OBJECTIVE The objective of this study was to determine whether transcutaneous bilirubin (TcB) measurements correlate with serum total bilirubin (STB) levels in indigenous, darkly pigmented African newborns with varying degrees of skin pigmentation, some of which had developed kernicterus. METHODS Jaundiced infants who were < or =2 weeks of age and admitted to Baptist Medical Center-Eku (Eku; ...

After completing this article, readers should be able to: 1. List the risk factors for severe hyperbilirubinemia. 2. Distinguish between physiologic jaundice and pathologic jaundice of the newborn. 3. Recognize the clinical manifestations of acute bilirubin encephalopathy and the permanent clinical sequelae of kernicterus.4. Describe the evaluation of hyperbilirubinemia from birth through 3 mon...

Normal full-term infants may have transient unconjugated hyperbilirubinemia that rarely exceeds 5 mg per 100 ml during the first 3 to 5 days of life (1, 2). This so-called physiologic hyperbilirubinemia is believed to result from delayed development of the hepatic glucuronide conjugating system (3-5), particularly glucuronyl transferase (6). Numerous factors, such as hemolysis, infection, drugs...

In July 2004, the Subcommittee on Hyperbilirubinemia of the American Academy of Pediatrics (AAP) published its clinical practice guideline on the management of hyperbilirubinemia in the newborn infant 35 weeks of gestation,1 and a similar guideline was published in 2007 by the Canadian Paediatric Society.2 Experience with implementation of the AAP guideline suggests that some areas require clar...

Severe neonatal unconjugated hyperbilirubinemia, with the risk of bilirubin encephalopathy or kernicterus in severe, untreated cases, occurs when bilirubin production exceeds the body's ability to eliminate it. The causes of neonatal hyperbilirubinemia are multifactorial and comprise increased hemolysis on the one hand, and diminished bilirubin conjugation on the other. In recent years, many of...

In 1959, Gerald Odell first proposed that albumin and tissue compete for binding bilirubin and that this competition is mediated by a very low concentration of free bilirubin (Bf) (bilirubin not bound to plasma proteins). He argued that displacement of albumin-bound bilirubin by binding competitors could explain the reported high incidence of kernicterus in premature infants receiving sulfonami...