Infantile cholestasis 浙江大学医学院附属儿童医院 江米足
Infantile cholestasis 浙江大学医学院附属儿童医院 江米足
Neonatal jaundice Neonatal jaundice is one of the most common conditions needing medical attention in newborn babies About 60% of term and 80% of preterm babies develop jaundice in the first week of life, and about 10% of breast fed babies are still jaundiced at age i month Neonatal jaundice is generally harmless but high concentrations of unconjugated bilirubin may occasionally cause kernicterus (permanent brain damage)
Neonatal jaundice ◼ Neonatal jaundice is one of the most common conditions needing medical attention in newborn babies. ◼ About 60% of term and 80% of preterm babies develop jaundice in the first week of life, and about 10% of breast fed babies are still jaundiced at age 1 month. ◼ Neonatal jaundice is generally harmless, but high concentrations of unconjugated bilirubin may occasionally cause kernicterus (permanent brain damage)
Physiologic jaundice Jaundice becomes visible on the 2nd-3rd day usually peaking between the 2nd and 4th days at 5-6mg/d and decreasing to below 2 mg/dl between the 5th and /th days of life 6-7 of full-term infants have indirect bilirubin levels 212.9 mg/dl and less than 3% have levels≥15mg/dl Indirect bilirubin levels in full-term infants decline to adult levels(1mg/dl) by 10-14 days of life
Physiologic jaundice ◼ Jaundice becomes visible on the 2nd-3rd day, usually peaking between the 2nd and 4th days at 5-6mg/dl and decreasing to below 2 mg/dl between the 5th and 7th days of life. ◼ 6-7% of full-term infants have indirect bilirubin levels ≥12.9 mg/dl and less than 3% have levels ≥ 15 mg/dl. ◼ Indirect bilirubin levels in full-term infants decline to adult levels (1mg/dl) by 10-14 days of life
In contrast to physiological unconjugated hyperbilirubinaemia which requires careful monitoring but is common and usually benign, the presence of significant conjugated bilirubin always indicates pathology
◼ In contrast to physiological unconjugated hyperbilirubinaemia, which requires careful monitoring but is common and usually benign, the presence of significant conjugated bilirubin always indicates pathology
Pathologic jaundice It appears in the 1st 24-36hr of life Serum bilirubin is rising at a rate faster than 5 mg/d/24hr. Serum bilirubin is 2 12 mg/dl in full-term or 10 14 mg/dl in preterm infants Jaundice persists after 10-14 days of life Direct-reacting bilirubin is 22 mg/dl at any time Among other factors suggesting a nonphysiologic cause of jaundice
Pathologic jaundice ◼ It appears in the 1st 24-36hr of life ◼ Serum bilirubin is rising at a rate faster than 5 mg/dl/24hr. ◼ Serum bilirubin is ≥ 12 mg/dl in full-term or 10- 14 mg/dl in preterm infants. ◼ Jaundice persists after 10-14 days of life. ◼ Direct-reacting bilirubin is ≥ 2 mg/dl at any time. ◼ Among other factors suggesting a nonphysiologic cause of jaundice