Neonatal Jaundice

Neonatal Jaundice: Causes, Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment

• Neonatal jaundice levels vary across the body: face ≈ 5mg/dl, trunk ≈ 10mg/dl, abdomen and mid-thigh ≈ 15mg/dl, and feet ≈ 20mg/dl.
• Pathophysiology involves breakdown of heme by heme oxygenase, leading to the formation of biliverdin, which is then metabolized to bilirubin and excreted through bile into the intestine.
• Causes of jaundice may be due to overproduction or decreased conjugation and clearance of bilirubin.
• Conjugated hyperbilirubinemia may result from hepatic or non-hepatic causes, while unconjugated hyperbilirubinemia can be pathologic or physiologic.
• Hepatic causes of conjugated hyperbilirubinemia include sepsis, TORCH infection, and hepatitis A&B infections, while non-hepatic causes include galactosemia, α 1-antitrypsin deficiency, and biliary atresia, among others.
• Physiologic unconjugated hyperbilirubinemia peaks at days 4-6 in term newborns and later in preterms, rarely rising to 15mg/dl.
• Haemolytic intrinsic causes include membrane defects and enzyme abnormalities, while extrinsic causes include alloimmune causes like ABO incompatibility.
• Non-haemolytic causes of jaundice include breastfeeding jaundice, breast milk jaundice, polycythemia, sepsis, and hypothyroidism, among others.
• Kernicterus, caused by high levels of bilirubin, can lead to lethargy, hypotonia, hypertonia, and long-term sequelae like cerebral palsy and sensorineural deafness.
• Diagnosis involves clinical assessment and measuring serum bilirubin levels, with a transcutaneous bilirubinometer being a common tool.
• Phototherapy using specific light wavelengths is the most common treatment for neonatal jaundice, indicated for prophylaxis in at-risk newborns and mild to moderate unconjugated hyperbilirubinemia.
• Exchange blood transfusion (EBT) may be required in severe cases, involving the removal and exchange of blood volume with freshly donated whole blood compatible with the child and mother.

Neonatal Jaundice: Causes, Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment

• Neonatal jaundice levels vary across the body: face ≈ 5mg/dl, trunk ≈ 10mg/dl, abdomen and mid-thigh ≈ 15mg/dl, and feet ≈ 20mg/dl.
• Pathophysiology involves breakdown of heme by heme oxygenase, leading to the formation of biliverdin, which is then metabolized to bilirubin and excreted through bile into the intestine.
• Causes of jaundice may be due to overproduction or decreased conjugation and clearance of bilirubin.
• Conjugated hyperbilirubinemia may result from hepatic or non-hepatic causes, while unconjugated hyperbilirubinemia can be pathologic or physiologic.
• Hepatic causes of conjugated hyperbilirubinemia include sepsis, TORCH infection, and hepatitis A&B infections, while non-hepatic causes include galactosemia, α 1-antitrypsin deficiency, and biliary atresia, among others.
• Physiologic unconjugated hyperbilirubinemia peaks at days 4-6 in term newborns and later in preterms, rarely rising to 15mg/dl.
• Haemolytic intrinsic causes include membrane defects and enzyme abnormalities, while extrinsic causes include alloimmune causes like ABO incompatibility.
• Non-haemolytic causes of jaundice include breastfeeding jaundice, breast milk jaundice, polycythemia, sepsis, and hypothyroidism, among others.
• Kernicterus, caused by high levels of bilirubin, can lead to lethargy, hypotonia, hypertonia, and long-term sequelae like cerebral palsy and sensorineural deafness.
• Diagnosis involves clinical assessment and measuring serum bilirubin levels, with a transcutaneous bilirubinometer being a common tool.
• Phototherapy using specific light wavelengths is the most common treatment for neonatal jaundice, indicated for prophylaxis in at-risk newborns and mild to moderate unconjugated hyperbilirubinemia.
• Exchange blood transfusion (EBT) may be required in severe cases, involving the removal and exchange of blood volume with freshly donated whole blood compatible with the child and mother.

Test your knowledge of neonatal jaundice with this quiz covering causes, pathophysiology, clinical manifestations, diagnosis, and treatment. Learn about the varying jaundice levels in different body parts, the different types of hyperbilirubinemia, causes including haemolytic and non-haemolytic factors, and potential complications like kernicterus. Understand the diagnostic process, including serum bilirubin levels and transcutaneous bilirubinometer use, as well as