Neonatal hyperbilirubinemia, acute bilirubin encephalopathy and Kernicterus: The conti-nuum is still valid in the 21st century

Abstract

Pediatr (Asunción RESUMENAunque la ictericia afecta a más de la mitad de los neonatos en la primera semana de vida, sólo un grupo de ellos pueden desarrollar hiperbilirrubinemia severa y estar en riesgo de desarrollar encefalopatía bilirrubínica. La afectación neurológica puede presentarse con un cuadro agudo (la encefalopatía bilirrubínica aguda), la cual puede o no progresar a una forma crónica (Kernicterus), o con una constelación de síntomas sensoriales, motores y cognitivos, subagudos o crónicos, dependiendo de la presencia de factores de riesgo que aumentan la susceptibilidad al daño neurológico. La bilirrubina libre interactúa con citoquinas inflamatorias y es la responsable del daño neuronal y de las células de la glía en el sistema nervioso central. A pesar de las diferentes medidas de prevención de hiperbilirrubinemia severa, se siguen reportando casos de Kernicterus sobre todo en países en vías de desarrollo, en algunos de los cuales constituyen un problema de salud pública.Palabras claves: Hiperbilirrubinemia neonatal; encefalopatía bilirrubínica; Kernicterus; ictericia. ABSTRACTAlthough jaundice affects more than half of infants in the first week of life, only a few of them develop severe hyperbilirubinemia and are at risk of developing bilirubin encephalopathy. Neurological involvement may occur acutely (acute bilirubin encephalopathy,) which may or may not progress to a chronic form (Kernicterus), or with a constellation of sensory, motor and cognitive, subacute or chronic symptoms, depending on the presence of risk factors that increase susceptibility to neurological damage. Free bilirubin interacts with inflammatory cytokines and is responsible for neuronal and glial cell damage in the central nervous system. Despite different methods to prevent severe hyperbilirubinemia, Kernicterus cases continue to be reported, especially in developing countries, including some where this condition constitutes a public health problem.

Diagnosis and Treatment of Late Jaundice in Late Preterm and Term Newborns: An Integrative Literature Review / Diagnóstico E Tratamento Da Icterícia Tardia Em Recém-Nascidos Prematuros Tardios E a Termo: Uma Revisão Integrativa De Literatura

“…Suganthi, Gokul (2016) 17 Experimental 181 Despite being a frequent change, neonatal jaundice has still been underrated. Early hospital discharge, lack of an accurate diagnosis, follow-up and adequate treatment have been the main causes of the resurgence of complications 27,28 .…”