Jaundice
Yellow discoloration of skin , sclera , mucous membrane .
Serum concentration : Neonate : >
5mg / d l children : >2 -3mg Idl
4 forms of bilirubin rn plasma :
1- on conjugated . bound to albumin
" "
2- Free unbound
- , in kernietervs can cross BBB
3- Conjugated only fraction to appear on urine
, the
4- 8 fraction covalently bound to Bilirubin appear when
, ,
there is Impaired excretion of bilirubin dueeo
cong
.
dz
Hepaeo biliary .
Heme deserveiron -
→ on cong .
→ liver
Bilirubin ↳
Urobilrnogen ← Intestine ← Cong bilirubin
.
I ↳
Stool
Urine
Types of brlrrubrn : Unconjugated ( indirect ]
• Bond to albumin
• fat solvable
Incidence: • cross BBB
Term : 60% • Toxic in
High level
pre term :
-
80%
conjugated bilirubin
Bilirubin source: •
conj .
W/ Glucoronrc acid
Hb -
75% • water solvable
myoglobin -25% • Excreted rn urine & scoot
• Not toxic
, Special characters rn Neonates:
-
more bilirubin produced
- much more hemolysis
- life span RBC = -70-80 days
mechanism of Neonatal jaundice :
1- A bilirubin load 2- f conjugation rn liver 3. defective
← t ↳ excretion
Normal Hemolysis cephal
Newborn hematoma
causes:
Ise 24 hour: pathological
-
Hemolytic anemia CGGPD )
- Torch
2nd - 3rd week :
-
physiological
- breast milk
-
Sepsis
-
polycythemia
-
Cephei hematoma
> 3 weeks :
- Breast milk
-
Hypothyroid
-
pyloric stenosis
-
Yellow discoloration of skin , sclera , mucous membrane .
Serum concentration : Neonate : >
5mg / d l children : >2 -3mg Idl
4 forms of bilirubin rn plasma :
1- on conjugated . bound to albumin
" "
2- Free unbound
- , in kernietervs can cross BBB
3- Conjugated only fraction to appear on urine
, the
4- 8 fraction covalently bound to Bilirubin appear when
, ,
there is Impaired excretion of bilirubin dueeo
cong
.
dz
Hepaeo biliary .
Heme deserveiron -
→ on cong .
→ liver
Bilirubin ↳
Urobilrnogen ← Intestine ← Cong bilirubin
.
I ↳
Stool
Urine
Types of brlrrubrn : Unconjugated ( indirect ]
• Bond to albumin
• fat solvable
Incidence: • cross BBB
Term : 60% • Toxic in
High level
pre term :
-
80%
conjugated bilirubin
Bilirubin source: •
conj .
W/ Glucoronrc acid
Hb -
75% • water solvable
myoglobin -25% • Excreted rn urine & scoot
• Not toxic
, Special characters rn Neonates:
-
more bilirubin produced
- much more hemolysis
- life span RBC = -70-80 days
mechanism of Neonatal jaundice :
1- A bilirubin load 2- f conjugation rn liver 3. defective
← t ↳ excretion
Normal Hemolysis cephal
Newborn hematoma
causes:
Ise 24 hour: pathological
-
Hemolytic anemia CGGPD )
- Torch
2nd - 3rd week :
-
physiological
- breast milk
-
Sepsis
-
polycythemia
-
Cephei hematoma
> 3 weeks :
- Breast milk
-
Hypothyroid
-
pyloric stenosis
-
