Document Detail


Neonatal bilirubin production-conjugation imbalance: effect of glucose-6-phosphate dehydrogenase deficiency and borderline prematurity.
MedLine Citation:
PMID:  15724035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate relations between production and conjugation of bilirubin in the pathophysiology of jaundice in glucose-6-phosophate dehydrogenase (G6PD) deficient neonates. METHODS: Term and borderline premature (35-37 weeks gestational age), healthy, male, G6PD deficient neonates were studied close to the beginning of the 3rd day. Blood carboxyhaemogobin corrected for inspired CO (COHbc; an index of bilirubin production) and serum total conjugated bilirubin (TCB; a reflection of bilirubin conjugation) were measured in simultaneously drawn blood samples by gas chromatography and reverse phase high performance liquid chromatography respectively. A bilirubin production-conjugation index comprising COHbc/TCB was determined; a high index reflects imbalance between the bilirubin production and conjugation processes. COHbc and TCB individually and the production-conjugation index were studied in relation to serum total bilirubin (STB) concentration. RESULTS: Fifty one G6PD deficient neonates were sampled at 51 (8) hours. COHbc values did not correlate with STB (r=0.22, p=0.15). TCB did correlate inversely with STB (r=-0.42, p=0.004), and there was a positive correlation between the production-conjugation index and STB (r=0.45, p=0.002). The production-conjugation index (median (interquartile range)) was higher in the premature (n=8) than term neonates (2.31 (2.12-3.08) v 1.05 (0.53-1.81), p=0.003). This difference was the result of changes in TCB. CONCLUSIONS: The data show that jaundice in G6PD deficient neonates is the result of an imbalance between production and conjugation of bilirubin with a tendency for inefficient bilirubin conjugation over increased haemolysis in its pathogenesis. Borderline premature infants are at special risk of bilirubin production-conjugation imbalance.
Authors:
M Kaplan; M Muraca; H J Vreman; C Hammerman; M T Vilei; F F Rubaltelli; D K Stevenson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  90     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-22     Completed Date:  2005-03-22     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F123-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Neonatology, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel. kaplan@cc.huji.ac.il
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MeSH Terms
Descriptor/Qualifier:
Bilirubin / biosynthesis,  blood,  metabolism*
Carboxyhemoglobin / analysis
Glucosephosphate Dehydrogenase Deficiency / complications,  metabolism*
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / etiology,  metabolism
Jaundice, Neonatal / etiology*,  metabolism
Male
Regression Analysis
Grant Support
ID/Acronym/Agency:
RR00070/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
635-65-4/Bilirubin; 9061-29-4/Carboxyhemoglobin
Comments/Corrections

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