In this episode, we discuss things you’ll need to know and think about before seeing an infant with jaundice. We will focus on infants from birth to 2 months of age. We will discuss the pathophysiology of hyperbilirubinemia, the difference between unconjugated and conjugated hyperbilirubinemia, the differential diagnosis, key elements of the history and physical exam, laboratory and imaging workup, and management.

Introduction to jaundice and hyperbilirubinemia
Jaundice is the yellowing of skin, sclerae, and mucous membranes caused by hyperbilirubinemia
Hyperbilirubinemia can be further separated into unconjugated or conjugated forms, which allows us to further differentiate etiology


Review of bilirubin breakdown pathway, to include enterohepatic circulation
Unconjugated hyperbilirubinemia etiologies:
Excessive or increased production of bilirubin
Cephalohematomas
Hemolysis: ABO and Rh incompatibilities; Red Blood Cell (RBC) membrane or enzyme defects, RBC oxidative stress (secondary to sepsis, asphyxia, and acidosis)


Decreased clearance of bilirubin
Breast milk jaundice
Prematurity
Hypothyroidism
Gilbert Syndrome
Crigler-Najjar Syndrome
Suboptimal Intake Jaundice
Medications


Combination of both
Physiologic jaundice




Conjugated hyperbilirubinemia etiologies:
Always pathologic
Biliary atresia
Briefly mentioned the vast range of other etiologies: infectious, genetic, metabolic, and anatomic


Key elements of history and physical examination for a jaundiced infant
History:
Onset
Feeding patterns (what, how much/often, quality of feeding)
Urine and stool diapers
Prenatal history
Delivery history
Family history


Physical exam:<...

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