Which are the causes of Kernicterus?

Kernicterus is a rare but serious condition that occurs in newborns when there is a buildup of bilirubin in the brain. Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. It is typically processed by the liver and excreted from the body. However, in certain cases, excessive levels of bilirubin can accumulate and cross the blood-brain barrier, leading to brain damage and the development of kernicterus.

There are several causes of kernicterus:

1. Severe jaundice: The most common cause of kernicterus is severe jaundice in newborns. Jaundice is a yellowing of the skin and eyes that occurs when bilirubin levels rise. In some cases, the liver may not be able to process bilirubin efficiently, leading to its accumulation in the blood. Severe jaundice can occur due to various factors, including blood type incompatibility between the mother and baby, Rh disease, or certain genetic conditions.



2. Delayed or inadequate treatment: If jaundice is not promptly diagnosed and treated, bilirubin levels can continue to rise, increasing the risk of kernicterus. It is crucial for healthcare providers to monitor bilirubin levels in newborns and initiate appropriate treatment, such as phototherapy or exchange transfusion, if necessary.



3. Prematurity: Premature infants are at a higher risk of developing kernicterus. Their livers may not be fully matured, making it more challenging to process bilirubin effectively. Premature babies also have a higher likelihood of experiencing other medical conditions that can contribute to jaundice and bilirubin buildup.



4. Inherited enzyme deficiencies: Certain genetic conditions can affect the enzymes responsible for processing bilirubin, leading to its accumulation in the blood. For example, Gilbert syndrome is a common inherited disorder that impairs the liver's ability to process bilirubin efficiently, increasing the risk of jaundice and potentially kernicterus.



5. Infection or illness: Infections or illnesses that affect the liver, such as hepatitis, can disrupt the normal bilirubin metabolism and contribute to the development of kernicterus.



6. Medications: Some medications, such as sulfonamides, can displace bilirubin from its binding sites, leading to increased levels in the blood. This can potentially contribute to the risk of kernicterus, especially in newborns with other predisposing factors.

It is important to note that kernicterus is a preventable condition. Timely identification and management of jaundice in newborns are crucial in preventing the progression to kernicterus. Healthcare providers should closely monitor bilirubin levels, especially in high-risk infants, and initiate appropriate interventions when necessary. Phototherapy, which involves exposing the baby's skin to special lights, can help break down bilirubin and reduce its levels. In severe cases, exchange transfusion may be required to remove the excess bilirubin from the blood.

If you suspect your newborn may have jaundice or if you have any concerns about their health, it is essential to seek medical attention promptly. Early detection and intervention can significantly reduce the risk of kernicterus and its potential long-term consequences.