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Sunday, July 14, 2013

Kernicterus Diagnosis

Kernicterus is brain damage caused by jaundice. It occurs when the level of bilirubin (a yellow substance produced by red blood cells when they break down) is so high that it moves blood out of the brain tissue. According to the Centers for Disease Control and Prevention, 60 percent of babies have jaundice, but only those who are not treated properly develop kernicterus.

Signs and Symptoms

    Kernicterus symptoms include yellow skin within 24 hours of birth, yellowing of the eyes, difficulty waking, lethargy, weak or limp appearance, shrill and high-pitched cry, and fever. Another sign of the condition is a baby who arches his body upward while lying in bed on his back. Any of these signs and symptoms need immediate medical attention.

Risk Factors

    A baby with the following risk factors should be monitored more closely for kernicterus: a sibling who had jaundice, bruises from birth, premature birth, problems feeding or going to the bathroom in the first few days after birth, and jaundice present in the first 24 hours after birth. Babies of East-Asian or Mediterranean descent and those born to mothers with O blood types or with RH-negative factor are also more prone to the condition.

Diagnosis

    A jaundice bilirubin test is performed on a newborn to check levels of bilirubin in the blood. A light meter placed on a baby's head measures transcutaneous bilirubin levels. If levels are high, blood tests are ordered. A small blood sample will be taken from the baby's heel to measure levels of bilirubin, or total serum bilirubin, in the blood. Blood tests will be repeated to check levels during treatment to ensure levels are dropping to normal.

Treatment

    Kernicterus can be treated with light treatment (phototherapy), in which the blue color in visible light changes a toxic level of bilirubin to non-toxic in the blood, eliminating it from the body. An exchange transfusion also can remove toxic bilirubin from the blood.

Warning

    Kernicterus.org states that you should never let doctors delay treatment to redo a blood test. The treatment should be started while new tests are being run. You also should not allow them to delay or interrupt treatment to determine the risk of exchange therapy. Instead, have the tests done while the baby is under the phototherapy lights. The site also says it is imperative that doctors check a baby for signs of kernicterus and make a diagnosis based on the total serum bilirubin levels, not indirect levels. Doctors should also measure and compare levels to hour-specific norms, because different levels are appropriate for specific aged babies. It is much easier to prevent kernicterus than to treat it.

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