Kernicterus | |
---|---|
Other names | Chronic bilirubin encephalopathy,[1] kernicterus spectrum disorder (KSD),[2] bilirubin induced neurological dysfunction (BIND)[2] |
Brain MRI showing hyperintense basal ganglia lesions on T2-weighted images. | |
Specialty | Pediatrics |
Symptoms | Poor feeding, decreased activity, vomiting[1] |
Complications | Seizures, cerebral palsy, hearing loss, vision problems, intellectual disability[3][1] |
Causes | High levels of bilirubin[1] |
Risk factors | Preterm, darker skin, bruising at birth, poor feeding[3] |
Diagnostic method | Based on symptoms[1] |
Differential diagnosis | Cerebral palsy, head trauma, TORCH infections, fetal alcohol syndrome, sepsis[4] |
Prevention | Treatment of newborn jaundice[3] |
Treatment | Symptomatic and supportive care[5] |
Frequency | 0.2 to 2.7 per 100,000 newborns[6] |
Kernicterus is brain damage due to high levels of bilirubin in a baby's blood.[3] Early symptoms may include poor feeding, decreased activity, jaundice, and vomiting.[1][5] Complications may include seizures, cerebral palsy, hearing loss, vision problems, problems with teeth, and intellectual disability.[3][1]
Risk factors include preterm, darker skin, bruising at birth, Rh disease, poor feeding, and certain genetic conditions.[3][6][4] Other risks include low albumin, sepsis, and the use of certain medications like ceftriaxone and aspirin.[1] The underlying mechanism involves unbound bilirubin entering the central nervous system and resulting in toxicity to brain cells.[2] Diagnosis is suspected based on symptoms; however, can only be confirmed at autopsy.[1]
Prevention involves treating newborn jaundice with light therapy, increased milk intake, and sometimes exchange transfusion.[3] Once damage has occurred there is no specific treatment.[1] Measures at this point include symptomatic and supportive care.[5] Complications are often permanent, once they occur.[7] About 15% of newborn deaths in the developing world are the result of kernicterus.[4]
Kernicterus is relatively rare affecting about 0.2 to 2.7 per 100,000 newborns.[7][6] Males are more commonly affected than females.[6] In the United States Black babies are more commonly effected than white.[7] The condition was named in 1904 by Christian Georg Schmorl, though was described earlier in 1875 by Johannes Orth.[2]
References
edit- ^ a b c d e f g h i j "Kernicterus - Pediatrics". Merck Manuals Professional Edition. Archived from the original on 23 November 2021. Retrieved 21 March 2022.
- ^ a b c d Polin, Richard A.; Abman, Steven H.; Rowitch, David; Benitz, William E. (29 July 2021). Fetal and Neonatal Physiology E-Book. Elsevier Health Sciences. p. 1813. ISBN 978-0-323-71285-9. Archived from the original on 22 March 2022. Retrieved 21 March 2022.
- ^ a b c d e f g "What are Jaundice and Kernicterus? | CDC". Centers for Disease Control and Prevention. 11 December 2018. Archived from the original on 8 August 2016. Retrieved 23 February 2020.
- ^ a b c Reddy, DK; Pandey, S (January 2022). "Kernicterus". PMID 32644546.
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(help) - ^ a b c Kock, Joanita De; Walt, Christa Van der (2004). Maternal and Newborn Care: A Complete Guide for Midwives and Other Health Professionals. Juta and Company Ltd. p. 31-66. ISBN 978-0-7021-6402-6. Archived from the original on 2022-03-22. Retrieved 2022-03-21.
- ^ a b c d Olusanya, BO; Kaplan, M; Hansen, TWR (August 2018). "Neonatal hyperbilirubinaemia: a global perspective". The Lancet. Child & adolescent health. 2 (8): 610–620. doi:10.1016/S2352-4642(18)30139-1. PMID 30119720.
- ^ a b c Okolie, F; South-Paul, JE; Watchko, JF (1 December 2020). "Combating the Hidden Health Disparity of Kernicterus in Black Infants: A Review". JAMA pediatrics. 174 (12): 1199–1205. doi:10.1001/jamapediatrics.2020.1767. PMID 32628268.