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Newborn diagnosed with kernicturus - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
Doctor :   Hi,
User :   Hi, . We have a 3 wk newborn who was diagnosed with jaundice at 1 wk with a billirubin level of 21.2. We are concerned about long-term damage. Kernicturus? is the only possible long-term damage, or are there other syndromes?
Doctor :   well its very common for the new borns to be jaundiced as the live will not be enough matured to take the load
Doctor :   yes kernicterus is one long term hassale but happens only when the bilirubin levels are very high
User :   How high would the level have to be in order to be concerned? This baby hit 21 as far as we know.
Doctor :   and its very common for the newborns to present with the high bilirubin levels due to the immaturity of the liver to take the load
Doctor :   21 is fine
Doctor :   need more than 30 and the baby to be sick , i mean fever aggravates the risk
User :   Let's say there actually was some damage done to the baby. What signs would we be looking for. We know that if the baby is arching his back or has a slack tone, this is something to worry about, but how much should we see these things in order to be concerned
Doctor :   its the fever and lethargy in the baby which is presented at early time s( as soon as the bilirubin enters the blood brain barrier )
Doctor :   the actual signs and symptoms are seen in the elder age
User :   What are the actual signs and symptoms that might occur later?
Doctor :   movement and language processing disorders
Doctor :   like delayed motor milesstones
Doctor :   and autism
User :   When we take the bilirubin level into account, can we say that there is effectively no crossing of the bilirubin into the brain at the level of 21, and that the crossing would only take place at a much higher level, like 30? The crossing would begin all at once, or only gradually as the level increases?
Doctor :   arching and high pitched cry now are not specific but rarely presented by babies going for kernicterus
Doctor :   the crossing is always a sudden presentation
Doctor :   always unpredictable
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