What is an icterus prolongatus?
Prolongatus is an icterus (jaundice) in newborns that persists for more than two weeks after birth. In the case of icterus prolongatus, the bilirubin level is still significantly elevated above normal values even after the 10th day of life. This can be recognized by the conspicuous yellowing of the skin and the sclerae (eye white) of the child. Prolonged jaundice is asymptomatic in most cases. Nevertheless, close medical supervision of the children is necessary in order to detect and treat a high increase in bilirubin in time, as otherwise serious complications and late complications can occur.
Causes
The majority of newborns (more than 60%) develop a neonatal icterus (Icterus neonatorum) in the first days after birth. This is a physiological icterus, i.e. a normal condition. In the womb, the babies have a different form of hemoglobin (red blood pigment).
At birth, the fetal hemoglobin is broken down and replaced by adultes, resulting in increased production of water-insoluble bilirubin. Bilirubin is a breakdown product of hemoglobin and is normally excreted by the liver via the bile. Since the liver of newborns is still immature, the transformation does not occur quickly enough and the bilirubin accumulates in the blood.
From there it passes into the skin and causes the characteristic yellow coloration. Normally the blood values have returned to normal after seven to ten days and treatment is not necessary. In the case of icterus prolongatus, the bilirubin values are still not normalized even after ten to fourteen days.
The causes of pathological icterus prolongatus are very diverse and range from malnutrition, metabolic diseases or liver dysfunction of the child (e.g. hepatitis, disorder of the bile ducts, Meulengracht’s disease or glucuronyltransferase deficiency) to underfunction of the thyroid (hypothyroidism). An early delivery date (less than 37 + 0 weeks of pregnancy) or insufficient food intake can also cause jaundice prolongatus. Another cause is the increased loss of red blood cells (haemolysis), as is the case with a severe infection of the newborn or bruising (haematomas).
