Perspective on Neonatal Hyperbilirubinemia

D. Sheriff, A. Jarari
{"title":"Perspective on Neonatal Hyperbilirubinemia","authors":"D. Sheriff, A. Jarari","doi":"10.4314/IJMU.V6I1.63976","DOIUrl":null,"url":null,"abstract":"Jaundice in newborns provides a different response from the parents when compared to jaundice in older children and adults. Physiologic hyperbilirubinemia occurs commonly in term newborn infants in the absence of any underlying pathologic cause. Yet, the jaundice itself is commonly regarded as a problem in the transition to extrauterine life. In Neonatal hyperbilirubinemia (NHB) the total bilirubin level is greater than 15mg/dL in 15 day or less old neonates and 2mg/dL in neonates above 15 days of age. Estimation of total bilirubin is preferred in the routine analyses for NHB compared to measurement of direct bilirubin. If certain conditions like sepsis, hepatic infections and other liver diseases are present it may be prudent to use direct bilirubin measurement. Yet contrary to the usual assumption of pathology, there are several lines of evidence supporting an adaptive role for neonatal hyperbilirubinemia. First, experimental and clinical evidence indicate that neonatal enzyme systems are not yet mature at birth; bilirubin has been demonstrated to scavenge potentially toxic oxygen free radicals that in later life are removed by the mature antioxidant enzyme system. Second, presence of bilirubin in mammals, similar patterns of expression of neonatal hyperbilirubinemia in nonhuman primates, and significant inter population variation in newborn serum bilirubin levels among humans all suggest that bilirubin production, metabolism, and excretion are under genetic control. Therefore bilirubin metabolism and its understanding may help improve its diagnosis and prognosis.","PeriodicalId":14472,"journal":{"name":"Internet Journal of Medical Update - EJOURNAL","volume":"15 1","pages":"44-50"},"PeriodicalIF":0.0000,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internet Journal of Medical Update - EJOURNAL","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4314/IJMU.V6I1.63976","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

Abstract

Jaundice in newborns provides a different response from the parents when compared to jaundice in older children and adults. Physiologic hyperbilirubinemia occurs commonly in term newborn infants in the absence of any underlying pathologic cause. Yet, the jaundice itself is commonly regarded as a problem in the transition to extrauterine life. In Neonatal hyperbilirubinemia (NHB) the total bilirubin level is greater than 15mg/dL in 15 day or less old neonates and 2mg/dL in neonates above 15 days of age. Estimation of total bilirubin is preferred in the routine analyses for NHB compared to measurement of direct bilirubin. If certain conditions like sepsis, hepatic infections and other liver diseases are present it may be prudent to use direct bilirubin measurement. Yet contrary to the usual assumption of pathology, there are several lines of evidence supporting an adaptive role for neonatal hyperbilirubinemia. First, experimental and clinical evidence indicate that neonatal enzyme systems are not yet mature at birth; bilirubin has been demonstrated to scavenge potentially toxic oxygen free radicals that in later life are removed by the mature antioxidant enzyme system. Second, presence of bilirubin in mammals, similar patterns of expression of neonatal hyperbilirubinemia in nonhuman primates, and significant inter population variation in newborn serum bilirubin levels among humans all suggest that bilirubin production, metabolism, and excretion are under genetic control. Therefore bilirubin metabolism and its understanding may help improve its diagnosis and prognosis.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
对新生儿高胆红素血症的看法
新生儿的黄疸与年龄较大的儿童和成人的黄疸相比,父母的反应不同。生理性高胆红素血症常见于没有任何潜在病理原因的足月新生儿。然而,黄疸本身通常被认为是过渡到子宫外生活的一个问题。在新生儿高胆红素血症(NHB)中,总胆红素水平大于15mg/dL的15天或更少的新生儿和2mg/dL的15天以上的新生儿。与直接胆红素测量相比,在NHB的常规分析中,总胆红素的估计是首选。如果某些情况,如败血症,肝脏感染和其他肝脏疾病的存在,可能是谨慎的使用直接胆红素测量。然而,与通常的病理学假设相反,有几条证据支持新生儿高胆红素血症的适应性作用。首先,实验和临床证据表明新生儿酶系统在出生时尚未成熟;胆红素已被证明可以清除潜在的有毒氧自由基,这些自由基在晚年被成熟的抗氧化酶系统清除。其次,哺乳动物中胆红素的存在,非人灵长类动物中新生儿高胆红素血症的相似表达模式,以及人类新生儿血清胆红素水平在种群间的显著差异,都表明胆红素的产生、代谢和排泄受遗传控制。因此,了解胆红素代谢及其作用有助于改善该病的诊断和预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Editorial: An overview of gamblers anonymous Herpes encephalitis in an elderly immunocompetent lady – A case report Traumatic long bone fractures in children seen in a metropolitan tertiary hospital in Enugu, Nigeria Laparoscopic colorectal cancer surgery - a prospective study of short-term outcomes of consecutive cases over 3 years Editorial : Plagiarism
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1