Kernicterus is a serious brain illness that need to be addressed immediately as it affects infants. In this article, you will learn more about the different causes, symptoms and treatments for kernicterus. Keep reading to learn more!
What is Kernicterus?
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Kernicterus is a rare disorder characterized by excessive levels of bilirubin in the blood. Also sometimes called hyperbilirubinemia, it occurs during infancy. Bilirubin is an orange or yellowish bile pigment which is made during the breakdown of red blood cells’ hemoglobin. If toxic levels of bilirubin accumulate in the brain, it can lead to a number of physical symptoms, including vomiting, fever, poor appetite and a lack of energy. Infants may also experience an absence of various reflexes or mild to severe muscle spasms. These spasms can affected the head and heels, bowing the body forward. In many cases, the condition poses life-threatening difficulties to infants.
Although 60% of newborn child have a high level of bilirubin (you might know this as jaundice), it’s still something to pay attention to, because sometimes babies can’t get rid of the substance as quickly as they need to. If the levels get too high, it can create an emergency situation.
Causes of Kernicterus
This brain illness occurs when the level of bilirubin in the blood becomes so high that it spills into the brain tissue. Think of it as severe jaundice. Common causes are:
- Damaged, underdeveloped or diseased liver
- Increased production of bilirubin
- Destruction of the red blood cells, which may occur if the blood type of the mother does not match that of the baby
- Premature births, particular those before 38 weeks of gestation
- Gilbert’s syndrome
- Blockage or obstruction of the bile duct
Some causes may have no apparent reason, and it isn’t proven that these causes alone are enough to cause kernicterus. Rh disease and other unknown factors may come into play.
Risk Factors of Kernicterus
Even though mild jaundice is common to newborns, there are some known factors that increase the risk of having a more severe form of it, or kernicterus. These risk factors include:
- When the babies are born premature, it will take a longer time for bilirubin levels to go down.
- Poor feeding prevents babies from passing food through their digestive system. Bilirubin is often removed through the stool.
- Having a family history of jaundice may be linked to other disorders, like the G6PD deficiency.
- Mother’s with O or Rh-negative blood tend to give birth to babies that have high levels of bilirubin.
Symptoms of Kernicterus
If left untreated, kernicterus can cause brain damage, so it’s important to seek help immediately if you notice any of the following symptoms:
- Changes in skin colour, particular an orange or yellow tint starting at the head
- Difficulty sleeping or waking up
- Problems eating, either from the bottle or breast
- Extreme fussiness
- Less than average dirty or wet diapers
Most cases of jaundice don’t really require treatment, but compilations can occur if it lasts too long. Brain damage will be marked by the following symptoms:
- Lack of energy or drowsiness
- A very high-pitched cry, or uncontrollable crying
- Stiffness or limpness of the whole body
- Trouble eating
- Reduced muscle tone, or muscle spasms
If brain damage is undiagnosed as a child, when they get older they may experience:
- Convulsions or seizures
- Unusual motor movement or development
- Muscle writhing and/or spasms
- Sensory problems
- Inability to gaze upward
Treatments for Kernicterus
First, the baby will be tested to diagnose the illness. A nurse or doctor will check the baby’s bilirubin levels by placing its head on a light meter. This light meter will tell them how much bilirubin is in the skin, and if the level is high, the doctor will order a bilirubin blood test.
Treatments for kernicterus are vital if the level of bilirubin is high or if the baby has additional risk factors. Treatments include:
- Making sure the baby gets enough fluids to pass the substance through their digestive system. Newborns should be going through at least 6 diapers a day, and their stool should turn from dark green to yellow.
- Phototherapy or light therapy will use a blue light on the baby’s skin to break down the bilirubin. This can be done at home or in a hospital setting, and while it’s mostly safe, it can cause side effects like a rash or loose stool.
- Blood transfusions may be done if the baby is not responding to other treatments. This is a last-resort method used to quickly lower bilirubin levels if the baby is showing signs of brain damage.