Kernicterus
290448
214089393
2008-05-22T01:26:59Z
209.11.191.1
Added BiliTool as external link
{{Infobox_Disease |
Name = {{PAGENAME}} |
Image = Bilirubin.svg |
Caption = [[Bilirubin]] |
DiseasesDB = 7161 |
ICD10 = {{ICD10|P|57||p|50}} |
ICD9 = {{ICD9|773.4}}, {{ICD9|774.7}} |
ICDO = |
OMIM = |
MedlinePlus = 003243 |
eMedicineSubj = ped |
eMedicineTopic = 1247 |
MeshID = D007647 |
}}
'''Kernicterus''' is damage to the brain centers of infants caused by increased levels of unconjugated-indirect [[bilirubin]] which is free (not bound to albumin). This may be due to several underlying pathologic processes. Newborn babies are often [[polycythemic]], meaning they have too many [[red blood cell]]s. When they break down the cells, one of the byproducts is [[bilirubin]], which circulates in the blood and causes [[Neonatal_jaundice|jaundice]]. Alternately, Rh incompatibility between mother and fetus may cause [[hemolysis]] of fetal red blood cells, thereby releasing unconjugated bilirubin into the fetal blood. Since the fetal [[blood brain barrier]] is not fully formed, some of this released bilirubin enters the brain and interferes with normal neuronal development.
Kernicterus may also be found in infants as a symptom of [[Crigler-Najjar syndrome]] type I, a hereditary hyperbilirubinemia that is fatal within 18 months of life.
In adults and older children, jaundice is harmless in and of itself. However, the tissues protecting the brain (the [[blood-brain barrier]]) are immature in newborns. Bilirubin penetrates the brain and is deposited in the [[basal ganglia]], causing irreversible damage. Depending on the level of exposure, the effects range from unnoticeable to severe [[brain damage]].
Some medications, such as the antibiotic [[co-trimoxazole]] (a combination of [[trimethoprim]]/[[sulfamethoxazole]]) may induce this disorder in the baby either when taken by the mother or given directly to the baby. Due to displacement of [[bilirubin]] from binding sites on [[serum albumin]]. The [[bilirubin]] is then free to pass into the [[Central Nervous System]], because the baby's [[blood-brain barrier]] is not fully developed.
== External links ==
*[http://bilitool.org BiliTool - Hyperbilirubinemia Risk Assessment for Newborns]
*[http://www.cdc.gov/ncbddd/dd/kernichome.htm CDC’s National Center on Birth Defects and Developmental Disabilities]
* [http://www.pickonline.org/ PICK - Parents of Infants and Children with Kernicterus]
{{Certain conditions originating in the perinatal period}}
[[Category:Neurology]]
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