If untreated, severe jaundice can cause hearing loss, mental retardation, cerebral palsy, kernicterus
and even death.
ID faces the dilemma that among the cases so diagnosed, causes can be identified only in 25%.7 These can be attributed to autosomal recessive chromosomal disorders.8 Genetic, acquired, socio-demographic and cultural factors are also highly associated with ID.9 Consanguinity is associated predominantly with undiagnosed cases.10 Prenatal, perinatal causes in mothers and perinates like low birth weight (LBW), asphyxia, delayed cry, anoxia, trauma and kernicterus
at the time of birth and postnatal causes in infants have a considerable share as well.10 Early initiation, exclusivity and duration of breastfeeding have an impeccable impact on the IQ scores and academic performance of children.11
Trends in hospitalizations for neonatal jaundice and kernicterus
in the United States, 1988-2005.
As high levels of unconjugated bilirubin can cause neurological damage (kernicterus
) due to its high fat solubility, it is very important to identify the cause for jaundice in neonates (1).
In some circumstances, such as ABO and Rh group incompatibility, hypothyroidism, glucose-6-phosphate dehydrogenase deficiency, or urinary tract infection, the bilirubin level may reach pathological levels and result in severe sequelae such as kernicterus
.9 Almost all the cases included in the study are in the neonatal period and none had pathological jaundice.
 In some cases, the aetiology of CP is not known, however, some common identifiable causes include birth asphyxia, severe jaundice/ kernicterus
, infections, neonatal seizures, prematurity and low birth weight.
Trimethoprim-sulfamatholxazole and nitrofurantoin should NOT be used in the neonate because of the respective risk of kernicterus
and hemolytic anemia.
Age Sex Risk factor for Imaging OAE (Years) hearing loss 1 1.5 M Nil Normal Present 2 2 M Neonatal Normal Present kernicterus
3 2 M Family history Bulbous internal Present auditory canal 4 3 M Neonatal jaundice Normal Present 5 3 M Neonatal jaundice Normal Present 6 4 F Nil Normal Present 7 5 F Nil Normal Present 8 6 M Nil Normal Present 9 6 M Nil Normal Present 10 6 M Nil Normal Present Sr.No.
In the neonatal period, it is especially important to prevent hyperbilirubinemia in order to protect the brain from kernicterus
. Anemia often needs to be treated with blood transfusion.
Mas, em alguns casos, os niveis de bilirrubina podem ficar extremamente elevados, aumentando o risco da lesao neurologica, kernicterus
Hyperbilirubinemia often results in kernicterus
with its attendant medical, economic, and social burden on the patients, families, and societies [6, 7].
The delay in treatment caused the boy to suffer severe kernicterus
- a very rare type of brain damage that occurs in a newborn with severe jaundice.