Neonate With Prolonged Unconjugated Hyperbilirubinemia

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Neonatal Hyperbilirubinemia

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
A 14 old male neonate having prolonged unconjugated hyperbilirubinemia was brought to me. His birth history was normal, he was born at 37 completed weeks by elective LSCS for maternal indication. baby was normal and no resuscitation was required. On day 2 of life he has icterus upto chest and on day 3 it progressed upto limbs. There was no ABO or Rh incompatibility, no family history of hemolytic disease, no s/o hypothyroidism. so sr bili was done which was15.2 mg with d.9 and indirect of 14.3 his hb was18 with tlc was n, so he was given photo therapy for 60 hours after which sr bili was 6 with d of 0.8 and id of 5.2. on f/u on d13 of life he was still having icterus with normal weight gain and investigations were showing sr bili of15.2 with d 0.9 and id 14.3 mg , his hb was17.7 gms ,sgpt 13, cpr neg, ps was normocytic normochromic so he was given a trial a of top feed for 36 hours after which his sr bili was14.1 with d of 1.1 and id of 13 mg. WHAT ARE OTHER PROBABLE CAUSES? HOW SHOULD HE BE INVESTIGATED AND TREATED FURTHER?IS THERE ANY ROLE OF PHENOBARB IN MANAGEMENT?
Answer
It may be exaggerated physiological jaundice. If it persists for more than 1 month, one may have to rule out Criggler Najer syndrome. Then a trial with phenobarb may be required to rule out between type 1 & 2. Back to All Questions

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