RT Book, Section
A1 Kaplan, Michael
A1 Bromiker, Ruben
A1 Hammerman, Cathy
A2 Stevenson, David K.
A2 Cohen, Ronald S.
A2 Sunshine, Philip
SR Print(0)
ID 1109793758
T1 Neonatal Jaundice and Hemolytic Disease of the Newborn
T2 Neonatology: Clinical Practice and Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071763769
LK accesspediatrics.mhmedical.com/content.aspx?aid=1109793758
RD 2024/04/19
AB Neonatal  jaundice,  implying  a  yellow  color  of  the  skin  and  mucous  membranes  due  to  bilirubin  deposition,  occurs  in  about  60%  of  infants  and  even  more  often  in  those  exclusively  breast  feeding.  In  most  cases,  the  jaundice  will  be  mild  or  moderate,  and  the  total  serum  bilirubin  (TSB)  will  not  endanger  the  newborn  infant.  Occasionally,  the  TSB  may  increase  to  potentially  dangerous  levels  and  require  treatment  with  phototherapy  or  rarely  exchange  transfusion  to  offset  any  further  increase.  Rarely,  the  TSB  may  rise  to  hazardous  levels,  at  which  bilirubin  may  cross  the  blood-brain  barrier  and  enter  the  brain  cells.  The  result  will  be  the  complication  of  acute  bilirubin  encephalopathy  (ABE),  in  many  cases  with  the  devastating  chronic  sequela  of  choreoathetotic  cerebral  palsy  known  as  kernicterus,  or  death.  Despite  attempts  to  eliminate  this  condition,  kernicterus,  although  a  rare  condition,  is  still  with  us  and  accompanies  us  into  the  third  millennium.  Many  cases  should  be  preventable.  Because  the  implications  for  affected  individuals  are  lifelong,  the  public  health  aspects  are  necessarily  of  major  importance.  Understanding  of  the  metabolism  of  bilirubin  and  the  pathophysiology  of  hyperbilirubinemia  are  crucial  to  the  prevention  of  this  condition,  as  discussed  in  this  chapter.