpha-thalassemia
    • Extrinsic causes of hemolysis
      • Alloimmunity (The neonatal or cord blood gives a positive direct Coombs test and the maternal blood gives a positive indirect Coombs test)
      • Hemolytic disease of the newborn (ABO)
      • Rh disease

Less common causes

• Less common causes of neonatal jaundice include the following disorders:
  • Non-hemolytic causes
    • Cephalhematoma
    • Polycythemia
    • Sepsis
    • Hypothyroidism
    • Gilbert's syndrome
    • Crigler-Najjar syndrome

• Hepatic causes
  • Infections
    • Sepsis
    • Hepatitis B
    • TORCH infections
  • Metabolic
    • Galactosemia
    • Alpha-1-antitrypsin deficiency
    • Cystic fibrosis
  • Drugs:
    • Losartan
    • Hydrochlorothiazide
  • Total parenteral nutrition

• Post-hepatic
  • Biliary atresia
• Bile duct obstruction

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Losartan, Hydrochlorothiazide
Ear Nose Throat	No underlying causes
Endocrine	Hypothyroidism
Environmental	No underlying causes
Gastroenterologic	Gilbert's syndrome, Crigler-Najjar syndrome, Alpha-1-antitrypsin deficiency, Biliary atresia, Bile duct obstruction
Genetic	Cystic fibrosis, Alpha-1-antitrypsin deficiency
Hematologic	Cephalhematoma, Polycythemia
Iatrogenic	No underlying causes
Infectious Disease	Sepsis, Hepatitis B, TORCH infections
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	Galactosemia, Total parenteral nutrition
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Alpha-1-antitrypsin deficiency
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• Alloimmunity
• Alpha-1-antitrypsin deficiency
• Alpha-thalassemia
• Arteriovenous malformation
• Bile duct obstruction
• Biliary atresia
• Cephalhematoma
• Crigler-Najjar syndrome
• Cystic fibrosis
• Galactosemia
• Gilbert's syndrome
• Glucose-6-phosphate dehydrogenase deficiency (also called G6PD deficiency)
• Hemolytic disease of the newborn (ABO)
• Hepatitis B
• Hereditary elliptocytosis
• Hydrochlorothiazide
• Hypothyroidism
• Losartan
• Polycythemia
• Pyruvate kinase deficiency
• Rh disease
• Sepsis
• Spherocytosis
• Splenomegaly
• TORCH infections
• Total parenteral nutrition

References

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