Neonatology pp 621-628 | Cite as

Kernicterus, Bilirubin Induced Neurological Dysfunction and New Treatments for Unconjugated Hyperbilirubinemia

  • Deirdre E. van Imhoff
  • Frans J. C. Cuperus
  • Peter H. Dijk
  • Claudio Tiribelli
  • Christian V. Hulzebos


In the 19th century it was already known that unconjugated hyperbilirubinemia could potentially harm the central nervous system of jaundiced newborn infants. Yellow staining of deep brain nuclei in jaundiced infants was first reported in 1847. The term kernicterus (in German, kern = nucleus; in Greek, ikterus = yellow) was first denoted in 1903 to describe the pathological findings of this specific yellow staining pattern [1]. Nowadays, kernicterus is not only used to describe the pathological findings, but also to describe the clinical findings of acute and/or chronic bilirubin encephalopathy in jaundiced infants [2, 3]. Although acute kernicterus is an unambiguous clinical disorder in severely jaundiced newborn infants with the possibility of permanent sequelae, subtle forms of bilirubin encephalopathy referred to as bilirubin-induced neurological dysfunction, also known as BIND have evolved more recently [4]. This chapter aims to describe the pathophysiology of bilirubin neurotoxicity, its clinical spectrum and diagnostic tools. Novel treatment modalities to prevent infants from developing severe unconjugated hyperbilirubinemia and bilirubin neurotoxicity will be highlighted.


Auditory Brainstem Response Total Serum Bilirubin Unconjugated Bilirubin Auditory Neuropathy Unconjugated Hyperbilirubinemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Deirdre E. van Imhoff
  • Frans J. C. Cuperus
  • Peter H. Dijk
  • Claudio Tiribelli
  • Christian V. Hulzebos
    • 1
  1. 1.Department of Pediatrics, Division of NeonatologyUniversity Medical Center GroningenGroningenThe Netherlands

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