from Section II - Cholestatic liver disease
Published online by Cambridge University Press: 05 March 2014
Introduction
Elevation of the serum bilirubin level is a common finding during the first week of life. This can be a transient phenomenon that will resolve spontaneously or it can signify a serious or even potentially life-threatening condition. There are many causes of hyperbilirubinemia and each has its own therapeutic and prognostic implications. Independent of the cause, elevated serum bilirubin levels can be potentially toxic to the newborn infant. This chapter will review perinatal bilirubin metabolism and address assessment, etiology, toxicity, and therapy for neonatal jaundice. Finally, the diseases in which there is a primary disorder in the metabolism of bilirubin will be reviewed regarding their clinical presentation, pathophysiology, diagnosis, and treatment. For more extensive referencing, see this chapter in the third edition of this textbook [1].
Production and circulation
Bilirubin (from Latin, bilis, bile; rube, red) is formed from the degradation of heme-containing compounds (Figure 12.1). The largest source for the production of bilirubin is hemoglobin. However, other heme-containing proteins are also degraded to bilirubin, including the cytochromes, catalases, tryptophane pyrrolase, and muscle myoglobin.
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