Kernicterus pp 161-173 | Cite as

Hyperbilirubinemia Revisited

  • David W. McCandless
Part of the Contemporary Clinical Neuroscience book series (CCNE)


In recent years there have been numerous papers published reexamining various concepts regarding unconjugated bilirubin and its apparent toxicity. Overall, results of these studies have shown that measurement of serum levels of unconjugated, conjugated, and/or total bilirubin may not be adequate for assessing the risk for kernicterus in newborn jaundiced infants. Especially measuring total bilirubin does not assess the contribution of unconjugated and conjugated bilirubin. It is assumed that in newborn infants the majority is unconjugated. Also not evaluated by either method is the contribution of “free” unbound to albumin bilirubin. It is this moiety of bilirubin, free and unbound to albumin which can move easily and rapidly into brain tissue.


Bilirubin Level Unconjugated Bilirubin Unconjugated Hyperbilirubinemia Bilirubin Encephalopathy Free Bilirubin 
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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Cell Biology & AnatomyRosalind Franklin University of Medicine & Science, Chicago Medical SchoolNorth ChicagoUSA

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