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Kernicterus:     more detail

Bilirubin guideline stresses increased awareness: would prevent kernicterus.(Clinical Rounds): An article from: Pediatric News by Norra MacReady, 2004-08-01 KERNICTERUS. Report based on a symposiun held at the IX INTERNATIONAL CONGRESS OF PAEDIATRICS, Montreal, July 1959. by Andrew Sass-Lortsak, 1961 LETTERS.(The Real Cause of Kernicterus)(Just Walk On Out)(Tedious Committee Meetings)(Letter to the Editor): An article from: Pediatric News Pathology of Kernicterus and Posticteric Encephalopathy: Presentation of 87 Cases, with a Consideration of Pathogenesis and Etiology (AMAERICAN ACADEMY FOR CEREBRAL PALSY) by WEBB HAYMAKER, 1961 Investigational drug looks good for hyperbilirubinemia: FDA panel debate.(Children's Health)(stannsoporfin): An article from: Family Practice News by Michele G. Sullivan, 2004-02-15 AAP Is Revising Hyperbilirubinemia Guidelines.: An article from: Pediatric News by Sally Koch Kubetin, 2001-10-01 Cry analysis in infants with Rh haemolytic disease (Acta paediatrica Scandinavica) by Maila Koivisto, 1987

lists with details

1. Neonatology On The Web: Kernicterus
   Teaching Files kernicterus. Division California. kernicterus is the termfor damage and staining of the brain tissue by unconjugated bilirubin.  
   http://www.neonatology.org/syllabus/kernicterus.html
   
   Extractions: Kernicterus Division of Neonatology, Cedars-Sinai Medical Center, Los Angeles, California. Kernicterus is the term for damage and staining of the brain tissue by unconjugated bilirubin. The basal ganglia, globus pallidus, putamen, and caudate nuclei are most intensely affected, but cerebellar and bulbar nuclei as well as white and gray matter of the cerebral hemispheres may also be involved. If the affected infants survives the neonatal period and subsequently dies, the yellow staining may no longer be present, but the basal ganglia will display microscopic evidence of cell injury, neuronal loss, and glial replacement. Bilirubin encephalopathy, presumably caused by kernicterus, is the term reserved for (1) the acute syndrome of stupor, hypertonia, and fever in the newborn with marked hyperbilirubinemia, (2) the chronic syndrome of neurologic sequelae observed following marked hyperbilirubinemia, which includes athetosis, gaze disturbance, and hearing loss. Approximately half of the infants with kernicterus observed at autopsy also have extraneural lesions of bilirubin toxicity. These include necrosis of renal tubular cells, intestinal mucosa, and pancreatic cells in association with intracellular crystal of bilirubin. Gastrointestinal hemorrhage may accompany these lesions. Although the diagnosis of kernicterus at autopsy has always relied on grossly yellow staining of the brain tissue and accompanying neuronal necrosis, animal studies have suggested that significant functional impairment of brain may result from hyperbilirubinemia even when there is no obvious staining or histologic evidence of cell damage.

2. Kernicterus, National Center On Birth Defects And Developmental Disabilities, CD
   FAQs about kernicterus. What is kernicterus? kernicterus is a type of brain damage that causes athetoid cerebral palsy  
   http://www.cdc.gov/ncbddd/dd/kernicterus.htm
   
   Extractions: Kernicterus is a type of brain damage that causes athetoid cerebral palsy and hearing loss. It also causes problems with vision and teeth and sometimes can cause mental retardation. In some newborn babies, the liver makes too much yellow pigment called bilirubin. When too much bilirubin builds up in a new baby's body, the skin and whites of the eyes turn yellow. This yellow coloring is called jaundice. Jaundice is very common in newborn babies and usually goes away by itself. A little jaundice is not a problem, but a few babies have too much jaundice. If not treated, high levels of bilirubin can damage the brain. Who can develop kernicterus? Any baby with untreated jaundice is at risk for kernicterus. This does not mean that every baby with yellow skin will have brain damage. Most babies with jaundice get better by themselves. If their skin is very yellow, they might need phototherapy treatment. If phototherapy does not lower the baby's bilirubin levels, the baby may need an exchange transfusion. Does jaundice always cause a problem?

3. Newborn Genitalia Exam
   Offers the pathophysiology, symptoms and signs and prognosis.  
   http://www.fpnotebook.com/NIC30.htm
   
   Extractions: Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Neonatology Examination Birth ... Ortolani Test Assorted Pages Neonatal Advanced Life Support Neonatal Airway Assessment Neonatal Breathing Assessment Neonatal Circulation Assessment ... Newborn Genitalia Exam Newborn Genitalia Exam Genitourinary Examination in Infants Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Neonatology Index Birth Dermatology Otolaryngology Examination Ophthalmology Fluids, Electrolytes, and Nutrition Gastroenterology Hematology and Oncology Infectious Disease Laboratory General Pulmonology Neurology Orthopedics Pharmacology Premature Surgery Page Examination Index ABC ABC Airway ABC Breathing ABC Circulation ABC Perfusion Approach Birth Apgar CV CV Cyanosis Derm Dubowitz Endo ENT ENT Hearing Eye GI Neuro Neuro Fontanelle Neuro Head Circumference Neuro Reflexes Ortho Ortho Ortolani Urology Female: Common normal findings Labia minora and Clitoris prominent Vaginal skin tag Mucoid discharge Male: Abnormal findings Undescended Testes (more common in premature infants) Communicating Hydrocele Inguinal Hernia (complicates Communicating Hydrocele Hypospadias (with or without

4. Kernicterus
   Premature infants are particularly prone to kernicterus. Excess bilirubin produces signs of jaundice and high levels of  
   http://www.babyzone.com/drnathan/K/Kernicterus.htm
   
   Extractions: Damage to the brain from high bilirubin levels in the blood. When bilirubin finds its way into brain cells it paralyzes the energy producing mechanisms causing the cells to die. Premature infants are particularly prone to kernicterus. Excess bilirubin produces signs of jaundice and high levels of bilirubin in the first few days of life. The baby also becomes progressively inactive, sometimes adopting a characteristic posture with arched back and neck. Without treatment, the baby is likely to die at the end of the first week of life. Kernicterus is completely preventable if jaundice is treated adequately. [drnathan/sitedex.htm] [drnathan/right.htm]

5. EMedicine - Kernicterus : Article By Shelley C Springer, MD, MBA, MSc
   Background Traditionally, the term kernicterus (literally yellow kern, with kern indicating the most commonly afflicted  
   http://www.emedicine.com/ped/topic1247.htm
   
   Extractions: (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Neonatology Last Updated: February 14, 2003 Rate this Article Email to a Colleague Synonyms and related keywords: acute bilirubin encephalopathy, chronic postkernicteric bilirubin encephalopathy, chronic bilirubin encephalopathy, profound pathologic hyperbilirubinemia AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Shelley C Springer, MD, MBA, MSc , Medical Director of Neonatal Intensive Care Unit, Hennepin County Hospital; Assistant Professor, Department of Pediatrics, University of Minnesota-Twin Cities Coauthor(s): David J Annibale, MD , Director of Fellowship Training Program in Neonatal-Perinatal Medicine, Associate Professor, Department of Pediatrics, Medical University of South Carolina Shelley C Springer, MD, MBA, MSc, is a member of the following medical societies: American Academy of Pediatrics American Medical Association Minnesota Medical Association National Perinatal Association , and South Carolina Medical Association Editor(s): Oussama Itani, MD

6. MEDLINEplus Medical Encyclopedia: Rh Incompatibility
   An extensive look at kernicterus, including a description, the causes, incidence and risk factors.  
   http://www.nlm.nih.gov/medlineplus/ency/article/001600.htm
   
   Extractions: Skip navigation Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Contents of this page: Erythroblastosis fetalis, photomicrograph Jaundice infant Antibodies Exchange transfusion - series Alternative names Return to top Kernicterus; Rh-induced hemolytic disease of the newborn; Hydrops fetalis Definition Return to top Rh incompatibility is a condition which develops when there is a difference in Rh blood type between that of the pregnant mother (Rh negative) and that of the fetus (Rh positive). Causes, incidence, and risk factors Return to top During pregnancy , red blood cells from the fetus can get into the mother's bloodstream as she nourishes her child through the placenta. If the mother is Rh negative, her system cannot tolerate the presence of Rh positive red blood cells. In such cases, the mother's immune system treats the Rh positive fetal cells as if they were a foreign substance and makes antibodies against the fetal blood cells. These anti-Rh antibodies may cross the placenta into the fetus, where they destroy the fetus' circulating red blood cells.

7. Haemolytic Jaundice
   of placental removal of bilirubin, but following birth the rapidly rising SBR places the baby at risk of kernicterus.  
   http://www.cs.nsw.gov.au/rpa/neonatal/html/newprot/rhesus.htm
   
   Extractions: Haemolytic Jaundice Rhesus isoimmunisation Rh-negative mothers who have become sensitised to the D-antigen in an Rh-positive fetus develop anti-D antibodies which can cross the placenta and attack the blood of Rh-positive fetuses in subsequent pregnancies. This leads to the condition usually referred to as Rhesus Isoimmunisation , but also referred to as Haemolytic Disease of the Newborn and Erythroblastosis fetalis . This condition primarily involves haemolysis of red blood cells before and after birth. In severe cases fetal anaemia develops, causing congestive cardiac failure ("hydrops fetalis"). The other consequence of haemolysis is release of haemoglobin which is rapidly converted to unconjugated bilirubin (SBR). The fetus is protected because of placental removal of bilirubin, but following birth the rapidly rising SBR places the baby at risk of kernicterus The incidence of Rhesus isoimmunisation has dramatically declined since the implementation of prophyaxis (treatment of Rh-negative mothers with anti-D antibody following birth of an Rh- positive baby, or in association with miscarriages, termination, ectopic pregnancies and other invasive proceedures). Once very common, we now treat about only 5 cases/year. Factors which increase the risk of kernicterus for a given SBR level include:

8. CHAPTER_THREE
   kernicterus (Bilirubin encephalopathy) is an acquired metabolic encephalopathy of the neonatal period.  
   http://www.akronchildrens.org/neuropathology/CHAPTER_THREE.html
   
   Extractions: ASPHYXIA AND HYPOXIC-ISCHEMIC ENCEPHALOPATHY In adults, the brain is about two percent of body weight and receives about fifteen percent of the cardiac output. In term babies, it is ten percent of body weight and uses energy not only to maintain electrical activity but also for growth. Thus, the neonatal brain is even more critically dependent on perfusion and oxygenation . Hypoxic-ischemic encephalopathy (HIE) in the perinatal period has many causes. Placental pathology can impair the exchange of gases across the placenta prenatally. During labor, placental abruptio and cord accidents impair fetal perfusion and oxygenation. The effects of HIE can be compounded by traumatic lesions caused by compression of the fetal head and hyperextension of the fetal neck. Postnatally, hyaline membrane disease, persistent fetal circulation, and congenital heart disease impair oxygenation, and heart failure and shock impair cerebral perfusion. Blood loss from intraventricular hemorrhage, subcapsular hematomas of the liver and other causes may be significant. Examination of the placenta is crucial in order to determine the cause of perinatal HIE, but even after placental examination, the cause often remains unclear. The nonspecific term

9. Kernicterus
   Issue 4 December 1929. Abstract. kernicterus. J. Gerrard  
   http://www3.oup.co.uk/jnls/supplements/braini/hdb/Volume_52/Issue_04/520526.sgm.

10. NORD - Kernicterus
    Offers synonyms, a general discussion and further resources.  
    http://www.stepstn.com/cgi-win/nord.exe?proc=GetDocument&rectype=0&recnu

11. Kernicterus In Full-Term Infants --- United States, 1994--1998
    kernicterus in FullTerm Infants - United States, 19941998. kernicterus dysplasia.kernicterus was diagnosed at age 6 months.  
    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5023a4.htm
    
    Extractions: Kernicterus is a preventable life-long neurologic syndrome caused by severe and untreated hyperbilirubinemia during the neonatal period. High levels of bilirubin are toxic to the developing newborn. In full-term infants, hyperbilirubinemia symptoms include severe jaundice, lethargy, and poor feeding. Features of kernicterus may include choreoathetoid cerebral palsy, mental retardation, sensorineural hearing loss, and gaze paresis. Kernicterus is not a reportable condition in the United States, and its prevalence is unknown; however, a pilot registry at a Pennsylvania hospital documented 90 cases in 21 states from 1984 to June 2001 (L. Johnson, Pennsylvania Hospital, Philadelphia, personal communication, 2001). This report summarizes case histories of four full-term, healthy infants who developed kernicterus and underscores that to prevent kernicterus, newborns must be screened and promptly treated for hyperbilirubinemia ( In early 2001, a national support group for parents of children with kernicterus conducted a survey on kernicterus. A convenience sample of 15 families was identified by word-of-mouth or through the Internet, and a self-administered questionnaire was mailed. For this report, a case was defined as a child in whom kernicterus (

12. Kernicterus
    kernicterus, by Tracy K. Lischer, Esq. The disorder is called kernicterus, andit arises when yellow jaundice is not diagnosed and treated appropriately.  
    http://www.alllaw.com/articles/personal_injury/article17.asp
    
    Extractions: Find A Lawyer Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Calculators Child Support DWI Home Legal Topics ... Personal Injury KERNICTERUS by Tracy K. Lischer, Esq. Doctors, parents, and lawyers need to be alerted to the re-emergence of a preventable medical disorder that is once again affecting children. The disorder is called kernicterus, and it arises when yellow jaundice is not diagnosed and treated appropriately. The hallmark of kernicterus is cerebral palsy. Now that new mothers and their babies are discharged at 48 hours or less, before jaundice has peaked, cerebral palsy from this cause is on the rise. Before aggressive early discharge, this disorder had been virtually eradicated. For younger pediatricians, seeing a patient with full-blown diagnosed kernicterus is like seeing a patient with polio; they never thought it would happen.

13. Nonphysiologic Neonatal Jaundice
    kernicterus Bilirubin Toxicity. Book, Home Page.  
    http://www.fpnotebook.com/NIC38.htm
    
    Extractions: Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Neonatology Gastroenterology Assorted Pages Jaundice in Newborns Breast Feeding Jaundice Neonatal Jaundice Causes Nonphysiologic Neonatal Jaundice ... Hepatomegaly in Newborns Nonphysiologic Neonatal Jaundice Non-physiologic Neonatal Hyperbilirubinemia Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Neonatology Index Birth Dermatology Otolaryngology Examination Ophthalmology Fluids, Electrolytes, and Nutrition Gastroenterology Hematology and Oncology Infectious Disease Laboratory General Pulmonology Neurology Orthopedics Pharmacology Premature Surgery Page Gastroenterology Index Jaundice Jaundice Physiologic Breast Feeding Jaundice Causes Jaundice NonPhysiologic Jaundice Nonphysiologic Kernicterus Jaundice Management Exchange Transfusion Jaundice Management Phototherapy Umbilicus Umbilicus Granuloma Umbilicus Urachal Anomaly See Also Neonatal Jaundice Criteria Jaundice in first 24 hours of life Serum Bilirubin Direct Bilirubin Term Infant Serum Bilirubin Jaundice persists longer than 1 week Except in Breast Feeding Jaundice Preterm Infant Serum Bilirubin Jaundice persist longer than 2 weeks

14. EMedicine - Kernicterus : Article Excerpt By: Shelley C Springer, MD, MBA, MSc
    Excerpt from kernicterus. Synonyms, Key Words Please click here to viewthe full topic text kernicterus. Background Traditionally, the  
    http://www.emedicine.com/ped/byname/kernicterus.htm
    
    Extractions: (advertisement) Synonyms, Key Words, and Related Terms: acute bilirubin encephalopathy, chronic postkernicteric bilirubin encephalopathy, chronic bilirubin encephalopathy, profound pathologic hyperbilirubinemia Background: Traditionally, the term kernicterus (literally yellow kern, with kern indicating the most commonly afflicted region of the brain, ie, the nuclear region) refers to an anatomic diagnosis made at autopsy based on a characteristic pattern of staining found in babies who had marked hyperbilirubinemia before they succumbed. Regions most commonly affected include the basal ganglia, hippocampus, geniculate bodies, and cranial nerve nuclei, such as the oculomotor, vestibular, and cochlear. The cerebellum can also be affected. Acute bilirubin encephalopathy, which refers to the clinical signs associated with bilirubin toxicity, ie, hypotonia followed by hypertonia, opisthotonus or retrocollis, or both, is usually synonymous with kernicterus. Prevalent in the 1950s and 1960s, kernicterus had virtually disappeared from the clinical scene, only to reappear during the 1990s. Early discharge of term infants (before their bilirubin peaks) may be a factor in the reemergence of this devastating neurologic affliction.

15. Katalog - Wirtualna Polska
    Serwis Katalog w Wirtualna Polska S.A. pierwszy portal w Polsce.  
    http://katalog.wp.pl/DMOZ/Health/Conditions_and_Diseases/Neurological_Disorders/

16. Kernicterus
    HOME kernicterus (Bilrubin Toxicity, Hemolytic Disease of the Newborn). PediatricPathology (Includes a Photo); kernicterus; Hemolytic Disease of the Newborn;  
    http://www.bdid.com/kernicterus.htm

17. Kernicterus
    kernicterus. kernicterus is the technical name for the specific form of braindamage due to excessive levels of bilirubin in the bloodstream.  
    http://www.drhull.com/EncyMaster/K/kernicterus.html
    
    Extractions: Help for sleepless parents Encyclopedia Index K kernicterus Search kernicterus Ordinarily, substances toxic to the brain cells are kept safely bottled up in the bloodstream by the which relates to the fact that the lining cells of the blood vessels of the brain are very selective about what substances they allow to pass from the bloodstream into the brain tissue. Certain toxic substances, and even many drugs, are thus excluded from the brain tissue. bilirubin (the waste product of hemoglobin breakdown from old red blood cells) can harm the brain. This waste product selectively stains and damages the part of the brain known as the basal ganglia. These areas control the fluidity of muscle movement. Kernicterus is the technical name for the specific form of brain damage due to excessive levels of bilirubin in the bloodstream. Because of this dreadful possibility, jaundice in babies is monitored closely. There is no absolute level of jaundice that is guaranteed to be dangerous, but intervention (either phototherapy or exchange transfusion Because the damage inflicted by excessive bilirubin concentrations is directed chiefly against the basal ganglia and other areas of the brain (hippocampus, geniculate bodies, various brainstem nuclei, and the cerebellum) with their crucial role in controlling motor movement - kernicterus was once the leading cause of athetoid (writhing)

18. Kernicterus & Newborn Jaundice
    Introduction Jaundice and kernicterus Jaundice. kernicterus. kernicterusis a form of brain damage caused by excessive jaundice.  
    http://www.kernicterus.org/
    
    Extractions: Introduction: Jaundice and Kernicterus Jaundice About 60% of newborn infants in the United States are jaundiced, that is they look yellow. Jaundice is the yellow coloring of the skin and other tissues. Jaundice can often be seen well in the sclera, the "whites" of the eyes, which look yellow. Many many babies look jaundiced (60%), but they are not deeply jaundiced, not jaundiced below the abdomen, and they act OK - they nurse, they aren't too sleepy, they have normal muscle tone, their cry is normal, they don't arch their backs. Kernicterus Information for Parents: The Jaundiced Baby Jaundice in Newborns and its Treatment About 60% of newborn infants in the United States are jaundiced, that is they look yellow. Excessive jaundice in newborn infants may cause brain damage. Jaundice is caused by a high level of bilirubin in the blood (hyperbilirubinemia) and tissues. When bilirubin gets too high it can be treated. Norms exist for bilirubin in term and nearly term babies based on the age in hours after birth. Other factors, such as prematurity, blood group incompatibilities between infant and mother including Rh and ABO blood types, and bruising, especially cephalohematomas and caputs, can increase bilirubin production and lead to excessive jaundice.

19. Kernicterus Lawsuit News Find Trial Lawyers And Attorneys For
    InjuryBoard News kernicterus Find trial lawyers and attorneys with experiencein lawsuits involving kernicterus. kernicterus. Need More? , Ask an Attorney.  
    http://www.injuryboard.com/lvlTwoInjury.cfm?varFrom=SearchResults&Injury2ID=117

20. Kernicterus Information Page Diseases Database
    kernicterus Information Page. kernicterus Gokernicterus specific sites. GoSendkernicterus to medical search engines (JavaScript enabled browsers only).  
    http://www.diseasesdatabase.com/sieve/item1.asp?glngUserChoice=7161

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