Neonatal Jaundice and Disorders of Bilirubin Metabolism

2021 ◽  
pp. 182-203
Author(s):  
Katherine M. Satrom ◽  
Glenn R. Gourley
Keyword(s):  
Neonatal Jaundice ◽  
Bilirubin Metabolism

scholarly journals Neonatal jaundice causes and management

2018 ◽  
Vol 5 (11) ◽  
pp. 4992
Author(s):  
Ruya Althomali ◽  
Renad Aloqayli ◽  
Basma Alyafi ◽  
Ahela Nono ◽  
Suhaib Alkhalaf ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Intravenous Immunoglobulins ◽  
Pharmacological Agents ◽  
Abo Incompatibility ◽  
Search Terms ◽  
Bilirubin Metabolism ◽  
Comprehensive Search ◽  
Neonates And Infants

80% of healthy neonates present with some degree of hyperbilirubinemia after birth, however, only 5-10% would require therapy to prevent damage or treat the cause of jaundice. Neonatal jaundice can be classified as physiological and pathological and can have several causes such as breast milk feeding, blood group incompatibility, hemolysis, or genetic defects of enzymes in the bilirubin metabolism pathway. We tried to understand the various types of neonatal jaundice, and also focus on its management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 2001 to March 2017. The following search terms were used: neonatal jaundice, hyperbilirubinemia, ABO incompatibility, neonatal hemolysis, kernicterus, phototherapy, exchange transfusion. Hyperbilirubinemia and jaundice are common issues encountered neonates and infants. Most cases of neonatal hyperbilirubinemia and jaundice are physiological and benign. However, some severe cases may progress to develop severe and permanent long-term complications. Therefore, early diagnosis and management is essential. Neonatal jaundice can be treated using phototherapy, pharmacological agents, intravenous immunoglobulins and exchange transfusion in severe cases.

Neonatal Bilirubin Workshop

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 537-540
Author(s):  
Lawrence M. Gartner ◽  
Charlotte S. Catz ◽  
Sumner J. Yaffe
Keyword(s):  
Neonatal Jaundice ◽  
Early Discharge ◽  
Future Research ◽  
Controversial Issues ◽  
Current State ◽  
Bilirubin Metabolism ◽  
The Family ◽  
Definition Of ◽  
Bilirubin Toxicity

A neonatal bilirubin workshop took place at The Rockefeller University on June 20 through 22, 1993 to consider controversial issues in the field of neonatal jaundice and bilirubin neurotoxicity, particularly as they relate to management. The conference was sponsored by the National Institute of Child Health and Human Development (Pregnancy and Perinatology Branch, Center for Mothers and Children), The Rockefeller University, and the Consiglio Nazionale delle Richerche (Italy). tk;4Presentations and discussion emphasized diagnosis, biochemistry, and mechanisms of bilirubin toxicity, the definition and consequences of kernicterus, and the appropriateness and safety of the various therapies currently in use. Identification of future research needs was an important agenda item. The conferees agreed that conventional management of jaundice in the newborn with phototherapy and exchange transfusion, as well as with phenobarbital in certain situations, had significantly reduced the occurrence of "traditional" kernicterus. However, the conferees acknowledged that the classical definition of kernicterus was in need of re-examination in view of the potential of bilirubin as a CNS toxin. Early discharge of newborns from the hospital has significantly altered diagnostic and therapeutic management of neonatal jaundice, transforming it into an outpatient problem. This transformation raises new questions regarding the best time to ascertain the cause(s) of jaundice and to identify risk factors to insure optimal management of the infant. Review of the current state of knowledge of bilirubin metabolism focused on new methods for measurement of unconjugated and conjugated bilirubin, measurement of bilirubin synthesis rates, the molecular biology of bilirubin conjugation and the developmental role of the family of enzymes known as glucuronyl transferase(s), and the role of genetic and other host factors in determining the safety or toxicity of bilirubin in the newborn.

scholarly journals Effect of Oncostatin M on Uridine Diphosphate-5′-Glucuronosyltransferase 1A1 through Cross Talk with Constitutive Androstane Receptor

2010 ◽  
Vol 24 (4) ◽  
pp. 745-753 ◽  
Author(s):  
Hisashi Masuyama ◽  
Hideki Nakatsukasa ◽  
Yuji Hiramatsu
Keyword(s):  
Cross Talk ◽  
Neonatal Jaundice ◽  
Constitutive Androstane Receptor ◽  
Oncostatin M ◽  
Orphan Nuclear Receptor ◽  
Uridine Diphosphate ◽  
Bilirubin Metabolism ◽  
Potential Indicator

Abstract Hyperbilirubinemia remains a common condition in neonates. The constitutive androstane receptor (CAR) is an orphan nuclear receptor that has been shown to participate in the activation of the uridine diphosphate-5′-glucuronosyltransferase 1A1 (UGT1A1) gene, which plays an important role in bilirubin clearance. Oncostatin M (OSM), a member of the IL-6 family, is involved in the maturation of fetal hepatocytes. We have demonstrated that low OSM levels are a potential indicator of neonatal jaundice and the need for phototherapy. In this study we examined the effects of OSM on CAR-mediated signaling to investigate its potential role in neonatal jaundice via the CAR-UGT1A1 pathway. We observed that OSM positively augmented the CAR and UGT1A1 expressions and CAR-mediated signaling in vivo and in vitro, through cross talk between the nuclear CAR receptor and the plasma membrane OSM receptor, via the MAPK cascade. These data suggest that OSM might play a role in bilirubin metabolism via the CAR-UGT1A1 pathway.

Mechanism of bilirubin elimination in urine: insights and prospects for neonatal jaundice

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mercy Thomas ◽  
Winita Hardikar ◽  
Ronda F. Greaves ◽  
David G. Tingay ◽  
Tze Ping Loh ◽  
...  
Keyword(s):  
Clinical Relevance ◽  
Neonatal Jaundice ◽  
Membrane Transporters ◽  
Transport Mechanisms ◽  
Inherited Disorders ◽  
Intestinal Excretion ◽  
Bilirubin Metabolism ◽  
Research Findings ◽  
Diagnostic Importance ◽  
Conjugated Bilirubin

AbstractDespite a century of research, bilirubin metabolism and the transport mechanisms responsible for homeostasis of bilirubin in serum remain controversial. Emerging evidence on the hepatic membrane transporters and inherited disorders of bilirubin metabolism have contributed to a greater understanding of the various steps involved in bilirubin homeostasis and its associated excretory pathways. We discuss these recent research findings on hepatic membrane transporters and evaluate their significance on the newborn bilirubin metabolism and excretion. New insights gained speculate that a proportion of conjugated bilirubin is excreted via the renal system, as an alternative to the intestinal excretion, even in normal physiological jaundice with no associated pathological concerns. Finally, this paper discusses the clinical relevance of targeting the altered renal excretory pathway, as bilirubin in urine may hold diagnostic importance in screening for neonatal jaundice.

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