Kernicterus

(Bilirubin encephalopathy)

The kernicterus is an injury to the brain caused by deposits unconjugated bilirubin in the basal ganglia and brainstem nuclei.

Normally, bilirubin is bound to serum albumin and remains in the intravascular space. but it can also cross the blood-brain barrier and cause a kernicterus, if the serum bilirubin concentration increased significantly (hyperbilirubinemia) and the serum albumin concentration is significantly decreased (z. B. in preterm infants), or the bilirubin is displaced by competitive binding of albumin (e.g. ., by sulfisoxazole, ceftriaxone, acetylsalicylic acid, free fatty acids and hydrogen ions during fasting, sepsis or acidosis).

The kernicterus is an injury to the brain caused by deposits unconjugated bilirubin in the basal ganglia and brainstem nuclei. Normally, bilirubin is bound to serum albumin and remains in the intravascular space. but it can also cross the blood-brain barrier and cause a kernicterus, if the serum bilirubin concentration increased significantly (hyperbilirubinemia) and the serum albumin concentration is significantly decreased (z. B. in preterm infants), or the bilirubin is displaced by competitive binding of albumin (e.g. ., by sulfisoxazole, ceftriaxone, acetylsalicylic acid, free fatty acids and hydrogen ions during fasting, sepsis or acidosis). Symptoms and complaints When premature babies can fail recognizable clinical symptoms of kernicterus. Early symptoms of kernicterus in term infants leads to lethargy, feeding problems and vomiting, opisthotonos, okulogyrischen crises, seizures and fatal outcome. Sequelae of kernicterus may be mental retardation, cerebral palsy choreoathetoid, sensorineural hearing loss and a vertical gaze palsy upwards in later childhood. it is unknown whether attenuated forms of kernicterus cause less serious neurological disorders (eg. as psychomotor limitations and learning difficulties). Diagnosis Clinical examination There is no reliable test that can determine the risk of kernicterus, the diagnosis can only be guessed. A definite diagnosis of bilirubin encephalopathy should be secured only by an autopsy. Therapy prevention of hyperbilirubinemia Treatment for already incurred kernicterus does not exist; he must be prevented only by the treatment of hyperbilirubinemia.

Health Life Media Team

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