Etiology of jaundice secondary to unconjugated hyperbilirubemia Overproduction of bilirubin a Increased rate of hemolysis Patient with a positive Coombs test ◆ Rh incompatibility ABO blood group incompatibility Patient with negative Coombs test Abnormal red cell shapes Red cell enzyme abnormalities G-6-PD Patient with bacterial or viral sepsis a Nonhemolytic causes of increased biliurbin load e Extravascular hemorrhage ◆ Polycythemia(红细胞增多症) ◆ Exaggerated enterohepatic circulation(肠肝循环) of biliurbin
Etiology of jaundice secondary to unconjugated hyperbilirubemia Overproduction of bilirubin ◼ Increased rate of hemolysis ◆ Patient with a positive Coombs test ⧫ Rh incompatibility ⧫ ABO blood group incompatibility ◆ Patient with negative Coombs test ⧫ Abnormal red cell shapes ⧫ Red cell enzyme abnormalities G-6-PD ◆ Patient with bacterial or viral sepsis ◼ Nonhemolytic causes of increased biliurbin load ◆ Extravascular hemorrhage ◆ Polycythemia (红细胞增多症） ◆ Exaggerated enterohepatic circulation（肠肝循环）of biliurbin
Etiology of jaundice secondar to unconjugated hyperbilirubemia Decreased rate of conjugation Physiologic jaundice(生理性黄疸) Crigler-Najjar syndrome Gillbert syndrome
Etiology of jaundice secondary to unconjugated hyperbilirubemia Decreased rate of conjugation Physiologic jaundice (生理性黄疸） Crigler-Najjar syndrome Gillbert syndrome
breast jaundice Reported by arias in 1960 60th1%~2% 80th 20%( De Angelis, 1982 82%( Lascair 1986) Maisels in 1986 1250 baby 97%12.5mg/d breast feeding 157mg/dl
breast jaundice ◼ Reported by Arias in 1960 ◼ 60th 1％～2％ 80th 20％（De Angelis,1982） 82％（Lascair, 1986） ◼ Maisels in1986 1250 baby 97％ 12.5mg/dl breast feeding 15.7mg/dl
Breast jaundice ■ Manifestation: jaundice, general condition is good a diagnosis the presence of moderate unconjugated hyperbilirubinemia for 6-8 weeks in a thriving infant without evidence for hemolysis hypothyroidism, or other disease strongly suggests this breast jaundice
Breast jaundice ◼ Manifestation: jaundice，general condition is good ◼ diagnosis： the presence of moderate unconjugated hyperbilirubinemia for 6 ~ 8 weeks in a thriving infant without evidence for hemolysis, hypothyroidism, or other disease strongly suggests this breast jaundice
Hemolytic disease
Hemolytic disease