Hyperbilirubinemia In Adults | Hyperbilirubinemia In Newborn

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Bilirubin is the breakdown of red blood cells, and if bilirubin increased, then it’s called hyperbilirubinemia.

Normal bilirubin level is 0.3 to 1.2mg/dl if it increases more than 12mg/dl; it’s called hyperbilirubinemia.

It is a yellowish discoloration seen on the face, eyes, and chest area.

Hyperbilirubinemia in Adults

Jaundice is not any disease, but it is a visible sign of an underlying disease process.

Individuals with jaundice will have a yellowish skin color and may also exhibit yellowing of the mucous layers and the whites of your eyes.

Hyperbilirubinemia in adults can be caused by some severe medical conditions and potentially life-threatening.

Hyperbilirubinemia in Newborn

Hyperbilirubinemia occurs when the amount of bilirubin in your newborn baby’s blood is too high.

Bilirubin is formed when a red blood cell breaks down. It becomes harder for babies to get rid of bilirubin at first. It accumulates in the blood, tissues, and fluids of the infant.

Bilirubin makes a baby’s skin, eyes, and other tissues turn yellow (jaundice). 

I had earlier shared Jaundice In Newborn Child: Symptoms, Causes, Types, and Treatment I hope you read the post.

 

Hyperbilirubinemia
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Table of Contents

Types of hyperbilirubinemia

Unconjugated bilirubin

In that end product of hemoglobin is a breakdown, and it is taken by the liver and by the enzyme it will turn into the conjugated bilirubin type.

Bilirubin that is bind with protein in the blood is called unconjugated bilirubin.

Conjugated bilirubin: it is water-soluble and is pass into the bile from the body, and it is broken down of the old red blood cells and travels from the liver to the small intestine.

It can be caused by:

  • Rh and ABO incompatibility(hemolytic disease)
  • Increased RBC fragility, prematurity
  • Glucose deficiency
  • Sepsis
  • Iatrogenic (drugs)
  • Breast milk jaundice
  • Cephalohematoma 
  • Hemoglobinopathies
  • Infant of a diabetic mother
  • Hypothyroidism
  • Idiopathic (unknown causes) 

Conjugated

It can be caused by:

  • Neonatal hepatitis
  • Bacterial infection
  • Toxoplasmosis, rubella, cytomegalovirus during intrauterine life
  • Trisomy 21 (Down’s syndrome)
  • Galactosemia 
  • Cystic fibrosis
  • Biliary atresia 

Sign and symptoms

  • Poor feeding and sucking 
  • Excessive jaundice 
  • Hypotonia 
  • Fatigue and lethargy 
  • High pitched crying 
  • Missing reflexes 
  • Vomiting 

Diagnosis of neonatal hyperbilirubinemia

  • Laboratory studies:
  • Blood group (ABO, Rh) status: mother and infants antibody screen of the mother 
  • Based on bilirubin levels
  • Complete hemogram including reticulocyte count
  • Serum albumin: to detect total bilirubin binding sites and to assess the need for albumin infusion
  • Other laboratory tests
  • Urine for reducing substance culture for infection
  • Hemoglobin electrophoresis
  • Osmotic fragility tests
  • Thyroid and liver function test
  • Radiology and ultrasonography: to detect intestinal obstruction, intraventricular hemorrhage, and tumor 
  • Measurement of bilirubin by jaundice meter.

Complication

  • A most common complication of hyperbilirubinemia is kernicterus.
  • It is a type of brain damage most often seen in babies.
  • It is caused by an extreme buildup in the bilirubin in the brain.

Kernicterus is a medical emergency, and babies with this condition need to be great right away to bring down their bilirubin levels and prevent further brain damage. 

Management

  • Phototherapy
  • Exchange transfusion
  • Pharmacologic therapy (Ex. Phenobarbital therapy) 

Phototherapy (light treatment)

  • To reduce the bilirubin by giving light treatment.
  • Baby’s skin and blood absorb these light waves and change bilirubin into products, which can pass from the body through excretory waste. 

Frequently Asked Question

 

What is the treatment for hyperbilirubinemia in adults?

Treatment of severe episodes of hyperbilirubinemia includes intensive phototherapy, exchange transfusion, plasmapheresis, and tin-mesoporphyrin. During periods of illness, low levels of bilirubin may cause kernicterus.

What is considered a high level of bilirubin in adults?

Normally, bilirubin levels in adults fall between 0.3 and 1.0 milligrams per deciliter (mg/dL). Anything above 1.2 mg/dL is considered elevated.

What happens if bilirubin is high in adults?

Generally, high level of bilirubin in the blood is known as hyperbilirubinemia. It also seems likely to cause jaundice. Jaundice is a yellowing of the skin and whites of the eyes due to brown and yellow bilirubin in the blood.

What causes hyperbilirubinemia in newborns?

Jaundice is a common condition in infants, especially babies born before 38 weeks’ gestation (preterm babies) and some breastfed babies. Jaundice in infants usually occurs because the baby’s liver is not mature enough to get rid of bilirubin in the bloodstream.

What is the treatment for hyperbilirubinemia?

Bilirubin absorbs that light. The baby is then placed under a special blue spectrum light. This often reduces high bilirubin levels. This technique is called phototherapy. Your child can receive this treatment day and night.

Side effects

  • Redness and discomfort (sunburn)
  • Dry and itchy skin
  • inflammation of the hair roots 
  • Bowel movements are sometimes loose and greenish color and dehydration due to jaundice

If you see any symptoms related to hyperbilirubinemia, let us know in the comment box. So we can help you

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