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Hyperbilirubinaemia: Symptoms, Cause and Treatment of Hyperbilirubinemia


The technical term for abnormally high levels of bilirubin is hyperbilirubinaemia. Bilirubin is a tetrapyrrole created by the normal breakdown of heme. The age distribution reflects the age distribution of the underlying disease states and ranges from the first month of life, as in cases of biliary atresia; through midlife, as in cases of viral hepatitis or primary biliary cirrhosis; to senescence, as in cases of biliary stones and malignancies.

Hyperbilirubinemia could be caused by

  • increased bilirubin production
  • decreased uptake into the liver cells
  • impaired conjugation
  • interference with the secretion of conjugated bilirubin.

Hyperbilirubinaemia after major thoracic surgery

Hyperbilirubinaemia is a common occurrence in patients who are admitted to intensive care units (ICUs) after major surgery, and it is associated with high mortality. Researchers have reported rates of hyperbilirubinaemia after cardiac operations involving cardiopulmonary bypass (CPB) that range from approximately 5% to 20% or even as high as 40%.

Conjugated hyperbilirubinaemia

Conjugated hyperbilirubinaemia is relatively common occurrence in neonates. The list of possible causes is extensive and a decision to investigate will depend on the clinical circumstances. The importance of recognizing congenital hyperbilirubinemia lies mainly in distinguishing it from other, more serious hepatobiliary disease: congenital conjugated hyperbilirubinemia or hepatobiliary diseases. Gilbert's syndrome is the most common congenital hyperbilirubinemia syndrome, occurring in about 5% of Caucasians.

Hyperbilirubinaemia in term infants

The potential dearly exists for possible screening of infants at risk of hyperbilirubinaemia after discharge, but such screening would have to be carefully targeted to avoid an unacceptable increase in workload.

Benign Hyperbilirubinaemia

In Gilbert's disease, the bilirubin detected is of indirect type and the condition is quite common in normal population and calls for no treatment. In Dubin Johnson syndrome - the bilirubin detected is that of direct reacting type. Both the above conditions are benign.

Hyperbilirubinemia: Problems in Newborns (Neonatal hyperbilirubinemia)

Hyperbilirubinemia may also occur when a newborn has a serious medical disorder, such as infection in the blood. In most newborns, the level of bilirubin in the blood increases in the first days after birth, causing the newborn's skin and the whites of the eyes to appear yellow (jaundice).

Diseases Associated with Hyperbilirubinemia

  • Hemolytic jaundice
  • Gilbert's disease
  • Physiological jaundice and Crigler-Najjar syndrome
  • Dubin-Johnson syndrome
  • Biliary obstruction

Hyperbilirubinemia and Jaundice

During pregnancy, the placenta excretes bilirubin. When the baby is born, the baby's liver must take over this function. Jaundice may occur with the breakdown of red blood cells due to hemolytic disease of the newborn (Rh disease), having too many red blood cells, or bleeding. About 2 percent of breastfed babies develop jaundice after the first week. Some develop breast milk jaundice in the first week due to low calorie intake or dehydration.

 

Disclaimer: This site is for educational purposes only. The information provided should not be used for diagnosing or treating a health problem or disease. If you have, or suspect you have a health problem, you should consult your health care provider.