How long does an icterus prolongatus last?
If icterus prolongatus is present, the newborn should be treated immediately with phototherapy. Treatment lasts one to two days, after which the yellow coloration quickly improves significantly. The prognosis for icterus prolongatus is good with appropriate therapy. The child recovers completely and consequential damage does not normally occur.
What are the accompanying symptoms?
The main symptom of jaundice is – as with any form of jaundice – the characteristic yellowing of the skin, which is usually visible to the naked eye. The yellow color is also very clearly visible in the eyes, namely in the white skin of the eye (sclera). A mild prolongatus jaundice, in which the bilirubin levels are below the threshold value, causes no symptoms and is largely asymptomatic – apart from the yellowing of the skin.
However, if the bilirubin concentration in the blood rises too high, bilirubin acts as a cell poison and causes severe complications. The water-insoluble bilirubin can then cross the blood–brain barrier and be deposited in the brain. As a result, certain areas of the brain are severely damaged, a condition known as acute bilirubin encephalopathy.
The newborns are tired, yawn frequently and appear very sleepy, also called lethargic. The damage to the brain can also cause breathing difficulties, fever, and clouding of consciousness and seizures. Laziness of drinking is also a very late symptom, indicated by a very pronounced icterus.
Very often an acute bilirubin encephalopathy ends fatally. If the affected babies survive the acute phase, a chronic bilirubin encephalopathy (kernicterus) develops, which can lead to severe late complications. However, bilirubin encephalopathies occur only very rarely. In most cases an icterus prolongatus runs without symptoms or can be treated very well by phototherapy.
Long-term consequences of prolonged jaundice
An untreated icterus prolongatus or an icterus prolongatus with a very severe course can lead to long-term late effects. The newborns develop the clinical picture of a chronic bilirubin encephalopathy (kernicterus). The bilirubin passes from the blood through the blood-brain barrier into the brain, deposits in certain areas and causes severe damage there.
The children show paralysis of the muscles (cerebral palsy), hearing and vision disorders as well as mental development disorders. Often a cernikterus also leads to a reduction in intelligence. Kernikterus is a serious disease that can lead to serious complications and even death of the child. However, it is a very rare consequence of icterus prolongatus.
