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Transcutaneous bilirubin nomogram for evaluating the risk of hyperbilirubinemia in Iranian healthy newborns

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World Journal of Pediatrics 2019年第1期15卷 72-77页

作者： Robabe Seyedi Mojgan Mirghafourvand Abdollah Jannat Dost Sakineh Mohammad-Alizadeh-Charandabi Mohammad Asghari Jafarabadi Shirin Osouli Tabrizi Department of Midwifery Students Research CommitteeFaculty of Nursing and MidwiferyTabriz University of Medical Sciences.Tabriz.1ran Social Determinants of Health Research Center Tabriz University of Medical SciencesTabrizIran Faculty of Medicine Tabriz University of Medical SciencesTabriz.Iran Midwifery Department Faculty of Nursing and MidwiferyTabriz University of Medical SciencesShariati-eqonobi Street.Tabriz 347-5 l 745.Iran Road Traffic Injury Research Center Faculty of HealthTabriz University of Medical SciencesTabrizIran

Background hyperbilirubinemia,which is mostly benign,is one of the most common problems in *** study was conducted to draw a skin bilirubin nomogram for evaluating the risk of hyperbilirubinemia requiring *** This cross-sectional study recruited 1066 healthy *** first transcutaneous bilirubin(TcB)measurement was performed before hospital discharge and within 12-48 h of *** neonates were followed up for 6 days after discharge based on their age at the time of *** neonates were divided into four groups based on the TcB values before discharge and age in hours,including the low-risk,medium-low-risk,medium-high-risk and high-risk *** percentage of neonates who progressed toward severe hyperbilirubinemia was then calculated in each percentile based on the follow-up TcB *** software was used to draw the *** on the TcB values at discharge and the neonate's age in hours,the skin bilirubin nomogram was drawn in 40,75 and 95 *** A total of 4.9%of the neonates were in the high-risk group,18.9%in the medium-high-risk group,34.8%in the medium-low-risk group and 41.2%in the low-risk *** risk of severe jaundice in the follow-up of the neonates in the highest-risk to the lowest-risk groups was 48.9,14.5,9.7 and 3.3%,*** The skin bilirubin nomogram can be used to predict severe hyperbilirubinemia in Iranian infants.

关键词： hyperbilirubinemia Iran Newborn Nomogram Transcutaneous bilirubin

Causes of severe neonatal hyperbilirubinemia: a multicenter study of three regions in China

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World Journal of Pediatrics 2021年第3期17卷 290-297页

作者： Xiao-Yue Dong Qiu-Fen Wei Zhan-Kui Li Jie Gu Dan-Hua Meng Jin-Zhen Guo Xiao-Li He Xiao-Fan Sun Zhang-Bin Yu Shu-Ping Han Department of Neonatology Women's Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital)NanjingChina Department of Neonatology Guangxi Maternal and Child Health Care HospitalNanningChina Department of Neonatology Northwest Women’s and Children’s HospitalXi’anChina Department of Neonatology Yinchuan Maternal and Child Health Care HospitalYinchuanChina

Background Available evidence suggests that our country bear great burden of severe ***,the causes have not been explored recently in different regions of China to guide necessary clinical and public health *** This was a prospective,observational study conducted from March 1,2018,to February 28,*** hospitals in three regions of China participated in the *** from infants with a gestational age≥35 weeks,birth weight>2000 g,and total serum bilirubin(TSB)level≥17 mg/dL(342μmol/L)were prospectively *** A total of 783 cases were *** were identified in 259 *** major causes were ABO incompatibility(n=101),glucose-6-phosphate dehydrogenase deficiency(n=76),and intracranial hemorrhage(n=70).All infants with glucose-6-phosphate dehydrogenase deficiency were from the central south *** from the central south region had much higher peak total bilirubin levels[mean,404μmol/L;standard deviation(SD),75μmol/L]than those from the other regions(mean,373μmol/L;SD,35μmol/L)(P<0.001).Conclusions ABO incompatibility was the leading cause in the east and northwest regions,but cases in the central south region were mainly caused by both ABO incompatibility and glucose-6-phosphate dehydrogenase deficiency,and infants in this region had a much higher peak total bilirubin *** hemorrhage may be another common *** thorough assessments and rigorous bilirubin follow-up strategies are needed in the central south region.

关键词： Causes hyperbilirubinemia Jaundice Neonate

Prediction of significant hyperbilirubinemia in term neonates by early non-invasive bilirubin measurement

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World Journal of Pediatrics 2017年第3期13卷 222-227页

作者： Manish Jain Akash Bang Anju Tiwari Shuchi Jain Department of Pediatrics MGIMSSevagramWardha MaharashtraIndia Department of Obstetrics&Gynecology MGIMSSevagramWardha MaharashtraIndia

Background:Neonatal jaundice is a common *** evaluated the utility and best cut-off values of 24-and 48-hour transcutaneous bilirubin indices (TcBI) in predicting subsequent significant hyperbilirubinemia and evaluated various associated maternal and fetal risk ***:TcBI at 24 and 48 hours and serum bilirubin levels at 72 hours of age were obtained for healthy,term,appropriate for gestational age *** with prematurity,birth weight hyperbilirubinemia,defined as serum bilirubin >17 mg/dL after 72 hours of life and various cut-offs,and were evaluated by calculating sensitivity,specificity and predictive ***:Of 500 newborns,4.6% had significant hyperbilirubinemia,27% had TcBI (mg/dL) hyperbilirubinemia (100% negative predictive value).The percentage of newborns with subsequent hyperbilirubinemia increased from 3.4% to 13.2% as their 24-hour TcBI increased from 6 to above 9 mg/dL and from 4.2% to 7.4% as their 48-hour TcBI increased from 8 to above 11 mg/*** best cut-off value was TcBI (mg/dL) 7 (odd ratio=4.86,95% confidence interval:1.66-15.22) at 24 hours and 10 (odd ratio=2.87,95% confidence interval:1.04-8.29) at 48 *** under the receiver operating characteristic curve for 24-and 48-hour measurements was 0.750 and 0.715,*** premature rupture of membranes,deep transverse arrest,post-date pregnancy,and fetal distress were significant risk factors for ***:Twenty-four and 48-hour TcB indices are good predictors of subsequent ***-four-hour TcBI had better predictive abili

关键词： hyperbilirubinemia neonate transcutaneous bilirubin

Bilirubin nomograms for identifi cation of neonatal hyperbilirubinemia in healthy term and late-preterm infants:a systematic review and meta-analysis

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World Journal of Pediatrics 2014年第3期10卷 211-218页

作者： Zhang-Bin Yu Shu-Ping Han Chao Chen Department of Pediatrics Nanjing Maternity and Child Health Care Hospital of Nanjing Medical UniversityNo.123 Tian Fei XiangMo Chou RoadNanjing 210004China Department of Neonatology Children's Hospital of Fudan UniversityNo.399 Wanyuan RoadMinhang DistrictShanghai 201102China

Background:hyperbilirubinemia occurs in most healthy term and late-preterm infants,and must be monitored to identify those who might develop severe *** serum bilirubin(TSB)or transcutaneous bilirubin(TcB)nomograms have been developed and validated to identify neonatal *** study aimed to review previously published studies and compare the TcB nomograms with the TSB nomogram,and to determine if the former has the same predictive value for signifi cant hyperbilirubinemia as TSB nomogram ***:A predefined search strategy and inclusion criteria were set *** selected studies assessing the predictive ability of TSB/TcB nomograms to identify significant hyperbilirubinemia in healthy term and late-preterm *** independent reviewers assessed the quality and extracted the data from the included ***-Disc 1.4 analysis software was used to calculate the pooled sensitivity,specificity,and positive likelihood ratio of TcB/TSB nomograms.A pooled summary of the receiver operating characteristic of the TcB/TSB nomograms was ***:After screening 187 publications from electronic database searches and reference lists of eligible articles,we included 14 studies in the systematic review and *** studies were of medium methodological *** remaining three studies were of low methodological *** studies evaluated the TcB nomograms,and seven studies assessed TSB *** were no differences between the predictive abilities of the TSB and TcB nomograms(the pooled area under curve was 0.819 vs.0.817).Conclusions:This study showed that TcB nomograms had the same predictive value as TSB nomograms,both of which could be used to identify subsequent signifi cant *** this result should be interpreted cautiously because some methodological limitations of these included studies were identifi ed in this review.

关键词： hyperbilirubinemia newborn systematic review transcutaneous bilirubin

Incidence and risk factors of post-phototherapy neonatal rebound hyperbilirubinemia

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World Journal of Pediatrics 2018年第4期14卷 350-356页

作者： Ismail Mohamed Elhawary Eman Abdel Ghany Abdel Ghany Walaa Alsharany Aboelhamed Shahinaz Gamal Eldin Ibrahim Department of Pediatrics Faculty of MedicineCairo UniversityAli Basha EbrahimPO Box 11562CairoEgypt Department of Pediatrics Ministry of HealthCairoEgypt

Background To determine the incidence and risk factors of post-phototherapy rebound hyperbilirubinemia because data about bilirubin rebound in neonates are lacking and few studies have concerned this condition. Methods A prospective observational study was conducted on 500 neonates with indirect hyperbilirubinemia who were treated according to standard guidelines. Total serum bilirubin (TSB) was measured at 24–36 h after phototherapy;significant bilirubin rebound (SBR) is considered as increasing TSB that needs reinstitution of phototherapy. Results A total of 124 (24.9%) neonates developed SBR with TSB increased by 3.4 (2.4–11.2) mg/dL after stopping pho-totherapy. Multiple logistic regression model revealed the following significant risk factors for rebound: low birth weight (B = 1.3,P < 0.001, OR 3.5), suspected sepsis (B = 2.5,P < 0.001, OR 12.6), exposure to intensive phototherapy (B = 0.83, P= 0.03, OR 2.3), hemolysis (B = 1.2,P < 0.001, OR 3.1), high discharge bilirubin level (B = 0.3,P = 0.001, OR 1.3), and short duration of conventional phototherapy (B = ? 1.2,P < 0.001, OR 0.3). Conclusions SBR should be considered in neonates with hemolysis, low birth weight, suspected sepsis, short duration of conventional phototherapy, exposure to intensive phototherapy, and relatively high discharge TSB. These risk factors should be taken into account when planning post-phototherapy follow-up.

关键词： Conventional phototherapy Hemolysis Intensive phototherapy Neonatal hyperbilirubinemia Rebound hyperbilirubinemia

Posaconazole-associated severe hyperbilirubinemia in acute myeloid leukemia following chemotherapy: A case report

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World Journal of Clinical Cases 2018年第16期6卷 1206-1209页

作者： Zai-Wei Song Yu-Chen Pan Zhen-Cheng Huang Wen-Xi Liu Rong-Sheng Zhao Hong-Mei Jing Fei Dong Department of Pharmacy Peking University Third Hospital Department of Hematology Peking University Third Hospital

BACKGROUND Posaconazole is a widely used azole antifungal agent, and posaconazole-associated severe hyperbilirubinemia is usually rare in clinical practice. We herein report a 58-year-old male with acute myeloid leukemia, who developed fungal infection following *** SUMMARY After administration of posaconazole oral suspension, the patient developed severe hyperbilirubinemia and jaundice(Common Terminology Criteria for Adverse Events, CTCAE-Grade 3) with a serum total bilirubin(T-BIL) peak level of 170 μmol/L, alkaline phosphatase level of 739 U/L, alanine aminotransferase level of 99 U/L, and gamma-glutamyl transpeptidase level of 638 U/L. After posaconazole withdrawal and symptomatic treatment with liver-protective agents, the level of T-BIL and other laboratory data decreased gradually, and related symptoms disappeared. After medication analysis and literature review, we consider that the patient had a cholestatic type of posaconazoleinduced liver injury, which was related to intracellular mitochondrial DNA damage. The case demonstrates that when patients with hematological malignancy develop severe infection following chemotherapy, combination of anti-infective drugs may contribute to ahigher risk of severe drug-induced liver injury. CONCLUSION This is the first thoroughly documented case report of posaconazole-associated severe hyperbilirubinemia. Therefore, in order to avoid severe adverse events, liver and renal function should be monitored closely before and during the administration of posaconazole.

关键词： Posaconazole hyperbilirubinemia Liver injury Acute myeloid leukemia Case report

COVID-19-induced transaminitis and hyperbilirubinemia:Presentation and outcomes

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World Journal of Gastroenterology 2023年第7期29卷 1123-1130页

作者： Zeinab Nabil Ahmed Said Safinaz Adel El Habashy Samy Zaky ESCMID Study Group for Viral Hepatitis Department of Medical Microbiology and Immunology Faculty of Medicine(For Girls)Al-Azhar UniversityCairo 11754Nasr CityEgypt Department of Pediatrics Ain Shams UniversityCairo 11391AbbaseiaEgypt Department of Hepato-gastroenterology and Infectious Diseases Faculty of Medicine(For Girls)Al-Azhar UniversityCairo 11754Egypt 不详

The risk of liver injury in patients with coronavirus disease 2019(COVID-19)infection is quite ***,liver function test abnormalities are still detected in COVID-19 patients despite the development of antivirals and the availability of several types of *** editorial describes liver involvement during COVID-19 infection in patients with or without preexisting liver injury,such as chronic liver disease,to elucidate COVID-19-induced liver function abnormalities and their severity,pathophysiology,clinical manifestations,and clinical and laboratory *** also discuss the effect of vaccination against COVID-19 to better understand host factors,such as age,gender,and race,on the incidence and severity of liver dysfunction at initial presentation and during the ***,we summarize the results of relevant meta-analyses published to date and highlight the importance of adequate liver function monitoring in the current climate of the overwhelming COVID-19 pandemic.

关键词： COVID-19 SARS-CoV-2 Liver injury Transaminases hyperbilirubinemia Pathophysiology

Hyperthyroxinemia at birth: a cause of idiopathic neonatal hyperbilirubinemia?

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World Journal of Pediatrics 2018年第3期14卷 247-253页

作者： Irena Ulanovsky Tatiana Smolkin Shlomo Almashanu Tatiana Mashiach Imad R.Makhoul Department of Neonatology Ruth Rappaport Children's HospitalRambam Medical CenterRambam Health Care CampusBat-Galim3109601 HaifaIsrael Rappaport Faculty of Medicine Technion-Israel Institute of TechnologyHaifaIsrael National Newborn Screening Program Public Health ServicesMinistry of HealthTel HashomerIsrael Department of Epidemiology Rambam Medical CenterHaifaIsrael

Background Some neonates develop idiopathic hyperbilirubinemia (INHB) requiring phototherapy, yet with no identifi able causes. We searched for an association between abnormal thyroid levels after birth and INHB. Methods Of 5188 neonates, 1681 (32.4%) were excluded due to one or more risk factors for hyperbilirubinemia. Total thyroxine (TT4) and thyroid stimulating hormone values were sampled routinely at 40-48 hours of age and measured in the National Newborn Screening Program. Results Of the 3507 neonates without known causes for hyperbilirubinemia, 61 (1.7%) developed INHB and received phototherapy. Univariate analyses found no signifi cant association between mode of delivery and INHB (vacuum-delivered neonates were a priori excluded). Nonetheless, in cesarean-delivered (CD) neonates, two variables had signifi cant asso-ciation with INHB: TT4 ≥ 13 μg/dL and birth at 38-38.6 weeks. In vaginally delivered (VD) born neonates, INHB was associated with weight loss > 7.5% up to 48 hours of age. Multivariate logistic regression analysis showed a strong eff ect of mode of delivery on possible signifi cant association with INHB. In CD neonates, such variables included: TT4 ≥ 13 μg/dL [P = 0.025, odds ratio (OR) 5.49, 95% confi dence interval (CI) 1.23-24.4] and birth at 38-38.6 weeks (P = 0.023, OR 3.44, 95% CI 1.19-9.97). In VD neonates, weight loss > 7.5% (P = 0.019, OR 2.1, 95% CI 1.13-3.83) and 1-min Apgar score 7.5% in VD neonates. We herein highlight some acknowledged risk factors for neonatal hyperbilirubinemia, and thus minimize the rate of INHB.

关键词： hyperbilirubinemia Neonate Phototherapy Thyroid hormone

Causes of immune dysfunction in hyperbilirubinemia model rats

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Asian Pacific Journal of Tropical Medicine 2015年第5期8卷 382-385页

作者： Xiao-Min Sun Ping Kang Ke Tao Department of General Internal Medicine Children's Hospital of Zhengzhou Burn Center of PLA Xijing Hospitalthe Fourth Military Medical University

Objective:To explore the causes of immune dysfunction in neonatal rats with ***:A total of 60 newborn SD rats were equally randomized into normal saline(NS) group,LPS control group,bilirubin control group,low-dose group and high-dose *** anesthesia,0.1 mL NS was given to the NS and LPS control group and different doses of bilirubin for the other groups;1 h later,the NS and bilirubin control group received the intraperitoneal injection of 0.05 mL NS and 1mg/kg LPS for the other *** 5 or 24 hours of model establishment,spleens were collected for detecting the expression levels of MyD88 and p-TAK1 protein and the spleen cells apoptosis by immunohistochemmistry and TUNEL *** 24 hours of model establishment,scrum inflammatory factors levels and T cell subsets distribution were determined by ELISA and flow ***:In contrast to low-dose bilirubin,high-dose bilirubin could induce spleen cells apoptosis in coordination with *** 5 hours of model establishment,compared with NS ***88 expression level in low-dose group elevated while p-TAK1 level in high-dose group reduced(P<0.05).In high-dose group,inflammotory factors levels and CD8^+T cells percentage were all higher than LPS control and NS group(P<0.05),while CD4^+ T cells percentage was lower than NS group(P<0.05).Conclusions:High-concentration plasma bilirubin in coordination with LPS could inhibit NF- κB signal pathways activation and aggravate inflammatory reaction,thus caused immunosuppression with inflammation cascade,which resulted in the immune dysfunction.

关键词： Bilirubin Myd88 p-p38MAPK Spleen cells hyperbilirubinemia