Diagnosis of nictitus
The diagnosis of the nuclear icterus is made on the basis of clinical abnormalities and laboratory chemical examinations. If the newborn child shows a yellowing of the skin before the 3rd or after the 10th day of life, a laboratory examination should be performed. If the bilirubin levels in the blood are significantly elevated, further diagnostic tests should be performed to determine the cause of the elevation. Further blood values can provide information as to whether a cell decay of the red blood cells, an organ disorder of the liver or a serious metabolic disease is behind the jaundice. Indications of a nuclear icterus and thus an involvement of the brain are given by certain symptoms and neurological abnormalities of the child.
Treatment of a nuclear icterus
The most important therapeutic measure is the so-called “phototherapy“. Here the newborn baby is illuminated with blue light, whereby the bilirubin is converted in the body in such a way that it can be excreted via the intestine and kidney. Phototherapy is only useful in certain cases of bilirubin elevation.
Furthermore, it can be accompanied by side effects such as diarrhea, dehydration and, in the worst case, long-term leukemia. Above a certain bilirubin level, phototherapy is not sufficient, which is why a blood exchange transfusion may have to be carried out. In the case of a nuclear icterus, the values are often already so high that this therapy is carried out immediately in the acute phase.
Donor blood with the same blood group is transfused. In order to prevent a nuclear icterus, the child should be fed regularly and sufficiently after birth. Breast milk and protein-rich nutrition are preferable.
How long does a nuclear icterus last?
It is difficult to give a general indication of the duration of the kernicterus. Several factors play a role here.For a short period of time, it is crucial that the trigger of the nuclear icterus is eliminated, that bilirubin levels are low and that the icterus responds quickly to therapy. If the cause for the increase in bilirubin is not found, the kernicterus can continue and progress despite the therapy being started. If possible, the values should be lowered within a few hours to days to prevent serious consequential damage. In the long term, however, irreversible damage may remain due to the kernicterus.
