1 Brown University, Providence, RI
2 Institute of Medical Biochemistry, University of Aarhus, Aarhus, Denmark
Kernicterus was a major problem of pediatrics in the first half of this century. Important progress has taken place since pediatricians have mastered rhesus disease, introduced exchange transfusion, avoided giving sulfonamides, and have placed at risk infants under blue light. These measures, and above all the general improvements in intensive care in modern neonatology units, have reduced the problem so that kernicterus is now mainly seen as secondary to prematurity, respiratory distress, and severe infections.1 There, it remains a challenge to both clinical and basic science. The mechanism (or mechanisms?) of bilirubin transfer from plasma to brain has not been settled; agreement has not been reached on laboratory methods for predicting kernicterus; and satisfactory guidance about which drugs to avoid, other than the bilirubin-displacing sulfonamides, remains to be given.