Kernicterus, (Bilirubin Encephalopathy) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
()
About this ebook
Kernicterus Exchange Transfusion Quote:
"This is why my classmate a neonatal pediatrician retired at the age of fifty five years old because he was sick of doing exchange transfusion every few days on small infants.
He felt very uncomfortable doing the exchange transfusion for the poor neonates who have to undergo it."
Kernicterus or Bilirubin encephalopathy (BE) is an infrequent neurological disorder that takes place in some newborns with severe jaundice.
The term "kernicterus" indicates the yellow staining produced by bilirubin.
Kernicterus is a result of neonatal jaundice.
The word kernicterus denotes yellow kern, kern being the structures of the brain that are most often involved.
They are the basal ganglia, hippocampus, geniculate bodies and cranial nerve nuclei, particularly the oculomotor, vestibular and cochlear.
This disorder most often forms in the first week of life, but may be observed up until the third week.
Some newborns with Rh hemolytic disease are at high danger for severe jaundice.
Kernicterus can form in seemingly healthy babies.
Bilirubin is a yellow pigment that is formed as the body removes old red blood cells.
High levels of bilirubin in the body can induce the skin to look yellow (jaundice).
If the level of bilirubin is very high or a baby is very ill, the bilirubin will move out of the blood and accumulate in the brain tissue if This can result in disorders such as brain injury and hearing loss.
Acute bilirubin encephalopathy (BE) is an acute medical presentation of bilirubin toxicity.
There is hypotonia followed by hyper-tonia, opisthotonus (hyper-extension of the spine causing backward arching of the neck and back) or retrocollis (backward arching of the neck).
Premature babies are in danger of kernicterus.
Risk factors for hyper-bilirubinaemia neurotoxicity are:
1. Isoimmune hemolytic disease,
2. Glucose-6-phosphate dehydrogenase (G6PD) deficiency,
3. Asphyxia,
4. Sepsis,
5. Acidosis and
6. Blood albumin
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Kernicterus, (Bilirubin Encephalopathy) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Kernicterus,
(Bilirubin Encephalopathy)
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2017 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Kernicterus, Diagnosis and Treatment and Related Diseases which is observed in some of my patients in my Family Clinic.
(What The patient Need to Treat Kernicterus)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank the patient for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Kernicterus
What is Kernicterus?
Kernicterus or Bilirubin encephalopathy (BE) is an infrequent neurological disorder that takes place in some newborns with severe jaundice.
The term kernicterus
indicates the yellow staining produced by bilirubin.
Kernicterus is a result of neonatal jaundice.
The word kernicterus denotes yellow kern, kern being the structures of the brain that are most often involved.
They are the basal ganglia, hippocampus, geniculate bodies and cranial nerve nuclei, particularly the oculomotor, vestibular and cochlear.
The cerebellum can also be involved.
This is observed in parts of the brain on autopsy.
This disorder most often forms in the first week of life, but may be observed up until the third week.
Some newborns with Rh hemolytic disease are at high danger for severe jaundice that can result in this disorder.
Infrequently, Kernicterus can form in seemingly healthy babies.
Incidence
Worldwide access to rhesus immunoprophylaxis, co-ordinated perinatal-neonatal care, and effective phototherapy has practically eradicated kernicterus in many countries
Seven frequency studies done internationally between 1988 and 2005 recognized an estimated frequency of kernicterus at 0.4-2.7 per 100,000 births
What is the cause of Kernicterus?
Causes
Kernicterus is produced by very high levels of bilirubin.
Bilirubin is a yellow pigment that is formed as the body removes old red blood cells.
High levels of bilirubin in the body can induce the skin to look yellow (jaundice).
If the level of bilirubin is very high or a baby is very ill, the bilirubin will move out of the blood and accumulate in the brain tissue if it is not attached to albumin (protein) in the blood.
This can result in disorders such as brain injury and hearing loss.
Acute bilirubin encephalopathy (BE) is an acute medical presentation of bilirubin toxicity.
There is hypotonia followed by hyper-tonia, opisthotonus (hyper-extension of the spine causing backward arching of the neck and back) or retrocollis (backward arching of the neck).
Premature babies are in danger of kernicterus.
Kernicterus infrequently affects a