Long term effect of

bilirubin toxicity
Toxic is not dependent with bilirubin
level
Bilirubin levels refer to total bilirubin
Kern icterus
Kern icterus : pathologic diagnosis and refers to
yellow staining of the brain by bilirubin together
with evidence of neuronal injury.
Microscopically : necrosis, neuronal loss, gliosis
The use of the term : clinical setting should be
used to denote the chronic and permanent
sequele of bilirubin toxicity
Acute bilirubin encephalopaty
The Clinical manifestation of bilirubin toxicity
seen in the neonatal periode
The clinical presentation :

- early phase
- intermediate phase
- advance phase
Early phase
Hypotonia
Lethargy
High-pitched cry
Poor suck
intermediate phas
Hypertonia of extensor muscles
(opisthotonus, rigidity, oculogyric crisis,
retrocollis)
Irritability
Fever
Seizures

Die / chronic bilirubin encepalopaty

advance phase

Pronounced episthotonus
Shrillcry
Apnea
Seizure
Coma
death
Chronic bilirubin encephalopaty
(kern ikterus)
Athetosis
Partial/complete sensorineural deafness
Limitation of upward gaze
Dental dysplasia
Intelectual deficits