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Kernicterus

(Bilirubin Encephalopathy)

By

Kevin C. Dysart

, MD, Nemours/Alfred I. duPont Hospital for Children

Last full review/revision Mar 2021| Content last modified Mar 2021
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Kernicterus is brain damage caused by unconjugated bilirubin deposition in basal ganglia and brain stem nuclei.

Normally, bilirubin bound to serum albumin stays in the intravascular space. However, bilirubin can cross the blood-brain barrier and cause kernicterus when serum bilirubin concentration is markedly elevated (hyperbilirubinemia Neonatal Hyperbilirubinemia Jaundice is a yellow discoloration of the skin and eyes caused by hyperbilirubinemia (elevated serum bilirubin concentration). The serum bilirubin level required to cause jaundice varies with... read more ), serum albumin concentration is markedly low (eg, in preterm infants Premature Infants An infant born before 37 weeks gestation is considered premature. Prematurity is defined by the gestational age at which infants are born. Previously, any infant weighing read more ), or bilirubin is displaced from albumin by competitive binders (eg, sulfisoxazole, ceftriaxone, and aspirin; free fatty acids and hydrogen ions in fasting, septic, or acidotic infants).

Symptoms and Signs of Kernicterus

Diagnosis of Kernicterus

  • Clinical evaluation

There is no reliable test to determine the presence of kernicterus, and the diagnosis is made presumptively. A definite diagnosis of kernicterus can be made only by autopsy.

Treatment of Kernicterus

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