Hyperbilirubinemia syndrome in infants: Clinical cases

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To date, neonatal jaundice has raised numerous questions for both pediatricians and neonatologists. Since the timing of newborn discharge from the maternity hospital has changed in recent decades, primary care pediatricians and other specialists must make a differential diagnosis between various causes of an increase in bilirubin and, consequently, jaundice. Conditions such as jaundice of a healthy newborn (physiological and breast milk jaundice), jaundice due to hemolysis, impaired hepatic clearance of bilirubin, abnormalities of the biliary tract development, congenital metabolic disorders, and infectious and inflammatory liver diseases are well known. In all cases, the pediatrician must determine whether jaundice is a consequence of a life-threatening disease. Unfortunately, to date, mistakes occur that can be avoided by following simple recommendations and using routine and cost-effective examination methods. Our clinical cases illustrate the main challenges associated with neonatal jaundice.

 

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Andrey Zaplatnikov

Russian Medical Academy of Continuous Professional Education

Email: alex.goriaynowa@yandex.ru
ORCID iD: 0000-0003-1303-8318

D. Sci. (Med.), Prof.

俄罗斯联邦, Moscow

Alexandra Goryainova

Russian Medical Academy of Continuous Professional Education

编辑信件的主要联系方式.
Email: alex.goriaynowa@yandex.ru
ORCID iD: 0009-0009-9339-4152

Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Alexander Dziadchik

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru
ORCID iD: 0000-0002-6751-3068

Department Head

俄罗斯联邦, Moscow

Olga Korenkova

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru
ORCID iD: 0000-0001-6569-7409

Pediatric Surgeon

俄罗斯联邦, Moscow

Tatiana Lavrova

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru

Department Head

俄罗斯联邦, Moscow

Svetlana Liubanskaya

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru

Pediatric Surgeon

俄罗斯联邦, Moscow

Evgenia Rossaus

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru

Neonatologist

俄罗斯联邦, Moscow

Alla Solozhentseva

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru

Pediatrician

俄罗斯联邦, Moscow

Sergey Stonogin

Bashlyaeva Children's City Clinical Hospital

Email: alex.goriaynowa@yandex.ru
ORCID iD: 0000-0003-3531-5849

Cand. Sci. (Med.)

俄罗斯联邦, Moscow

参考

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2. Fig. 1. Appearance of the patient Z. (jaundice with a greenish tint) (a) at the age of 11 months and (b) the color of his stool (hypocholic). Weight: 6500 g. Bashlyaeva Children's City Clinical Hospital

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3. Fig. 2. Inspissation of the bile. Acholic stool. Premature baby, gestational age of 29 weeks.

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4. Fig. 3. Biliary atresia. State after liver transplantation. Cholestasis syndrome. "Gray stool".

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5. Fig. 4. Biliary atresia. Diagnosed at 5.5 months of age. A liver transplant is planned. Hypocholic stool.

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6. Fig. 5. Normal stool color. Neonate, 3.5 weeks.

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7. Fig. 6. Breast milk jaundice. A 6-week-old child.

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8. Fig. 7. Biliary atresia. A 5-month-old child. Diagnosed at 3.5 months. Jaundiced skin with a greenish tint. A liver transplant is planned.

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9. Fig. 8. Biliary atresia. Diagnosed at 5.5 months of age. Jaundiced skin with a greenish tint. A liver transplant is planned.

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10. Fig. 9. Dark urine. Hypoplasia of the biliary tract (Alagille syndrome). A 4-month-old child. Diagnosed at 4 months, the diagnosis was confirmed by genetic testing.

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11. Fig. 10. Dark urine. Biliary atresia. State after liver transplantation. Graft rejection syndrome.

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