PEDIATRICS Vol. 69 No. 3 March 1982, pp. 267-272
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Turkel, S. B.
Right arrow Articles by Hodgman, J. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Turkel, S. B.
Right arrow Articles by Hodgman, J. E.

A Clinical Pathologic Reappraisal of Kernicterus

Susan Beckwitt Turkel MD1, Carol A. Miller MD1, Marta E. Guttenberg MD1, Diane Radovich Moynes MD1, and Joan E. Hodgman MD1

1 Departments of Pathology and Pediatrics, University of Southern California School of Medicine, Los Angeles County-University of Southern California Medical Center, Los Angeles

Kernicterus at autopsy, traditionally associated with hyperbilirubinemia, is now often observed in the absence of markedly elevated levels of serum bilirubin. Attempts to document clinically predictive risk factors for kernicterus have been largely unsuccessful in the current population of sick neonates. In a study of 32 pairs of newborns with and without kernicterus at autopsy and matched for gestational age, weight, length of survival, and year of birth, no differences were found when multiple clinical factors thought to potentiate risk for kernicterus were compared. Microscopic sections of brains from these same matched pairs were then evaluated without knowledge of the clinical or gross findings according to prearranged criteria. Statistical analysis of the microscopic findings was done, comparing each observed change in each anatomic site, all changes in each site, and each change in all sites. Although the gross pattern of staining followed that of classic kernicterus, the expected, specific histologic changes characteristic of kernicterus were found in only three patients. Spongy change, or edema, was significantly more common in the grossly stained brains (P <.0005), but other findings were similar in both groups. Gross bilirubin staining of the neonatal brain with neither hyperbilirubinemia nor specific microscopic changes is probably not the same clinicopathologic entity as classic kernicterus.

Submitted on April 6, 1981
Accepted on August 6, 1981




This article has been cited by other articles:


Home page
 J Child NeurolHome page
S. Katar, H. O. Akay, M. Taskesen, and C. Devecioglu
Clinical and Cranial Magnetic Resonance Imaging (MRI) Findings of 21 Patients With Serious Hyperbilirubinemia
J Child Neurol, April 1, 2008; 23(4): 415 - 417.
[Abstract] [PDF]

Home page
 PediatricsHome page
P. Govaert, M. Lequin, R. Swarte, S. Robben, R. De Coo, N. Weisglas-Kuperus, Y. De Rijke, M. Sinaasappel, and J. Barkovich
Changes in Globus Pallidus With (Pre)Term Kernicterus
Pediatrics, December 1, 2003; 112(6): 1256 - 1263.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
Y. Yilmaz, S. Degirmenci, F. Akdas, S. Kulekci, A. Ciprut, S. Yuksel, F. Yildiz, L. Karadeniz, and A. Say
Prognostic Value of Auditory Brainstem Response for Neurologic Outcome in Patients With Neonatal Indirect Hyperbilirubinemia
J Child Neurol, October 1, 2001; 16(10): 772 - 775.
[Abstract] [PDF]

Home page
 J Child NeurolHome page
Y. Yilmaz, G. Alper, G. Kilicoglu, L. Celik, L. Karadeniz, and S. Yilmaz-Degirmenci
Magnetic Resonance Imaging Findings in Patients With Severe Neonatal Indirect Hyperbilirubinemia
J Child Neurol, June 1, 2001; 16(6): 452 - 455.
[Abstract] [PDF]

Home page
 PediatricsHome page
K. L. Yeo, M. Perlman, Y. Hao, and P. Mullaney
Outcomes of Extremely Premature Infants Related to Their Peak Serum Bilirubin Concentrations and Exposure to Phototherapy
Pediatrics, December 1, 1998; 102(6): 1426 - 1431.
[Abstract] [Full Text] [PDF]

Home page
 ScienceHome page
G. Drummond and A Kappas
Chemoprevention of neonatal jaundice: potency of tin-protoporphyrin in an animal model
Science, September 24, 1982; 217(4566): 1250 - 1252.
[Abstract] [PDF]